Grand Rounds Recap 9.20.23

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Grand Rounds Recap 9.20.23

Another excellent week for UCEM Grand Rounds! We started the day with an introduction to universal HCV screening in the ED from our pharmacy colleagues. We then transitioned to a great discussion on concussions sports medicine faculty Dr. Gawron. Next, Dr. Guillaume led us through diagnostics and therapeutics for nonconvulsive status epilepticus. Then, Dr. Shaw presented two cases of PRES and the importance of recognizing this diagnosis. Finally, R4s led the way through a simulation on adrenal insufficiency as well as structured oral boards case practice.

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Grand Rounds Recap 5.3.23

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Grand Rounds Recap 5.3.23

Join us to recap our Grand Rounds session from the first week in May. Starting with the April M&M report expertly delivered by Dr. Broadstock- featuring atypical ACS, as well as the aggressive management of a CCB overdose. Followed by Dr. Mullen taking us through a set of cases involving near misses, as she reflects on things she learned during her four years in residency. Next up, Dr. Hajdu educated us about the presentation, pathophysiology, and evidence-based management of mild TBI’s/concussions in the ED. Lastly, we finish off with Air Care GR featuring details about the TOWAR study, review of management of pediatric seizures, as well as tips & tricks to improve our flight-related documentation.

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Grand Rounds Recap 04.21.21

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Grand Rounds Recap 04.21.21

Extra! Extra! We had excellent content this week in Grand Rounds. Dr. Paulsen started us off with discussing the difference in generational and gender-based communication approaches in our quarterly Leadership Curriculum. Drs. Frankenfeld and Ijaz then expertly discussed their new status epilepticus algorithm in QI/KT. Dr. Hill discussed his passion for diltiazem use in A.fib with RVR in his attending case follow up. Dr. Martella educated us on the evidence behind the most common medications given for renal colic in the ED during his R1 Clinical Treatment. Lastly, Drs. Broadstock and Lang battled it out in CPC involving a case of thyroid storm.

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Grand Rounds Recap 09.30.20

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Grand Rounds Recap 09.30.20

This week’s Grand Rounds was full of excellent cases, Bayesian statistics, and uncovered cognitive biases.

From Morbidity & Mortality Conference by Dr. Hughes, to airway expertise by Dr. Carleton, to tips to decrease stress by Dr. Koehler, to learned lessons from near misses by attendings Dr. Continenza, R. Thompson, and Sabedra, this summary is one you’re going to want to pay attention to!

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Air Care Series: Status Epilepticus Update

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Air Care Series: Status Epilepticus Update

The diagnoses and treatment of status epilepticus continutes to evolve. Review the latest evidence for status epliepticus management in the critical care transport medicine environment, including an evolving role for Ketamine!

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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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Grand Rounds Recap 06.24.20

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Grand Rounds Recap 06.24.20

The final Grand Rounds of the 2019-20 academic year offered an incredible line up of lectures followed by an annual residency program evaluation and wrap-up by the outgoing chief residents, lovingly called “KJAM”.

Dr. Golden presented our monthly Morbidity and Mortality conference, full of cases to learn from and improve clinical care. Dr. Shaw presented his Taming the SRU lecture on a case of massive hemoptysis in an otherwise young and healthy patient. Dr. Murphy-Crews delivered a moving R4 Capstone lecture, demonstrating the low NNT for ED thoracotomies and highlighting that resilience is not the issue when it comes to burnout and physician suicide.

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Grand Rounds Recap 6.10.20

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Grand Rounds Recap 6.10.20

This week we reconvened with our pediatric colleagues for a case series of seizures and COVID autoimmune vasculitis. Drs Modi, Harty and Jarrell took us through global health case series and finally guest lecturer Dr. Kenji Inaba from LAC-USC gave us some take-home tips in hemorrhage management.

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Grand Rounds Recap 3.27.19

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Grand Rounds Recap 3.27.19

Enjoy this week’s Grand Round’s Recap. Dr. Murphy started us off with a great Morbidity and Mortality conference with a variety of fascinating cases. Next, Dr. LaFollette taught us some pearls for HEENT emergencies if you are out in the community. Dr. Hunt took us through transfusion reactions and how to manage them, followed by Dr. Hall discussing the management pearls of Nonconvulsive Status Epilepticus. Next, Dr. Connelly taught us how we can incorporate alternative EKG leads into our practice, and Dr. Klaszky finished our day with a nuanced take of how to manage refractory septic shock. It was a jam packed day full of great learning!

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Grand Rounds Recap 8.22.18

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Grand Rounds Recap 8.22.18

The week started off with our AirCare team discussing indications for procedures performed pre-hospital. The AirCare team continued by taking us through several cases in our quarterly AirCare M&M. We then got some oral boards practice with Drs. McDonough and LaFollette. The day finished with a simulation led by Dr. Hill covering patients who wish to leave AMA as well as the terrifying lengthening QTc.

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Grand Rounds Recap 1.10.18

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Grand Rounds Recap 1.10.18

Grand rounds this week started off with a review of the EMTALA law with Dr. Hinckley, as well as some case discussion.  This was followed by a presentation from our clinical pharmacists, PharmD's Nicole Harger and Madeline Stephens, on anti-epileptic medications and their uses, as well as an update on our medication supplies in the ED.  Drs. Murphy-Crews and Scanlon then presented their evidenced based algorithm for the management of STEMI, followed by our combined peds EM lecture with Dr. Kevin Overmann on the evaluation of the pale child and pediatric anemia.  This was followed by Dr. Ludmer's R4 case follow up/best of residency cases.  The day finished up with Dr. Sim Mand presenting her clinical diagnostics lecture on the assessment and management of the non-pregnant patient with abnormal uterine bleeding. 

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Grand Rounds Recap - 7/20/2016

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Grand Rounds Recap - 7/20/2016

This 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.

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Grand Rounds Recap 9/9

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Grand Rounds Recap 9/9

Case Follow up with Dr. Winders

The Sick Patient with Pulmonary Artery Hypertension (PAH)

  • PAH defined as right heart catheterization with mPAP > 25mmHg, which can be estimated by echo
  • Readily associated with right ventricular failure, measured by TAPSE < 1.8 with M mode over tricuspid annulus
  • EKG can also help identify these patients with right axis deviation or right atrial enlargement
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Grand Rounds Recap - 3/18/15

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Grand Rounds Recap - 3/18/15

Evidence-Based Emergency Medicine: Vent Management with Drs. Axelson & Scupp

The term Acute Lung Injury (ALI) is being phased out and instead Acute Respiratory Distress Syndrome (ARDS) is now graded mild, moderate, and severe depending on the PaO2:FiO2 ratio

The median onset of ARDS after presentation to the ED was 2 day but could be anywhere from 5 hours to 5 days

ARDS Net was a foundational trial in ventilator management and was a triall of tidal volume and plateau pressures.  The primary end point, mortality, was reduced by >20% when folks were on a low TV (6cc/kg) and lower PP (25-30 mm Hg).

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