Dr. Freiermuth kicked off this week’s Grand Rounds with a recap of how to approach research in EM. Dr. Leech demonstrated the value to hemorrhage control and fistula complications. Drs. Harty and Comiskey faced off in a CPC case of DRESS syndrome and finally Drs. Gottula and Skrobut gave our quarterly Air Care Grand Rounds on HEMS stroke management.
Read MoreThe care of trauma patients is constantly evolving. From the time of injury to OR or ICU, there are dozens of management decisions that can improve the care and outcome for your patients. In our most recent journal club we took a look at 3 articles that looked at the management of trauma patients in the ED and ICU. Should we be adding vasopressin to our massive transfusion protocols? Is DL dead for trauma patients? Should we move to use IO’s early in traumatic arrests?
Read MoreTreating pain in pregnancy can be… well… a pain. With limited non-teratogenic options in the prepartum patient, Dr. Finney takes a dive into the evidence behind what you can use the next time you have a gravid patient who needs your help.
Read MoreReviewing our own neuroimaging just got a little easier with expertise shared by Dr. Knight. Trauma resuscitations just got a little more evidence-based with Journal Club covering VL>DL, IO>IV, and arginine vasopressin administration. Our kindness, attitude, and desire to take breaks all can improve with the help of Dr. Li’s R4 Capstone. Finally, Quarterly Sim/Oral Boards covered the spectrum of pediatric DKA with cerebral edema, to PTA, to trauma in the elderly, highlighting the breadth and depth of emergency medicine.
Read MoreAs a general rule, mechanical ventilation of obese patients is more complex and difficult than in those with a normal body habitus. Obese patients have decreased chest wall compliance due to increased truncal adiposity, amongst other factors. They are also predisposed to other comorbidities that can lead to more involved physiologic challenges.
Critical Care Transport teams commonly transport patients who are intubated and mechanically ventilated. These patients are intubated for a variety of reasons, from altered mental status to hypercapnea to hypoxia. One of the more common challenges we face in our patients who are mechanically ventilated is difficulty with oxygenation – whether the patient is suffering primary or secondary hypoxemic respiratory failure.
Read MoreChest wall trauma can be exceedingly painful, predisposing patients to splinting, atelectasis, and pneumonia. Chest wall nerve blocks provide analgesia and can facilitate necessary procedures. Dr. Hassani takes us through a case of through a case of traumatic pneumothorax with chest tube placement, and the serratus anterior block.
Read MoreThis week’s Grand Rounds offers a potpourri of topics, from Change Leadership via the Leadership Curriculum by Drs. McDonough & Fermann, to fundamentals and pearls of female GU infections by Dr. Fabiano, to a deep dive on hypermobility type of Ehlers-Danlos Syndrome by Dr. Jensen, to neonatal abdominal pain by Dr. Thomas (CCHMC PEM Fellow).
Read MoreThis week’s Grand Rounds was full of excellent cases, Bayesian statistics, and uncovered cognitive biases.
From Morbidity & Mortality Conference by Dr. Hughes, to airway expertise by Dr. Carleton, to tips to decrease stress by Dr. Koehler, to learned lessons from near misses by attendings Dr. Continenza, R. Thompson, and Sabedra, this summary is one you’re going to want to pay attention to!
Read MoreJoin us as we welcome our guest lecturer, Dr. Luke Messac, for our Global Health Grand Rounds. Dr. Modi then expertly takes us through the ED management of traumatic brain injury in his R4 Case Follow Up. Dr. Diaz makes her lecture debut with dermatologic emergencies. Drs. Winslow and Zalesky walk us through the evidence-based approach to neonatal resuscitation in their QI/KT, and lastly, we end the day learning about the power of positive psychology in our Wellness Curriculum.
Read MoreElectruction is a significant cause of morbidity and mortality with a widely variable injury pattern. Join the Air Care Series and Annals of B Pod teams as we dive into the pathophysiology and literature surrounding electrocution.
Read MoreJoin us as we explore our EMS Grand Rounds with Dr. Gray, discussion of pain management in pediatrics with Dr. Bryant, and the evidence-based approach to pericarditis treatment with Drs. Stevens and Jensen. Drs. Chuko and LaFollette then go head-to-head in our beloved CPC, Dr. Martella takes us through the diagnosis and management of myasthenia gravis, and Dr. Berger outlines the importance of taking care of our critically ill patients with humanity and kindness in his R3 Taming the SRU lecture. Lastly, Dr. Gottula wraps up with a discussion on how to excel at the little things during his R4 Capstone.
Read MoreWhen an ovary decides to play a game of twister, it’s time for the emergency medicine physician to intervene. Join us as Dr. Urbanowicz recounts a tale of an ovarian torsion.
Read MorePericarditis is inflammation of the pericardial sac. Classically, pericarditis presents with sharp and pleuritic chest pain which is relieved by sitting up and forward. Pericarditis has multiple etiologies, but is most commonly idiopathic, assumed to be viral, in developed countries (1). Treatment of pericarditis should be targeted to the underlying etiology if possible (1). For presumed viral, idiopathic causes, most patients are treated with non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine (1).
Read MoreThe week started off with an anxiety inducting lecture on medical malpractice. Not to be outdone our PEM colleagues gave us a simulation with a 29 week premature delivery. This was followed by a review of different long term tubes that are in our patients. We were honored to have Drs. Mallory and Unaka give us a lecture on structural racism and how this has impacted racism in medicine, as well as how we can do better.
Read MoreIn our most recent journal club, we took a look at 3 articles focused on the use of ketamine in the Emergency Department. When treating pain with ketamine, does a rapid administration of ketamine result in more dysphoria? When used for RSI, is ketamine more hemodynamically stable than etomidate? When using ketamine for procedural sedation in adult patients, does pre-treatment with versed or haldol decrease clinically significant emergence agitation?
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.
