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.
Read MoreWe 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.
Read MoreDr. Ham led off this week’s Grand Rounds reviewing cases from the month of November for our monthly Morbidity and Mortality conference. Dr. Chuko then led us through a deep dive on the diagnosis and treatment of male genitourinary disorders and was followed by Dr. Frankenfeld who led our small group discussion on STEMI equivalents. A battle of minds ensued between Dr. Gawron and Dr. Betz of an interesting case of traumatic rhabdomyolysis. Finally, Dr. Crook reviewed all of the latest important changes to the southwest Ohio EMS protocol.
Read MoreNo Lung? No problem! Join Liz Powell, Paige Barger and Adam Gottula as they take a look at the basics of VV ECMO in the transport environment.
Read MoreTrauma scene flights are often the first thing people think of when they think of Helicopter EMS. Although we know that HEMS and Critical Care Transport involves much more than just scene flights, they are still a critical part of most HEMS programs’ mission and capabilities. In addition, many flights are “modified scenes” or “scene intercepts,” meaning the HEMS crew meets the EMS crew at an outlying hospital helipad, or arrives shortly after the patient’s arrival to an under-resourced ED. Many of these patients are critically ill, and a subset will require intubation and ventilation. Once intubated is bag valve ventilation enough? Or should all these patient’s be placed on a mechanical ventilator?
Read MoreWhile high-quality CPR delivers the best outcomes in cardiac arrest, this is challenging in a transport environment. Dr. Connelly reviews the evidence behind mechanical chest compression in CPR, exploring its practicality to the Helicopter EMS (HEMS) environment.
Read MoreDrs. Winslow and Habib started the Grand Rounds off with a case-based discussion on the Centor Criteria and testing for strep pharyngitis. Drs. Walsh and Sabedra led an interesting discussion about a case of TTP. In his R4 Case Follow Up lecture, Dr. Nagle presented about DKA and family presence during resuscitation. Dr. Hogan, one of the EMS Fellows, gave a great presentation about the current controversies in cardiac arrest management. Finally, the week wrapped up with some great simulation and cases from our PEM fellows about post T&A bleeds, PTA, and acute chest syndrome.
Read MoreWhile often alarming, neonatal resuscitation is critical in the care of a neonate. In the critical care transport environment preparations is crucial in optimizing resuscitation success. In this edition of Air Care Series, Dr. Irankunda walks us through neonatal resuscitation in the transport environment.
Read MoreIn this edition of the Air Care series we take a look at the LVAD via post and podcast, introducing you to the meeting of man and machine. Adam Gottula, MD interviews Liz Powell, MD and Paige Barger, NP covering the spectrum of LVAD basics from common functions to life threatening complications.
Read MoreThis week, we started Grand Rounds with ED-critical care research brought to us by UC Alumnus Dr. Brian Fuller. He discusses ventilator management in the ED and how ED sedation may affect patient outcomes. Dr. Harrison then presented an overview and common utilization errors of ED observation from his year as a Resident Assistant Medical Director, followed by Dr. McKee’s case of inhalational chlorine exposure. Dr. Alwan discussed updates to the less than 60 day fever protocol at CCHMC and Dr. Zozula walked through the dispatcher assistance protocols to give us an idea of what happens before they enter the ED doors.
Read MoreWe know that alterations in hemodynamics do not only occur in hemorrhagic shock. Both obstructive (such as from tension pneumothorax) and neurogenic shock (for example, from a spinal cord transection), can result in hemodynamic compromise that would not be corrected by blood product administration. There have been some studies that have shown isolated traumatic brain injury (TBI) can also cause hemodynamic derangements. This article looks at a paper which attempts to examine the incidence of cardiovascular instability in patients with TBI.
Read MoreThis was an exciting week of Grand Rounds discussions on a variety of topics. We began with a discussion of prehospital sepsis care and an update on EMS protocols in Southwest Ohio. The combined EM-Neuro conference provided a lively discussion on Guillain-Barre syndrome. The quarterly operations update was followed by a detailed discussion on esophagitis management in the ED. Finally, the pediatric fellows led a series of case discussions on a variety of devastating pediatric illness.
Read MoreThis 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.
Read MoreThis week's grand rounds started off with our EMS team represented by Dr. McMullan updating us on new EMS stroke protocols, an upcoming trial for pre-hospital ketamine use, as well as a refresher on notification calls. This was followed by Dr. Shaw, who made his grand rounds lecture debut discussing the diagnostic and clinical utility of lactate. Drs. Harty and Toth then went mano-a-mano in another installment of the CPC lecture series, during which they discuss the presentation, workup and management of carotid cavernous fistula. Dr. Gorder then presented her clinical soap box, using the example of NG tube placement for SBO as a platform for addressing the impact of dogma within medicine. Our peds EM colleagues then steered the ship for the final 2 hours, discussing 2 oral boards cases (fussiness in a newborn and HSP) as well as putting on a pediatric trauma simulation.
Read MoreThis week's Grand Rounds served as our annual EMS Disaster day, where we tried on our HazMat gear, ran a mock mass casualty incident (MCI), and heard from Dr. Otten about his experience with multiple MCIs over the course of his career.
Read MoreSRU (pronounced "shrew") = Shock Resuscitation Unit
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
