Diagnostics: Flex your D Dimer

/
Diagnostics: Flex your D Dimer

In times of COVID, a Dimer of 3000 is nothing to look twice about, however there was an earlier (and future) time where the D Dimer is the hallmark of pulmonary embolism risk stratification. Dr. Comiskey breaks how how this once dichotomous tool has recent data to increase its specificity in elderly patients, pregnant patients and those with low pretest risk factors. Take a look, and when this whole pandemic is over your quiver will be fuller of Dimer tips.

Read More

Grand Rounds Recap 4.1.20

/
Grand Rounds Recap 4.1.20

As we continue our teleconferenced grand rounds, we started with a timely review of ARDS management and refractory hypoxemia with Dr. Shaw, two successful faculty guessed CPCs presented by Drs Irankunda and Pulvino and finally Dr. Jarrell gave us a much needed break with a baking show from her kitchen, with an included recipe for a mug cake!

Read More

Grand Rounds Recap 03.25.20

/
Grand Rounds Recap 03.25.20

In our first ever teleconferenced Grand Rounds - this week Dr. Kathryn Banning presented us with opportunities to improve the care we deliver in our monthly morbidity and mortality conference. Then, our panel of expert clinicians and self-aware humans engaged us all in a discussion of wellness and longevity that was at times vulnerable and candid, but also enlightening from start to finish. Finally, we learned more about radio operations and reflected on both failures and victories in HEMS CQI cases with our Air Care leadership team.

Read More

Grand Rounds Recap 3.11.20

/
Grand Rounds Recap 3.11.20

This week’s Grand Rounds started with a great Airway Grand Rounds lecture by Dr. Carleton. Dr. Frankenfeld led a discussion on face and mouth infections followed by Dr. Li’s Taming the SRU lecture on loperamide overdose. We had a great lecture by Dr. Thompson about healthcare change methodology. The week wrapped up with pediatric simulation focusing on ultrasound.

Read More

10 Things I hate about you: FAST edition

/
10 Things I hate about you: FAST edition

The FAST is one of the most commonly utilized sonographic examinations in the modern emergency department, which also means that it represents one of the most frequent opportunities for error. In this month’s post, Dr. Owens illustrates the pitfalls you should avoid to become an ultrasound aficionado in trauma.

Read More

Grand Rounds Recap 3.4.20

/
Grand Rounds Recap 3.4.20

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.

Read More

Mastering Minor Care: Management of Migraines

/
Mastering Minor Care: Management of Migraines

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.

Read More

What to do about the Flu?

/
What to do about the Flu?

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.

Read More

Grand Rounds Recap 2.19.20

/
Grand Rounds Recap 2.19.20

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.

Read More

Air Care / B Pod Series: Intravenous Fluid Resuscitation

/
Air Care / B Pod Series: Intravenous Fluid Resuscitation

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.

Read More

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

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

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.

Read More