Grand Rounds Recap 6.19.19

Grand Rounds Recap 6.19.19

This week we had our annual Disaster Day. We started with the legendary Dr. Otten giving us a rundown on disaster preparation and planning. Dr. Calhoun then led us through our disaster activation protocols at UCMC. We then used these principles in a complex mass casualty even simulation. The day ended with an analysis of how these protocols worked in real life during the Fifth Third Shooting.

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Grand Rounds Recap 4.24.19

Grand Rounds Recap 4.24.19

This week’s grand rounds started off strong with Morbidity and Mortality led by Dr. Baez. She discussed a wide variety of topics including stress testing in the ED, precautions, hearing loss, aspiration, and tamponade. Dr. Randolph followed this up with an insightful discussion on high risk ED discharges. The Global Health Team then shared some of the fascinating cases they encountered overseas. Dr. Sabedra reflected on how much we learn from each other by giving a heartfelt talk on what she has learned from her fellow R4’s. We continued with Dr. Gawron reviewing the many cervical spine rules and how to properly apply them. To conclude, Drs. Skrobut and Roche went head to head in this weeks CPC. Who wins? Read on to find out.

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Grand Rounds Recap 8.29.18

Grand Rounds Recap 8.29.18

This weeks grand rounds started off with a Morbidity and Mortality presentation by Dr. Baez including topics such as STEMI in LVH, pharmocologic cardioversion, and septic arthritis of the finger. This was followed by Dr. Freiermuth who gave us some pearls on the approach and management of sickle cell patients in the ED. Dr. Shaw then discussed some disturbing new health policy issues. Dr. Essell, a Heme/Onc attending at Jewish Hospital then walked us though GvHD, Acute Leukemia emergencies, and a fascinating new treatment option for blood cancers CAR-T. The day continued with a review of burn management by Dr. Spigner. Dr. Walsh then finished the day with an overview of carboxyhemoglobinemia and methemoglobinemia.

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CSF Evaluation in Subarachnoid Hemorrhage

CSF Evaluation in Subarachnoid Hemorrhage

So, what constitutes a “positive” tap when evaluating for subarachnoid hemorrhage?

Traditional teaching is that a positive tap is Xanthochromia or blood in the CSF

What exactly is Xanthochromia?

The word xanthochromia is simply Greek for “yellow color.”  It refers to the yellow color that CSF can take in certain situations.  Some of these situations are listed below:

  • Elevated CSF protein            
  • Jaundice
  • Hypervitaminosis A
  • Rifampin Therapy
  • Elevated Bilirubin
  • Oxyhemoglobin

What we are especially interested in when evaluating for subarachnoid hemorrhage is bilirubin and oxyhemoglobin.

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