Grand Rounds Recap 04.14.21

Grand Rounds Recap 04.14.21

This week’s Grand Rounds was jam-packed with great morsels for all! Dr. Finney kicked us off with a discussion on orbital infections, Dr. Frederick discussed the nuances of dynamic EKG changes in the ED and consultation etiquette in her R3 Taming the SRU lecture, Dr. Iparraguirre discussed pearls of wisdom for his R4 Capstone, Dr. Kein expertly discussed the literature behind the most commonly used medications for agitation in the ED, Drs. Mullen and Ham battled head-to-head in a CPC case highlighting ethylene glycol toxicity, Dr. LaFollette presented a rare case of metformin-associated lactic acidosis, and lastly Dr. Runkle wrapped the day up with pearls for rural PEM.

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Droperidol for Agitation in the ED - No Danger to the Dangerous?

Droperidol for Agitation in the ED - No Danger to the Dangerous?

Droperidol is a versatile medication with a number of potential uses for patients in the Emergency Department. It is also a medication surrounded in some degree of mystique because of the decision by the FDA in 2001 to issue a black box warning for its use in response to reports of QT prolongation and torsades de pointes. Many at the time (and since) have argued that, despite these case reports, droperidol is a safe and effective medication that can be used for the treatment of agitation, nausea and vomiting, and migraine. We have previously covered much of this background in a previous blog post. In our most recent journal club, we discussed 3 articles that looked at the safety and efficacy of droperidol for treating acutely agitated patients. Take a read and listen below for an in depth look at each of these papers.

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Grand Rounds Recap 8.8.18

Grand Rounds Recap 8.8.18

This week started with a discussion on how we can improve our documentation to maximize our level V billing. This was followed by a summary of practice changing literature over the last year, a discussion on how we deal with failure in the clinical setting, and a guide to the approach of the agitated pediatric patient. Finally, we broke into small groups to learn about ENT emergencies.

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The Agitated Patient

The Agitated Patient

I don’t know if this has happened to you yet.  It happened to me on my first shift as an intern.  I hadn’t laid hand on a stethoscope in months.  I had just unloaded the cardboard boxes from my rental truck into my new place.  As I was settling in to my first few patient encounters one of our nurses approached me to say that a patient had been brought into our area that was extremely agitated.  I looked up to see a man being held down by multiple police officers, thrashing and swearing.  

“What can I give him?” She said.

“How about a hug?” I replied.

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