March 06, 2020

Grand Rounds Recap 3.4.20

March 06, 2020/ Guest User

We had an outstanding week in Grand Rounds, led off by a visiting lecturer and UC EM Class of 2013, Dr. Renee Salas. Dr. Salas is currently Assistant Professor at Harvard Medical school and a Yerby Fellow at the Center for Climate, Health, and Global Environment. Her talk was entitled “Climate Crisis and Clinical Practice - Implications for Emergency Medicine.” Next, Dr. Baez presented a fascinating Ultrasound Grand Rounds with Ultrasound M&M. Drs. Frederick and Walsh led us through their new clinical pathway for Non-Pregnant Vaginal Bleeding in their QI/KT. Dr. Klaszky gave his R4 Clinical Capstone lecture on how to make effective presentations.

March 04, 2020

Mastering Minor Care: Management of Migraines

March 04, 2020/ Guest User

Sometimes finding a way to treat a migraine in a patient can induce a migraine in ourselves! Join Dr. Zalesky in learning about the diagnosis of migraines, the red flags associated with the diagnosis, and learning how to best manage a patient that walks through your emergency department doors with disabling migraine.

February 28, 2020

What to do about the Flu?

February 28, 2020/ Jeffery Hill, MD M.Ed

It’s the height of flu season and our most recent Journal. Club focused on a couple of papers digging into the treatment of influenza as well as the association of cardiovascular events with influenza infections. Take a read and a listen to hear about the utility (or potential lack thereof) of oseltamivir as well as the evidence behind a newer medication for treatment of influenza, baloxavir.

February 21, 2020

Grand Rounds Recap 2.19.20

February 21, 2020/ Guest User

This week featured an all-start lineup of resident lectures. Dr. Golden started us off with an amazing M&M, followed by Dr. Mullen enlightening us on eating disorders and the management in the ED. Dr. Iparraguirre taught us about the management of the severely burned patient. Dr. Laurence and Dr. Lagasse faced off in another interesting CPC. Finally Dr. Goff, hit it home with review of pneumonia severity scores and their clinical context.

February 18, 2020

Air Care / B Pod Series: Intravenous Fluid Resuscitation

February 18, 2020/ Guest User

Normal saline has taken hold as the de facto resuscitative fluid in the majority of health care institutions in the developed world. Walk through the recent data with Dr. Christopher Shaw which suggests that balanced fluids may provide benefit to patients suffering from a wide array of critical illnesses.

February 16, 2020

Yeah, it's Pneumonia, But How Bad is it Really?

February 16, 2020/ Jeffery Hill, MD M.Ed

According to the American Thoracic Society (ATS) in 2018, 1 million patients required hospitalization for pneumonia and there were 50,000 associated deaths. Pneumonia was the leading cause of sepsis and septic shock and not surprisingly therefore qualified in the top 10 most expensive inpatient hospitalizations.(1) Given these findings, some have sought opportunity to develop mechanisms to assess and safely triage pneumonia patients to either inpatient or outpatient treatment strategies based upon pneumonia severity scores. In October 2019, the Infectious Diseases Society of America (IDSA) in conjunction with the ATS published recommendations for the assessment, treatment and disposition of immunocompetent adult patients with community acquired pneumonia which included several clinical decision rules also known as pneumonia severity scores.(2) The recommended decision rules and several associated, emerging tools are reviewed here.

February 14, 2020

Grand Rounds Recap 2.12.20

February 14, 2020/ Guest User

Dr. McDonough and Dr. Palmer kicked off this week with an engaging session of leadership curriculum discussing self-promotion as well as how to write an effective CV. Dr. Forde walked us through the exciting topic of Mobile Stroke Units during EMS Grand Rounds. Lastly, Dr. Krack walked us through some interesting and terrifying pediatric heme-one emergencies.

February 06, 2020

Grand Rounds Recap 2.5.20

February 06, 2020/ Guest User

This week in grand rounds we had an excellent discussion on leadership and how emergency medicine can impact the future of medicine by visiting lecturer, Dr. Andra Blomkalns current chair at Stanford University and UC alumni. Dr. Golden enlightened us on diabetes technology so we can better take care of our diabetic patients with insulin pumps and continuous glucose monitoring.

