CTs for SAH - Does Time Even Matter?

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CTs for SAH - Does Time Even Matter?

Spontaneous subarachnoid hemorrhage (SAH) is a can’t miss diagnosis for patients presenting to the emergency department with a headache. The diagnosis is associated with a 30% mortality at 30 days, and approximately 30% of survivors may have long-term neurocognitive deficits (Rincon et al., 2013). The majority of spontaneous SAH are secondary to a ruptured arterial aneurysm (80%) while non-aneurysmal SAH are often due to low pressure venous bleeds, arteriovenous malformations, and other more rare causes. This post will recap the existing literature on the diagnosis of aSAH and will focus on breaking down a recently published paper by Vincent, et al which may inform our future practice.

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Caustic Skin Injuries

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Caustic Skin Injuries

Chemical burns are also an evolving pathology, with thousands of new chemicals added to the market each year (4). Since 2000, both assault and warfare with chemical weapons have increased, although these pathologies vary based on practice location (1). For instance, chemical burns can comprise up to 14% of burns in the developing world, compared to 3% in the US and Europe (2, 5). It is therefore important to understand your local chemical burn patterns, in much the same way providers learn local patterns of antibiotic resistance.

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Grand Rounds Recap 12.21.22

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Grand Rounds Recap 12.21.22

This week, we reviewed some ENT pearls, discussed the differential diagnosis of bilateral upper extremity weakness in a fantastic CPC case, discussed paraneoplastic syndromes, and held a hands on airway workshop.

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Grand Rounds Recap 11.16.22

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Grand Rounds Recap 11.16.22

This week features an R4 Capstone on “Leading from the Front” with Dr. Ijaz, and overview of thoracic outlet syndrome with Dr. Stothers, two incredible lectures from Dr. Gita Pensa on Litigation Stress and Trial vs. Settlement, and Air Care Grand Rounds with a focus on impella and ECMO transports.

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What Drip to Use After the Drop - Post-Cardiac Arrest Hypotension

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What Drip to Use After the Drop - Post-Cardiac Arrest Hypotension

During a cardiac arrest resuscitation, finally palpating a pulsatile flow beneath your gloved fingertips brings a sense of satisfaction like no other. But just as you go to finally breathe a sigh of relief and wipe the beading sweat off your brow, your now widening pupils focus on the patient’s steadily plummeting blood pressure. As you begin to sense your own heart palpitating, you think about medications to utilize in hopes of staving off another round of chest compressions. Since you’ve already given four doses of code-dose epinephrine, maybe an epinephrine infusion is best? You also recall that norepinephrine seems to be a popular choice in patients with shock, so maybe you should start that instead?

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Grand Rounds Recap 11.9.22

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Grand Rounds Recap 11.9.22

This week, we heard about a case of HELLP syndrome on AirCare from Dr. Comiskey, learned about acute liver failure with Dr. de Castro, practiced hands-on ultrasound skills including superior cervical plexus block, TEE, and DVT US with Drs. Baez, Frederick, and Minges, and reviewed NRP with Dr. Vinet

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Family Presence in Cardiac Arrest Resuscitations

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Family Presence in Cardiac Arrest Resuscitations

Cardiac arrests are an inevitable reality for emergency medicine providers. There is often a debate on whether family members presence during CPR will lead to more emotional burdens on the family members who witnessed these resuscitations. This study aimed to determine if there are increased rates of PTSD-related symptoms of close relatives who witnessed CPR of a family member.

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Grand Rounds Recap 11.2.22

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Grand Rounds Recap 11.2.22

Join us for another excellent Grand Rounds starting with educational M&M case points with Dr Zalesky, Social EM Grand Round on Language Justice with Dr. Diaz and Jarrell - Immunotherapy Complications with Dr. Rodriguez and R3 TamingtheSRU with Dr. Stevens to close out the day.

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