Fearsome Foliage - An Overview of Toxic Plants

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Fearsome Foliage - An Overview of Toxic Plants

Spring has sprung... and so have many species of toxic plants! Poison centers across the United States receive over 100,000 reports of exposures to toxic plants annually. It is often difficult for Emergency Medicine providers to determine the quantity and time of exposure. Plant identification presents another challenge, and can even require the input of a botanist. Now that is an interesting consult! Thankfully, some of the more common and/or dangerous plant poisonings have been well-categorized, and are summarized in this post.

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Grand Rounds Recap 4.5.23

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Grand Rounds Recap 4.5.23

This week we start off with Dr. Mullen’s lessons from morbidity and mortality conference. This is followed by R1 Dr. Vaishnav with a diagnostics talk on hyperthermia. Dr. Adan walks us through the always terrifying world of laryngectomy patients and finally guest lecturer Dr. Ray Bignall gives an excellent talk on disparities in medicine and how we address them

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Grand Rounds Recap 3.15.23

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Grand Rounds Recap 3.15.23

What a packed week! We reviewed a harrowing case of massive bee envenomation (with insects in the airway) w/ Dr. Yates, R4 wisdom and philosophies with Dr. Mullen, an overview of hydrocephalus with Dr. Stothers, a CPC of a brain tumor presenting with aphasia with Dr. Glenn, a dive into hyperviscosity syndromes with Dr. Beyde, and a wonderful series of lectures on the Language of Being Well & Embracing Fear in EM with visiting professor Dr. Arlene Chung.

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Diastolic Shock Index: A clinically relevant predictor of poor outcome in septic shock?

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Diastolic Shock Index: A clinically relevant predictor of poor outcome in septic shock?

Early recognition and resuscitation of patients in septic shock are critical skills for an emergency medicine physician. Many clinical decision-making tools have been developed and validated in their use to identify and define those who are in sepsis or septic shock, as well as predict a patient’s overall risk of morbidity and mortality, including tools like the SIRS criteria and SOFA score. The diastolic blood pressure is determined by vascular tone, and thus it can be assumed that a decrease in the diastolic blood pressure should correlate with the pathologic vasodilation in septic shock. As a result, the authors of this study hypothesized that the relationship between heart rate and the diastolic blood pressure (i.e. the diastolic shock index) could provide providers a tool to quickly identify patients that are at risk for unfavorable outcomes.

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Grand Rounds Recap 3.8.23

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Grand Rounds Recap 3.8.23

We are back with a special grand rounds with visiting professor Dr. Arun Nagdev discussing a variety of ultrasound guided nerve blocks in the ED, CPC with Drs. Harward and Roche, and a review of multiple etiologies and management of pediatric seizure with our CCHMC PEM colleagues.

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Grand Rounds Recap 2.15.23

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Grand Rounds Recap 2.15.23

Check out this week’s MASSIVE recap with Dr. Connelly’s poignant lessons from her time with Sydney HEMS, Dr. Broadstock’s R4 case follow up of HIV myositis, Dr. De Castro’s extensive Vitamin deficient review, Small Groups on task saturation and ITE review and a Palliative Medicine lecture by dual trained Dr. Kiser.

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Grand Rounds Recap 2.1.23

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Grand Rounds Recap 2.1.23

This week in Grand rounds, we had some case reflection from R4 Dr.Zalesky reminding us to avoid anchoring, be aware of our biases for or against patients, and avoid creating a rude work environment. Dr. Moulds and Dr. Goel had a CPC showdown with a case of Cecal Diverticulitis, while Dr. Artiga gave us the low down on Lung Ultrasound in the ED. We wrapped up the day with an R4 lead simulation on a case of Thyrotoxicosis.

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Grand Rounds Recap 2.8.23

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Grand Rounds Recap 2.8.23

During Grand Rounds this week, we had the pleasure of hosting our Brian Gibler visiting lecturer Dr. John Deleda who Spoke about Henry Ford Hospitals COVID-19 response and the leadership lessons he learned over his career. Dr. Della Porta then gave us the rundown on different blood products and using TEG. We discussed PPROM, Breech delivery, and neonatal resuscitation with Dr. Crawford. The CPC showdown with Dr. Minges and Dr. Brower ended as a case of Hyperleukocystosis and Leukostasis. We ended the day with a talk from our PEM colleagues on inborn errors of metabolism.

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