April 23, 2019

The Return of Droperidol...

April 23, 2019/ Jeffery Hill, MD M.Ed

Have you heard the news! Droperidol is back and available in the United States. After a prolonged hiatus the medication has been picked up by a new manufacturer and may be finding its way to a hospital pharmacy near you. Since it has been some time since the medication has been in common use, and since the memory of its effectiveness may be buoyed by a sense of nostalgia or otherwise viewed through rose colored glasses, now is as good a time as any to take a stroll through the literature and learn a bit more about the effectiveness and side effect profile of the medication.

April 22, 2019

Diagnostics: C-Spine Rules

April 22, 2019/ Ryan LaFollette, MD

Clearance of cervical spine is more within the house of Emergency Medicine than anywhere else, so it implores that when we clear a cervical spine using our rules, we take a second to consider the sensitivity, specificity and even more importantly the exclusions that were used in the derivation and validations in these studies. Dr. Gawron takes a look through these rules for our review

April 19, 2019

Grand Rounds Recap 4.17.19

April 19, 2019/ Guest User

Enjoy this weeks Grand Rounds Summary. We had a great small group session on conflict resolution presented by Dr. McDonough and Leenellett of the leadership curriculum team. Next, Drs. Iparraguirre and Li taught us about an evidence-based approach to epistaxis. We completed our morning going through a great simulation on Acute Myocardial Infarction requiring Thrombolysis with Drs. Colmer, Mckee, Harrison, and Continenza.

April 17, 2019

A Case of the Swollen Leg - III Recap

April 17, 2019/ Ryan LaFollette, MD

Not every swollen leg was made equal, nor should they all be treated the same. In the second installment of our case series, join us on the discussion of a rare vascular complication of the lower extremities.

April 12, 2019

Grand Rounds Recap 4.10.19

April 12, 2019/ Guest User

Have fun reading this week’s Grand Rounds Recap! Dr. McDonough provided an insightful talk on Physician Depression and Wellness to start our morning. Following this, we had an excellent session on TEG’s multitude of uses in the ED. We had a variety of ophthalmology pearls shared by Drs. Owens, Scanlon, Ventura, and Harty. Then, Dr. Krack, one of Cincinnati Children’s Hospital’s Pediatric EM fellows shared helpful hints in taking care of pediatric patients with Congenital Heart Disease. Next, Dr. Pulvino shared her clinical diagnostics lecture on Platelet Disorders. Dr. McKee finished our day with an exciting talk on medical ethics and how they apply to the Emergency Department. Enjoy!

April 10, 2019

The A Fib Chicken and Egg - III Recap

April 10, 2019/ Jeffery Hill, MD M.Ed

This is the first in a series of 3 blog posts recapping our residency’s most recent asynchronous small group exercise. For these posts, we’ll start with a case vignette and then highlight some key aspects of the presentation and cover some key learning points. You can also take a listen to the accompanying podcast for a slightly more in depth look at the case.

April 05, 2019

Diagnostics: TEG, you're it

April 05, 2019/ Ryan LaFollette, MD

Thromboelastography (TEG) may be less ordered than traditional coagulation studies, however gives much more specific and detailed information to your patient’s coagulopathy. Join Dr. Wolochatiuk as she explores the indications and interpretations of the TEG.

March 29, 2019

Grand Rounds Recap 3.27.19

March 29, 2019/ Guest User

Enjoy this week’s Grand Round’s Recap. Dr. Murphy started us off with a great Morbidity and Mortality conference with a variety of fascinating cases. Next, Dr. LaFollette taught us some pearls for HEENT emergencies if you are out in the community. Dr. Hunt took us through transfusion reactions and how to manage them, followed by Dr. Hall discussing the management pearls of Nonconvulsive Status Epilepticus. Next, Dr. Connelly taught us how we can incorporate alternative EKG leads into our practice, and Dr. Klaszky finished our day with a nuanced take of how to manage refractory septic shock. It was a jam packed day full of great learning!

March 27, 2019

Telling Tall Tales: Dogma in Emergency Medicine

March 27, 2019/ Jeffery Hill, MD M.Ed

In our training and education as Emergency Medicine providers, we often come to accept certain practice patterns as fact. When these established “facts” come along with fantastical clinical claims (don’t give your corneal abrasion patients tetracaine, it’ll melt their corneas; don’t use lido with epi for digital blocks, their finger will fall off; don’t use beta-blockers in patients on cocaine, their BP will skyrocket due to unopposed alpha-effects), we should probably look to question their supporting evidence.

March 25, 2019

Diagnostics: Alternative EKG Leads

March 25, 2019/ Ryan LaFollette, MD

Ever have a patient that looks more concerning than their EKG? Perhaps their ischemia is in that anatomically difficult to access right ventricle or even posterior. Join Dr. Connelly in looking at the utility of right sided, posterior and Lewis leads and bring something new to your next chest pain patient.

March 22, 2019

Grand Rounds Recap 3.20.19

March 22, 2019/ Guest User

Enjoy this week’s Grand Rounds Recap! Dr. Jordan Bonomo started us off with a fascinating talk on brain death, and how therapeutic hypothermia in the post-arrest patient can make this diagnosis more challenging. Next up, Dr. Harrison taught us some pearls on management of the bradycardic peri-arrest patient. Dr. Nagle shared with a us how to rescuscitate a patient with acute aortic dissection. Lastly, Dr. Summers talked to us about PRES and how to recognize and treat this rare disorder.

March 19, 2019

US - Pregnancy The LABUR protocol: Ultrasound of the Month

March 19, 2019/ Guest User

Your pregnant patient gets rushed in uncomfortable and just shying of pushing but you have a few minutes to panic. Why panic when you can grab a probe and get some information about your impending delivery? Dr. Bernardoni guides us through the LABUR exam and the finer points of the term OB POCUS.

March 14, 2019

Grand Rounds Recap 3.13.19

March 14, 2019/ Jessica Baez

This week’s Grand Rounds began with a practical discussion of the CBC and differential by Dr. Hassani. Dr. Hughes and Thompson led a fantastic CPC on a case of myxedema coma, and Dr. Whitford discussed CT over-utilization in the emergency department. We finished the day with our pediatrics colleagues who walked us through anxiety-provoking cases of aortic coarctation, bacterial tracheitis, and neonatal jaundice. Check it out!

March 12, 2019

Grand Rounds Recap 3.6.19

March 12, 2019/ Jessica Baez

From surgical airways to the undifferentiated shock patient, this week’s Grand Rounds was packed full of clinical pearls. Dr. Carleton started with a discussion of a tachycardia-inducing failed airway requiring cricothyrotomy. Drs. Jensen and Makinen presented a very detailed review of the literature and their proposed algorithm on infective endocarditis. Dr. Harty reviews a fascinating case of cecal volvulus that was identified early with the aid of a RUSH exam, while Dr. Liebman walked us through an approach to the patient with inhalation injuries. Finally, Dr. Roblee led an excellent review of SBP. The discussion was full of information you might use on your next shift!

March 10, 2019

The CBC and the Man Behind the Curtain

March 10, 2019/ Jeffery Hill, MD M.Ed

It’s been called “the refuge of the intellectually destitute (physician)” by Amal Muttu. The CBC is a much maligned test that is nevertheless one of the the most frequently ordered diagnostic tests in the ED. To truly know how to interpret this test, one must understand its individual components, the possible causes of variations from normal for those components, and how it integrates into the clinical presentation of the patient. Also, it can’t help but to know and understand some of the historical background…

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