Deviated uvula but wondering if there is any peritonsillar abscess (PTA) to drain? Once again, ultrasound to the rescue. Join Dr. Jazmyn Shaw as she reviews the views and approaches to using US for PTA localization.
Read MoreJoin Dr. Stothers as he takes us through a serious case of an Anti-Xa overdose and the clinical nuances that face providers in caring for these patients.
Read MoreWe had a jam packed grand rounds this week, which started off with a simulation and ultrasound demonstration from our AirCare team. Next Dr. Vaughan took us through the dermatologic emergencies we cannot miss, and Dr. Ferreri discussed why every decompensated patient should receive an sonographic waves for assessment. We continued with our third installment of Landmark Studies of EM, covering the important papers on traumatic resuscitations. Finally, Dr. Bryant took us through a global health inspired case and Dr. Otten taught us about the medications that can be toxic to pediatrics in small doses.
Read MoreLumbar punctures can be a high stress and difficult procedure for many. Dr. Knudsen-Robbins walks us through the optimal setup, performance, and troubleshooting of this procedure, including the ultrasound-assisted LP! Check out this article before your next LP attempt to breeze through this procedure with ease.
Read MoreJoin us as we “knock out” an outline for the evaluation and management of patients presenting to the ED with a concussion. Dr. Arnold highlights the importance of thorough discharge instructions and strict return precautions.
Read MoreDr. Sobocinski takes us through a rare but interesting case of upper extremity swelling leading to limb ischemia caused by deep venous occlusion.
Read MoreThis week at Grand Rounds we started off with a lively discussion of some unique case presentations during M&M presented by Dr. Yates. Drs. Wosiski-Kuhn and Stothers then walked us through the most pressing research papers in our Mini-Lit Blitz, followed by Dr. Benoit talking us through ideal Post-ROSC Care. Finally, our QI/KT on necrotizing soft tissue infections was expertly presented by Drs. Schor and de Castro.
Read MoreJoin us as we recap another fantastic Grand Rounds session. We started off with our longitudinal leadership curriculum, specifically focusing on recruitment and building a team. This was led by two prominent leaders in our very own emergency department- Drs. Fermann and LaFollette. Next, we join Dr. Finney on a journey as she reflects on the relationships we build with our patients and their families, as well as providing insight on how to cope with the grief that we may face following the most difficult cases. Lastly, Drs. Chhabria, Davis, and Gobble, help us prepare for the upcoming ITE exam by providing us with useful quick hits relating to orthopedic injuries, PEM, and toxicology.
Read MoreWe started off the day strong with a R4 Case Follow Up lecture presented by Dr. Yates who led an excellent discussion on psychosis, including maintaining a broad differential for secondary psychosis and appropriate management. We then transitioned to an R1 Clinical Knowledge lecture where Dr. Segev guided us through interstitial lung disease and fibrosis ranging from epidemiology to diagnosis and treatment. This then followed by a hand-on high acuity low opportunity procedure review including esophageal balloon tamponade, transvenous pacemaker placement, and chest wall escharotomy. The hands-on sessions continued into the afternoon where our CCHMC colleagues led a simulation on neonatal shock. Overall, a great day at UCEM Grand Rounds!
Read MoreWe are back and ready for our first grand rounds of the year! We had a great variety in lectures today. Dr. Wosiski-Kuhn shared her capstone on violence against healthcare workers. Dr. Martella followed up a case of a patient with a spontaneous coronary artery dissection and their puzzling ED clinical presentation. Dr. Guillaume helped us troobleshoot and optimize our options for vascular access including EJ cannulation, ultrasound-guided IVs and all things PICC line. Dr. Haffner took us through a pathophysiology and treatment review of a patient with a very large calcium channel blocker overdose. The R2 team of Drs. Della Porta and Hajdu presented their protocol on alcohol withdrawal in the ED. We learned about the use of panorex as a new study for certain dental patients in conjunction with oral surgery from Dr. Urbanowicz. Finally, Dr. Baez dropped some protips to be confident and competent at a busy community ED site.
Read MoreEstablishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. However, in at least 10% of patients, blind insertion of a peripheral IV may be unsuccessful for a variety of reasons. In this post, we will review multiple alternative access options, as well as briefly discuss concerns related to PICC lines.
Read MoreThis week we started off with a riveting M&M presented by Dr. Kletsel, where we discussed massive GI bleeds, renal abscesses, and more. This was followed by a face off for the ages between Drs. Beyde and Bonomo on an uncommon presentation of thyrotoxicosis. Finally, a group of R4s led us through an educational simulation of BRASH syndrome and some informational oral boards style cases.
Read MoreReplacing gastrostomy tubes that have fallen out or are no longer functioning is a common procedure in the Emergency Department. Often, these replacements are smooth and easy. There are times however when the replacement process can get complicated with the need to dilate quickly stenosing tracts and/or the need to consult a sub specialist to assist with replacement. This post covers the key historical factors to gather on these patients and the basics steps in replacing the tubes.
Read MorePlacement of a foley catheter is usually a simple process. However when it doesn’t go smoothly, when the foley just won’t seem to pass, there are specific approaches that are needed to successfully catheterize the patient. Suprapubic catheters will also frequently need replacement and troubleshooting in the ED.
Read MoreJoin Dr. Della Porta as she describes the considerations emergency physicians should have when treating patients who have presentations suggestive of suicide-related behaviors and how to evaluate safe discharge plans.
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.
