Under Pressure - Compartment Syndrome Diagnostics

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Under Pressure - Compartment Syndrome Diagnostics

Compartment syndrome is a surgical emergency that can present after a variety of insults, ranging from those we commonly encounter in the ED (fractures, crush injuries) to more rare clinical presentations (snake bites, electrocution). The initial elevation of compartment pressures can be secondary to internal (ex. bleeding, swelling, fluid overload) and/or external (ex. compressive devices, burn eschar) factors. In this post, we detail the history/physical and diagnostic evaluation of possible compartment syndrome.

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Grand Rounds Recap 12.18.19

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Grand Rounds Recap 12.18.19

Dr. Ham led off this week’s Grand Rounds reviewing cases from the month of November for our monthly Morbidity and Mortality conference. Dr. Chuko then led us through a deep dive on the diagnosis and treatment of male genitourinary disorders and was followed by Dr. Frankenfeld who led our small group discussion on STEMI equivalents. A battle of minds ensued between Dr. Gawron and Dr. Betz of an interesting case of traumatic rhabdomyolysis. Finally, Dr. Crook reviewed all of the latest important changes to the southwest Ohio EMS protocol.

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Grand Rounds Recap 11.28.18

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Grand Rounds Recap 11.28.18

Check out this week’s recap of Grand Rounds! Dr. Tim Murphy took us through some fascinating cases with Morbidity and Mortality Conference. Next, we got to dive deep into toxicology. Dr. Kelli Jarrell led us through a case she had of a TCA overdose, Dr. Shawn Hassani taught us about Beta Blocker and Calcium Channel Blocker overdose, and Dr. Woods Curry took us through a oral boards session during Quarterly Sim reviewing Aspirin toxicity. Quarterly Simulation also had an oral boards case discussing inferior STEMI complicated by complete heart block, as well as an awesome simulation teaching the fundamentals of teamwork and closed loop communication by having a lucky R3 run a code with a blindfold on. We’re excited to share the learning highlights with you!

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Grand Rounds Recap 6.6.18

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Grand Rounds Recap 6.6.18

This week we were led through the evaluation and management of the difficult pediatric airway with Dr. Carleton in our quarterly airway grand rounds, and discussed cranial nerve abnormalities with Dr. Neel in our recurring EM-neuro combined conference. Dr. Jarrell presented an interesting case of a child with a cough and weight loss, and Dr. Jensen walked us through the clinical utility of BNP. Finally, Dr. Miller presented an interesting case of a patient with multisystem organ failure and cecum perforation. 

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Grand Rounds Recap 10.26

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Grand Rounds Recap 10.26

We had another great week at Grand Rounds to wrap up the month of October.  Dr. Betham ran the gamut of medical knowledge in her M&M, teaching us from organophosphate poisoning to rhabdomyolysis.  Drs. Merriam and Curry battled in a CPC about submassive and massive PE.  Dr. Shewakramani taught us about all things dental and Dr. Scupp brought it home with his soapbox about the importance of balance in IV fluid resuscitation.

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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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