February 03, 2020

Intrathecal Baclofen Withdrawal

February 03, 2020/ Jeffery Hill, MD M.Ed

Intrathecal baclofen withdrawal is characterized by increased spasticity, hypertension, tachycardia, hyperthermia, altered mental status, and seizures. In the most severe cases, autonomic instability, rhabdomyolysis, diffuse intravascular coagulopathy, multisystem organ failure, and death can occur. In this episode of the research corner, we cover a recently published case report where intrathecal baclofen withdrawal was treated successfully with dexmedetomidine.

February 01, 2020

Grand Rounds Recap 1.29.20

February 01, 2020/ Guest User

This week we had another great M&M where Dr. Klaszky covered exciting topics such as refractory V fib, hypothermia and cerebral malaria. We learned about misnomers, mimics and lies about TB from Dr. Owens. Dr. Zalesky skillfully walked us through a simplified approach to reading brain MRIs. Lastly, Dr. Leech and Dr. Goel faced off in a CPC involving a patient with ALS.

January 29, 2020

Hypocalcemia in Trauma

January 29, 2020/ Jeffery Hill, MD M.Ed

We are all familiar with the “lethal triad” of trauma – coagulopathy, hypothermia, and acidosis. We have multiple methods wherein we attempt to prevent or reverse these physiologic derangements. In particular, in recent years many teams have focused heavily on limited crystalloid infusions, increasing our early blood product transfusion (especially plasma), and early administration of tranexamic acid.

One of the main reasons we focus on these interventions is to address trauma-induced coagulopathy. Trauma-induced coagulopathy has a multifactorial etiology and is contributed to by the other corners of the triad (hypothermia and acidosis). However, one of the least appreciated contributing factors are electrolyte deficiencies, in particular calcium.

January 27, 2020

Diagnostics: Brain MRI

January 27, 2020/ Ryan LaFollette, MD

If you have ever nodded along as someone described an MRI series weighting, you are not alone. As this modality becomes more accessible to the Emergency Physician, it is incumbent on us to familiarize ourselves with the critical aspects and critical diagnoses of MRI and how to speak the language. Dr. Zalesky takes us on a tour of the physics, indications and low-down of MRI from the ED.

January 22, 2020

US Case of the Month - Watchers of the Walls

January 22, 2020/ Guest User

Dr. Mand brings Ultrasound Case of the Month into the new decade with a thorough discussion of echocardiographic evaluation of patients with suspected acute coronary syndrome (ACS) in the emergency department, including limitations, correlation with other established diagnostic modalities, and a review of the existing evidence.

January 18, 2020

Grand Rounds Recap 1.15.20

January 18, 2020/ Guest User

We had another great week in Grand Rounds, starting with a QI/KT presentation from Drs. Hunt and Pulvino about Tumor Lysis Syndrome. Next, Dr. Meigh gave a great presentation about TORCH infections and Dr. Spigner gave his R4 Capstone lecture on pre-hospital sepsis care. We welcomed a guest speaker, Dr. Henning, from podiatry who discussed a number podiatry emergencies. Finally, the week wrapped up with a simulation of an inferior STEMI in trauma.

January 10, 2020

Grand Rounds Recap 01.08.20

January 10, 2020/ Jared Ham

This week we brought in the new Roaring 20s with an exciting lineup. Drs. Gauger, Humphries, Jarrell, and Owens led us through a simulated case of hypertensive emergency in a cocaine body packer. Dr. Gressick taught us about blunt carotid artery injuries, and Dr. Gottula discussed resuscitation of septic patients with comorbid CHF and ESRD. Dr. Ham took a detour from clinical topics to discuss how to go about finding your niche in medicine, and Dr. Doerning increased our financial literacy with his high-yield points. Finally, our colleagues from Cincinnati Children’s helped us learn the nuances of having difficult conversations with children and their families.

Blog

Taming the SRU

SRU (pronounced "shrew") = Shock Resuscitation Unit

Categories

Links

Some Helpful Foam

Tags