Annals of B Pod - Spring 2022 Issue
/The spring issue of AoBP has sprung! Read on for some interesting cases, as seen and told by our emergency medicine residents.
Read Moreemergency medicine tamed
Taming the SRU. The SRU is the "Shock Resuscitation Unit." It is a crucible of clinical training for the residents of the University of Cincinnati Emergency Medicine Residency training program.
The spring issue of AoBP has sprung! Read on for some interesting cases, as seen and told by our emergency medicine residents.
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In this week’s Grand Rounds, Dr. Carleton reviews our new and old airway equipment and describes best approaches for ETT exchange, Dr. Laurence shares insight on creative approaches to asking questions, appreciative inquiry, and questioning barriers for patients, Dr. Glenn discusses atypical headache etiologies including IIH, giant cell arteritis, acute angle closure glaucoma, and trigeminal neuralgia, Drs. Kein and Adan match wits in a CPC case of digoxin toxicity, and our PEM colleagues take us through a case of a critically ill infant with a ductal dependent lesion.
Headaches account for approximately 4 million, nearly 3% of all ED visits annually. [1] We classify headaches as either primary (benign) or secondary, with secondary headaches occurring due to underlying pathology. In the ED, the goal is to alleviate symptoms safely and effectively while excluding dangerous causes of headaches. While nearly 98% of headaches in the ED are primary or benign [2], ruling out secondary causes of headaches is imperative as failing to diagnose correctly may result in significant morbidity or mortality.
Read MoreIn this week’s Grand Rounds, Dr. Gibler Visiting Professor and UCEM Alum, Dr. Chris Miller, shares his insight on emergency medicine leadership development and our role in healthcare’s evolution, Drs. Tillotson and Yates guide us through their evidence-based QI/KT protocol for hypertension evaluation and management in the ED, Dr. Sobocinski discusses the pathophysiology, presentation, and management of PRES and RCVS, and Dr. Wolochatiuk shares lessons learned and approach to bias in medicine during her R4 Capstone.
Read MoreHand lacerations are common, from cutting ham to avocado to the incidental hand-through-glass presentation. Join Nicole Barkados as she reviews the can’t-miss history, physical and repair tips for your next hand lac.
Read MoreWe kicked off the month of March with a jam-packed Morbidity and Mortality Conference with Dr. Meaghan Frederick highlighting some of our amazing cases from downstairs including features on high sensitivity troponin, stridor and complicated alcohol withdrawal. Next up, Dr. Katherine Connelly walked us through how to troubleshoot in-transport alarms and failures of cardiac assist devices. Lastly, Dr. Bill Hinckley shared pearls of wisdom from his years at Air Care.
Read MoreIn this week’s Grand Rounds, Dr. Li shares his evidence-based savvy on out-of-hospital cardiac arrest and termination of resuscitation, Dr. Freiermuth guides us through implementation science, Dr. Grisoli leads us through a case-based discussion of hemophilia diagnosis and treatment, and Drs. Finney and Jarrell go head to head over a case of Dapsone-induced methemoglobinemia.
Read MoreEmergent presentations of hemophiliacs are very common, and often the degree of their need for resuscitation needs to be tailored to disease, mechanism and follow up. Join Dr. Grisoli for a just-in-time resource for managing bleeding hemophiliacs.
Read MoreIt was another riveting week of Grand Rounds here in Cincinnati! Drs. Kate Connelly, Shawn Hassani, Allie Hunt and Eddie Irankunda kicked us off with a high stakes simulation case and discussion of aortic and vascular emergencies. Dr. Irankunda then reflected on his journey through residency via the filter of the 1990's classic TV show, ER, with many life lessons along the way. After a brief operations update with Dr. Fermann, we finished up with a case-based discussion of evaluation of vomiting in pediatric patients during our monthly combined conference with our PEM colleagues from Cincinnati Children’s Hospital.
Read MoreIn this week’s Grand Rounds, Dr. Laurence led us through an incredible and education Morbidity and Mortality Conference, Drs. Gillespie and Continenza worked through a dramatic case combining vision changes and rash, Dr. Wright reminded us to not forget the esophagus in our patients with chest pain and Dr. Connelly gave a fantastic overview of EMS provider education and systems structure in her R4 Capstone. Finally, our incredible visiting professor, Dr. Megan Rybarcyzk gave us insight into building an emergency medicine education program in the midst of a pandemic and provides tips and tricks for those seeking a career in global health.
Read MoreThis week, we started off with an excellent journal club led by Drs. Ijaz and Mullen discussing interventions aimed at improving access to primary care from the Emergency Department and then followed along with Drs. Ferreri and Skrobut as they battled out a case of mysterious altered mental status during the crowd favorite, CPC. Dr. Pulvino reminded us that not all rashes are simple through her case follow up and Dr. Gobble took us on a deep dive of the diagnosis and management of gastroparesis and cyclic vomiting syndrome. Finally, we closed out the day with lessons in nasal endoscopy and cricothyrotomy from the airway guru himself, Dr. Steven Carleton.
Read MoreFind out what to look for in sarcoidosis optic neuropathy as Dr. Crawford leads us through an interesting case of unilateral painful vision loss.
Read MoreNausea and vomiting accounts for one of the most frequent chief complaints we see in the emergency department. For those presenting with another complaint, N/V is often an associated symptom. Treatment of these symptoms not only improves patient satisfaction, but also decreases associated complications, like dehydration and electrolyte abnormalities.
The etiology behind a patient’s N/V is highly variable, with a broad differential that stretches across all organ systems. Although often an acute presentation, N/V is increasingly being linked to set of chronic disorders, such as gastroparesis (GP), cyclic vomiting syndrome (CVS) and cannabinoid hyperemesis syndrome (CHS). While the work-up and initial evaluation in the ED is similar for all, specifically ruling out potentially life-threatening diagnosis or complications, the clinical presentation and management vary subtly between these syndromes.
Read MoreThis week’s Grand Rounds featured some amazing content! Starting with Dr. Paulsen, our leadership curriculum session focused on processing and learning from failure. We then discussed IV contrast extravasation with Drs. Milligan and Wosiski-Kuhn as they debuted their QI/KT protocol. Dr. Crawford reminded us of the dangers of carbon monoxide and we closed the day with an excellent introduction to the benefits of simulation-informed design with Visiting Lecturers Dr. Chris Hicks and Dr. Andrew Petrosoniak.
Read MoreNothing is scarier than the patient that you suspect is going to decompensate in front of you, and nothing will make that case more than seeing a clot in transit on bedside echo. Join Dr. Wolochatiuk as she discusses the signs of right heart strain and management of a patient with clot in transit.
Read MoreSRU (pronounced "shrew") = Shock Resuscitation Unit
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.