Grand Rounds Recap 9.6.23

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Grand Rounds Recap 9.6.23

Join us for a review of another fantastic week of Grand Rounds. We start with Dr. Minges expertly guiding us through performing DVT studies in the ED, to help us better address the needs of the patients in front of us. Dr. Kreitzer presents the data, as well as and personal experience, to passionately advocate for including family members in the ED and ICU’s- including procedures, resuscitation, rounds, and multidisciplinary meetings. Meanwhile, Dr. Onuzuruike refreshes our foundation knowledge pertaining to AICD’s in the ED. Lastly, Drs. Negron and Wright reflect on their expertise as leaders in the SRU to teach us all about managing the most difficult airways- including intubating through the nose and even an supraglottic device.

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Grand Rounds Recap 8.9.23

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Grand Rounds Recap 8.9.23

Join us as we recap our last week of Grand Rounds, including our first intern lecture of the year focusing on pericarditis & myocarditis. Learn about the art of skillfully resuscitating a patient with an LVAD, as well as the tips/tricks for effectively communicating with patients, from our senior residents. Learn how to confidently handle ENT emergencies in the community and orthopedic trauma in a limited-resource settings. Our pharmacy colleagues gave us an timely update on use of Precedex in the ED, as well as Andexxa vs. PCC for reversal of Xa-inhibitors. Lastly, our pediatric EM colleagues joined us to discuss to subtle difference in diagnosis and management of neonatal & pediatric seizures compared to adults.

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Grand Rounds Recap 08.12.20

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Grand Rounds Recap 08.12.20

This week’s Grand Rounds started off with Dr. Minges walking us through how to perform ultrasound-guided regional anesthesia. Drs. Curry and Ryan then presented the first Year Directives of the academic year discussing EMTALA criteria and how to negotiate a contract. Drs. Wosiski and Iparraguirre expertly discussed the literature behind angioedema management. Drs. Crawford and Doerning battled it out on a case involving hiccups (read to find out more about this fascinating case). And lastly, Dr. Stratton from our PEM division walked us through how to approach the pediatric patient and pearls on how to determine “sick” from “not sick".”

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Swelling out of the Blue - Angioedema in the ED

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Swelling out of the Blue - Angioedema in the ED

Angioedema is like urticaria in that both are transient swelling of well-demarcated areas. However, angioedema involves swelling of deeper tissues, producing nonpitting edema of the dermis and subcutaneous layers. It is most often seen in the eyelids and lips, and sometimes in the mouth and throat. While it is not pruritic it may be painful. In the US, angioedema accounts for approximately 100,000 ER visits annually (1). Across the world, 35% of prescriptions written for hypertension are for ACE-inhibitors (>40 million people). With a reported incidence of angioedema in 0.1–0.7% of those patients on ACEI, there are approximately 40,000 cases of ACEI-associated angioedema worldwide annually (2).

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Grand Rounds Recap 12.4.19

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Grand Rounds Recap 12.4.19

After a brief hiatus we returned to grand rounds this week and started off with an in depth discussion on common overdoses and treatments in the ED with our guest lecturer and expert toxicologist Dr. Gillian Beauchamp. We then got some hands on time with the new hand held ultrasound machines that are now available on Air Care as well as reviewed pre-hospital management of traumatic pneumothoaces with Dr. Humphries. Finally, airway guru Dr. Carleton took us on a deep dive on airway management in angioedema.

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Grand Rounds Recap 12.5.2018

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Grand Rounds Recap 12.5.2018

We had another excellent Grand Rounds this week! Dr. Carleton started us off with some thrilling airway cases in his continuing Airway Grand Rounds series. Next, we were transported to Africa for a case based discussion on Global Health with Drs Owens, Sabedra, Ventura, and Murphy-Crews. Dr. Skrobut and Chris Shaw then took us through a deep dive of the current literature on the management of upper GI bleeds. Dr. Ham then taught us about ACE-I induced angioedema through the lens of an amazing case of a patient who required a cricothyrotomy to save her life! Next up, we had Dr. Gleimer go up against Dr. Faryar in our Clincal Pathological Case series where we a classic presentation of Addison’s disease in a pediatric patient. Dr. Hunt then led us through small group discussions on the application of the HEART Score in patients presenting to the ED with chest pain. We wrapped up the day with Dr. Isaac Shaw who presented a the management of SVT in a complicated patient.

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Grand Rounds Recap 9.28.2016

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Grand Rounds Recap 9.28.2016

Dr. Axelson kicked off Grand Rounds this week with a look at DKA, hypercalcemia, suicide in the ED and more during M&M. Then we learned about Hereditary Angioedema, Thyroid Emergencies, Concussions, NIPPV and got a chalk talk about setting end goals of resuscitation from Dr. Dave Norton.  

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Airways, like Martinis, are Best "Dry"

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Airways, like Martinis, are Best "Dry"

Have you ever looked down the blade of a laryngoscope and said to yourself, “Damn!  This airway is just too dry!”  I thought not.  Rather, we often look down the blade into a mucky swamp of secretions that drip from the pharyngeal walls like drool from a big, sloppy dog, and often obscure familiar landmarks and goop-up our optical and video adjuncts.  Is there no solution?  There is!  Let us review an illustrative case...

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Grand Rounds Recap 4/20

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Grand Rounds Recap 4/20

Simulation with Dr. Hill

Transitions of care can be a high risk time for our patients, especially amidst the chaotic environment that can be the SRU. 

Pre-planning sign out is an effective strategy to make the transition smooth. One to two hours out from the shift's end, take them time to start getting things in order for the end of the shift.

As emergency medicine physicians we have the tendency to want to wrap up our patients at sign out as nicely as possible. This is a good habit, realizing that it can predispose to premature closure, and, particularly in the case of an unpredictable SRU, should be applied with caution...

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