Grand Rounds Recap 5.9.18

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Grand Rounds Recap 5.9.18

This week Drs. Harty & Gauger walked us through the literature surrounding the care of the patient in cardiac arrest as part of their Quality Improvement & Knowledge Translation project. Dr. Kristiana Kaufmann, a visiting professor from Wayne State, provided us a look at Global Health opportunities. Our Quarterly Simulation session, lead by Dr. Bryant, was a case of a 15 year old with new onset SOB and polyarthralgias. Lastly Drs. Stettler & LaFollette provided us with mock oral boards cases.

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Grand Rounds Recap 4.25.18

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Grand Rounds Recap 4.25.18

This week’s Grand Rounds was kicked off with our W. Brian Gibler visiting professor series with Dr. Ali Raja M.D., MBA, MPH, and Vice Chair of Emergency Medicine at Massachusetts General Hospital. He gave us his insights on how to help move our specialty towards evidence based practice, as well as his tips on leadership within the context of academic emergency medicine. This was followed by our monthly Morbidity and Mortality Conference with Dr. Titone. Dr. Shah then gave his R4 Clinical Soap Box on the utility of ultrasound in cardiac arrest, and the conference finished with Dr. Whitford giving his R3 Taming the SRU case follow up.

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Grand Rounds Recap 3.14.18

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Grand Rounds Recap 3.14.18

This week's Grand Rounds opened with Dr. Curry discussing the paucity of literature on double defibrillation in VF. Dr. Mand then led small group discussions about the clinical utility of the pelvic xray. This was followed by Dr. Kreitzer expertly identifying incomplete Brown-Sequard Syndrome in Dr. Banning's CPC. Dr. Liebman discussed an interesting presentation of meningitis in a pediatric patient. Finally, our PEM colleagues led case based presentations of pediatric DKA, cat scratch disease, and a simulation featuring a patient in hypothermic cardiac arrest.  

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Grand Rounds Recap 1.24.18

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Grand Rounds Recap 1.24.18

This week's Grand Rounds started off with our monthly Morbidity and Mortality conference with Dr. Titone.  This was followed by a lecture on pediatric bloody diarrhea with Dr. Shan Modi.  Dr. Claire O'Brien then gave her Clinical Soap Box lecture on cost and waste within the healthcare system.  Dr. Kreitzer then gave an evidence based lecture on current research in sepsis and refractory septic shock, followed by our consultant of the month lecture with Dr. Anthony Blanchard from podiatry discussing foot wounds and osteomyelitis.

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Grand Rounds Recap 10.5.2016

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Grand Rounds Recap 10.5.2016

This week we had a Grand Rounds jam packed with clinical knowledge. When was the last time you considered the differential diagnosis of an elevated troponin? It's not just ACS! Read on to learn more about thyroid storm, refractory Vfib and Vtach, lithium toxicity, inflammatory markers, and more. As well as a special clinical soapbox about how Ohio became the epicenter of the nation's heroin epidemic.

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Out of Hospital Cardiac Arrest - Part 1

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Out of Hospital Cardiac Arrest - Part 1

The UC Division of EMS has recorded a series of podcasts to celebrate EMS Week 2016.  We are honored to be able to engage EMS Providers throughout the world with this forum.  If you practice pre-hospital medicine, we would like to say thank you and that we appreciate everything you do to provide a high level of care to ill and injured patients in a wide variety of austere environments.  For this podcast, we were joined by Dr. Dustin Calhoun, Associate Director of the UC Division of EMS, as well as two of this year’s UC EMS Fellows, Dr. Mike Bohanske and Dr. Justin Benoit.

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A Lonely Road - Recap and Expert Commentary

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A Lonely Road - Recap and Expert Commentary

A couple of weeks back, we kicked off our “Flights” portion of our Air Care Orientation Curriculum.  Dr. Latimer outlined a challenging patient case for use to consider and an excellent discussion ensued.  As a reminder of the case, here’s how it was posed:

Your patient is a 56 year-old male with unknown medical history who was an un-helmeted motorcyclist found in a ditch roughly 40 feet from his motorcycle which was discovered in the middle of the road by a passing motorist. The accident was un-witnessed, but the bike was found just beyond a sharp downhill curve in the rural farm road. EMS has BLS capabilities only and they have placed the patient on a backboard and loaded him into the unit.

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Grand Rounds Recap 1/27

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Grand Rounds Recap 1/27

Morbidity and Mortality Conference with Dr. Toth

  • Clinical Decision Unit Usage:  We want to keep using our observation protocols for patients that are appropriate for the CDU. These patients must have a priori identifiable endpoints and a plan for care.
  • Discharge vital signs: Revisiting a theme from last month, tachycardia at discharge is associated with badness. Abnormal vital signs must be addressed.
  • Shift Change: Turnover is fraught with increased risks regarding patient care. Be vigilant that your sign out can anchor the oncoming provider.
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Grand Rounds Recap - 11/18

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Grand Rounds Recap - 11/18

This week we recap the latest IOM recommendations on cardiac arrest management, evidence-based update on anaphylaxis management, management of the morbidly obese code and discuss the ins and outs of immunosuppressive agents.

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A Pain in My Heart - Curated Comments and Expert Commentary

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A Pain in My Heart - Curated Comments and Expert Commentary

Thanks to everybody who chimed in on our last "Flight"! We had a great discussion on the management of the STEMI transfer patient.  These aren't just "milk runs" as pointed out by Dr. Hinckley.  The highlights of the discussion are below with additional commentary on the case by Dr. Bill Hinckley and Air Care Resident Assistant Medical Director Dr. Matt Chinn.  Out final flight will be lifting off June 1 and it's a doozy - looking forward to the discussion!

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Running a Code (in Tight Quarters)

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Running a Code (in Tight Quarters)

How many hands does it take to run a code?   Think about that for a bit...

In the SRU, the available hands seem essentially limitless.  There's a train of PCAs and medical students lined up to perform CPR, a nurse to run the monitor and defib, a nurse and/or pharmacist pulling up meds and mixing drips, a nurse charting, a MD dedicated to the airway, a RT to help with bagging, not to mention the MD running the whole show.  At a minimum you probably have 10 hands ready to ensure compressions are as uninterrupted as possible, to keep a check on the respiratory rate, to hook up monitors, push meds, defib, and all the other tasks that are necessary to code a patient.

Now what do you do in the back of the helicopter when a patient loses a pulse?

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