Grand Rounds Recap - 7/23/14

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Grand Rounds Recap - 7/23/14

n general, the best way to learn is to challenge yourself.  Teaching styles should take into account different learner types and levels

Learner levels:

  • Beginner: early 3rd year medical student
    • Can be an observer initially but transition these learners to the next stage
    • Keeps you on point as you have to really know what you are talking about
    • Incorporate them into your H+P
    • Transitional: ask them to perform supervised H+Ps as this prevents them from developing bad habits
    • Advanced:OMP (one minute preceptor) or SNAPPS model
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Grand Rounds Recap - 7/16/14

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Grand Rounds Recap - 7/16/14

Oral Boards Case with Dr. Blomkalns

The pt is a 70 yo M who presents with AMS, weakness and nausea for 1-2 days. He complains of diffuse weakness and feeling "sick". His hx is significant for HTN, HLD, CHF and he takes digoxin. Vital signs on arrival are BP 90/60 with HR 47. There is concern for digoxin toxicity, so dig level is obtained and is 2.4

(normal is less than 1.2).

His K is 6 and Cr is 1.9. EKG shows LBBB.

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Transvenous Pacemaker Placement - Part 1: The Walkthrough

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Transvenous Pacemaker Placement - Part 1: The Walkthrough

If you are interested in seeing the placement of a Transvenous Pacemaker after reading this post check out Part 2 (Procedural Slide Set) and Part 3 (the first person view of the procedure)

Reasons to Pace in the First Place

Hemodynamically unstable+

1. Sinus Bradycardia - seen in 17% of acute MI patients (especially inferior or anterior wall MI) [1,2]

2. AV Block - may be due to ischemia (15-19% of all Acute MI) [2,3]

3. Drug Overdose - with the goal of maintaining adequate hemodynamics while your medical therapy/dialysis has an opportunity to work.

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