This week we start off with an exciting CPC showdown between Drs. Chhabria and Baez, followed by a new proposed pathway for the diagnosis and treatment of Carbon Monoxide Poisoning by Drs. Moulds and Wright. Next, the pediatric department reviewed “one pill can kill” for our pediatric populations, and finally we heard from Dr. Frank about competency in medicine and medical education.
Read MoreWe 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.
Read MoreThis week’s Grand Rounds featured some amazing content! Starting with Dr. Paulsen, our leadership curriculum session focused on processing and learning from failure. We then discussed IV contrast extravasation with Drs. Milligan and Wosiski-Kuhn as they debuted their QI/KT protocol. Dr. Crawford reminded us of the dangers of carbon monoxide and we closed the day with an excellent introduction to the benefits of simulation-informed design with Visiting Lecturers Dr. Chris Hicks and Dr. Andrew Petrosoniak.
Read MoreThis week Dr. Koehler has great teaching points on epistaxis, PRES and more during M&M. Dr. McMullan recounts a harrowing tale of compassion in a case follow up. Dr. Wosiski-Kuhn gives a timely reminder on carbon monoxide and cyanide toxicities followed by Dr. Roblee’s acidotic arrest case and Dr. Lane wraps up with some business need-to-knows of EM.
Read MoreThis weeks grand rounds started off with our monthly Morbidity and Mortality with Dr. Lagasse. We then discuss in Aircare grand rounds led by Drs. Dang and Renne the always harrowing complex patient transfers including LVAD, EKOS and more.
Read MoreIn this week's grand rounds, Dr. Stolz discussed all things DVT and the modified two-point compression study for lower extremity clots. In our recurring EM-neuro combined conference, Dr. Stettler discussed the recent DAWN trial results, and how to incorporate CT perfusion studies into our acute ischemic stroke decision trees. In our Quarterly Sim, we discussed the management of the crashing patient from a house fire, and practiced our escharotomy skills. In our mock oral boards, we went through cases on STEMI, carbon monoxide exposure and limb ischemia. Finally, Dr. Lane discussed the workup of acute diarrhea in the adult population, and Dr. Shah went through a particularly unique toxidrome presentation in his R4 Case Follow Up.
Read MoreThis week Dr. Knight taught us about the management of seizures and about how to manage our own fear. We were schooled on the hypotensive LVAD patient by Drs. Boyer, DeVries and Winders. We learned about oncologic emergencies from Dr. Continenza. Dr. Gorder tamed the SRU and taught us about chemical asphyxiation and burn injuries in the process.
Read MoreCase 1: 18 wk patient with vaginal spotting who is Rh- but antibody+
Bedside U/S shows fetal abnormality due to Rh alloimmunization with fetal hydrops. Positive antibody screening on gravid female should warrant obstetric consultation. Rhogam administration within 72 hours of bleeding is important.
Case 2: 40 wk female with gestational DM present with crowning fetus who fails to immediately deliver secondary to shoulder dystocia.
Treatment: stop pushing and avoid traction. Initially attempt hyperflexion of legs and suprapubic pressure to release (McRoberts maneuver). Then consider episiotomy because subsequent maneuvers involve twisting the baby to get shoulder into a different plane.
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.
