Join Us for another week of Grand Rounds as Visiting Professor Dr. Wilcox guides us through management of hypoxemia respiratory failure in the ED and Visiting Professor Dr. Henwood recounts her experiences with ultrasound in global health.
Read MoreThis is a great paper recently presented at the Critical Care Transport Medicine Scientific Forum. It covers a subject area I have always been interested in. Over time, our understanding of critical care has evolved to show the importance of a low tidal volume strategy for ventilating patients, particularly those with lung injury/ARDS. However, even patients with normal lungs are potentially harmed by high tidal volume strategies.
Read MoreThis week Dr. Irankunda and Dr. Berger took us through their excellent QIKT on strangulation and asphyxiation. Dr. Knight walked us through the initial ventilator management in the ED. Dr. Habib talked about some common mythology and Dr. Makinen lead us through a physiologically challenging airway in a sick trauma patient. Ended with a thrilling R4 sim focusing on altitude illnesses.
Read MoreInvasive ventilation is one of the most frequently applied interventions utilized for critically ill patients. However, as with all medical interventions, there are potential risks and harms which must be balanced with perceived benefit. As our understanding of physiology grows, we have found more and more potential harms associated with invasive mechanical ventilation. This review of a recent article published in JAMA explores the impact of different tidal volume strategies for patients who do not have ARDS.
Read MoreThis week, we started Grand Rounds with ED-critical care research brought to us by UC Alumnus Dr. Brian Fuller. He discusses ventilator management in the ED and how ED sedation may affect patient outcomes. Dr. Harrison then presented an overview and common utilization errors of ED observation from his year as a Resident Assistant Medical Director, followed by Dr. McKee’s case of inhalational chlorine exposure. Dr. Alwan discussed updates to the less than 60 day fever protocol at CCHMC and Dr. Zozula walked through the dispatcher assistance protocols to give us an idea of what happens before they enter the ED doors.
Read MoreDr. Grosso kicked off Grand Rounds this week with March M&M by diving deep into some core content, including BB and CCA overdoses, influenza, massive transfusion, post-intubation hypotension, and neurological catastrophes causing cardiac arrest. Dr. O'Brien broke down coagulopathy of liver disease and DIC for us while Dr. Golden taught us about febrile seizures. Drs. McKee and Colmer talked through the evidence behind their CPQE pathway on vent management in obstructive lung disease. Drs. Liebman and Powell went head to head in a CPC case about sternal osteomyelitis to round out another excellent week of learning.
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.
