Current screening tools for pediatric septic shock and sepsis are highly specific but lack sensitivity. This study substituted age adjusted vital sign measures and a pediatric shock index into currently existing pediatric sepsis scoring systems to create the qPS4.When utilizing a cut off of ≧ 2 points, the qPS4 was highly sensitive and specific, and identified pediatric septic shock far sooner into a patient's course.
Read MorePneumomediastinum is defined as the infiltration of air into the mediastinum and its structures. This disease process can be benign, but also requires careful evaluation and management, and in severe cases may require surgical intervention. This post helps the emergency physician learn to both identify and treat this rare but important clinical entity.
Read MoreJoin us for another exciting week of Grand Rounds! This week, we had Research and Peer Review Basics with Dr. Freiermuth, Pediatric airway cases, hand injuries and how we can better ensure a safe discharge in trauma
Read MoreDr. Diaz McDermott walks us through a a case of an unusual complication of orbital cellulitis and how POCUS can expedite diagnosis and management!
Read MoreVenous thromboembolisms (VTE) are difficult enough to diagnose and treat in the standard patient. However, this becomes even more of a challenge in the pregnant patient. In this post, we will discuss in depth the work up of VTE in the pregnant patient, which often requires slightly different risk stratification tools. We will also discuss various treatment options for VTE in pregnancy and the post partum period.
Read MoreJoin us for another exciting week of Grand Rounds! This week, we had Morbidity and Mortality conference where we learned about posterior hip dislocations, hypertensive emergency, subacute combined degeneration secondary to nitrous oxide use, spinal epidural abscesses, small bowel obstructions, management of agitation in the Emergency Department, and status epilepticus. This was followed up by an R3 Taming the SRU lecture on high-grade heart block and transvenous pacemakers and a discussion on finding your niche in academic emergency medicine. We had an exciting R2 CPC case of acute salicylate toxicity, followed by intern core content with a discussion of penile disorders and urologic emergencies, and ended the day with Dr. Sobocinski's R4 capstone.
Read MoreThere is a wide variation in practice, particularly in obtaining neuro-imaging in patients presenting with vertigo. Many patients are imaged and subjected to a longer length of stay, and on the other side of the coin, some patients with serious pathology fall through the cracks. The authors of this study set out to create a risk score to apply to patients who present to the ED with vertigo which would identify the patients at risk for serious pathology (which they defined as stroke, TIA, vertebral artery dissection, or brain tumor).
Read MoreBlood transfusion is a typical activity in Emergency Medicine and while consent to the side effects are fortunately uncommon, they are a core skillset so join Dr. Sprys-Tellner in learning the numbers and reactions that define the category.
Read MoreWeakness is a common, though sometimes vague, presenting symptom in the ED. Neuromuscular (NM) weakness can have various causes, ranging from common and relatively easy to diagnose conditions (such as strokes and trauma) to less common and more difficult to diagnose ones (such as vascular pathologies, infections, autoimmune diseases, and neoplasms). This post focuses on how to localize weakness to differentiate types of NM weakness and presents classic cases of diffuse weakness caused by three diseases.
Read MoreJoin us as one our OBGYN consultants, Dr. Pensak, takes us through the intricacies and varied management of early pregnancy loss. Then, Dr. Lang takes us through STEMI equivalent presentations as well as sneaky STEMI mimics! Finally, our education was rounded out with our pediatric triple threat. We discussed NRP and simulated resuscitation of a bradycardic neonate, practiced umbilical vein cannulation as well as considered a prolonged fever work-up in a case of Kawasaki and the intricacies of lumbar punctures in the pediatric population!
Read MoreWhile not a daily occurrence in the ED, bullous skin diseases (bullous pemphigoid, pemphigous vulgaris, SJS, SSSS) are critical diagnosis for the Emergency Physician to identify and initiate treatment. Join Dr. Rehfeldt as she parses through them.
Read MoreJoin us for another week of Grand Rounds! We had a visit from Dr. Melissa Platt of the ABEM Board of Directors discussing the upcoming changes to the ABEM certification exam. Dr. Lawton presented to us about frequent fliers in the Emergency Department. Dr. Shewakramani spoke to us about sepsis metrics and operational changes that have been made in our department, and we closed with an exciting R3 Taming the SRU lecture with Dr. Artiga discussing difficult intubations.
Read MoreJoin us for another exciting week of Grand Rounds! Today we discussed capacity management and ED throughput, discussed best practices for bedside teaching and and giving a presentation, discussed disposition for orthopedic complaints in the community, reviewed skin adhesives and hypertensive emergency, and listened to a “year in review” of some of our most exciting ultrasound cases from the previous academic year.
Read MoreWe started off this week with our first morbidity and mortality conference of the year given by chief resident Dr. Moulds. Dr. LaFollette then shared clinical pearls with us from multiple case follow ups followed by Dr. Brower who discussed the evidence behind a multitude of superstitions. We finished up with a lecture from dual EM/PEM trained faculty Dr. Cindy Chang who discussed high risk, low prevalence diseases in children.
Read MoreThis complication of blunt facial trauma is nothing to turn your nose up at! Join us as we review relevant anatomy and walk through the management of nasal septal hematomas.
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.
