Dr. Koehler reviews cases and shared clinical pearls with this month’s Morbidity and Mortality Conference, Dr. Kowalenko visits virtually to discuss ABEM Board Certification and give us a medical history lesson on Presidential Assassinations
Read MoreWhat’d we cover in this week’s Grand Rounds? Dr. Mand expertly delivered her final Morbidity & Mortality conference of the year, covering a spectrum of pathology from pediatric cardiac arrest to BRASH syndrome. Dr. Ryan gave the second part of the highly informative medical malpractice series. Dr. Stark reviewed hand injuries for her R1 Clinical Knowledge, an EM bread & butter lecture series. To cap things off, Dr. Hunt reviewed an R3 case where she tamed the SRU.
Read MoreAnyone who’s faced a patient with refractory V fib or V Tac, knows the certain pang of hopelessness that strikes when round and round of epi, CPR, and shocks fails to deliver a return to organized rhythm. ECMO is an option. Baring the availability of perhaps one of the most resource-intensive procedures in medicine, what option does one have? If nothing is working what do you change? Beta blockers? Change up the shocks? Is that bicarb you’re giving doing any good? This post and the affiliated podcast will cover 3 articles looking at the evidence for these new and old treatments for cardiac arrest.
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 MoreThis week’s Grand Rounds started off with Dr. Paulsen walking us through how to create an enriching learning environment for our students and junior residents in the Emergency Department. Dr. Gleimer then presented an inspirational R4 Case Follow Up of a v.fib cardiac arrest that lived to tell the tale on his experience and second lease on life. Lastly, Drs. Gottula and Skrobut skillfully demonstrated best practice patterns for managing STEMI patients in helicopter EMS transport.
Read MorePediatric cardiac arrests are, potentially, some of the most challenging patients for an emergency physician to care for. Cognitively, emotionally; these patients push us to our very limits. In this journal club recap, we cover 3 recently published articles looking at the care of these patients. Should survivors be cooled? Is Epi any good? Which is better amiodarone or lidocaine?
Read MoreThis 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.
Read MoreThis week in grand rounds started off with Dr. Humphries reviewing the evidence of various interventions in traumatic cardiac arrest and providing a clear algorithm to follow in patients who suffer blunt traumatic cardiac arrest. We then had an in depth discussion on the approach to the encephalopathic patient in the Emergency Department. Dr. Bryant then presented some interesting cases that she had on her most recent trip to Guyana, followed by Dr. Ramsey’s in depth review of the emergent complications of acute leukemia. We finished off the day with our pediatric Emergency Medicine colleagues who led us through a simulation and oral boards cases.
Read MoreDr. Golden kicked grand rounds off this week with our monthly morbidity and mortality conference, followed by Dr. Lane’s deep dive on massive pulmonary embolism in cardiac arrest and how to approach this. Dr. Owens then gave us a detailed review on a probably-more-common-than-you-think parasite that has started popping up in the US, and our excellent ED pharmacists gave us a crash course on common antidotes to various poisonings, overdoses, and bites that we frequently see in the ED. Finally, Dr. Ham finished up with a review of the importance of chronic hypertension in our ED population and how we can make a difference especially those with limited access to care.
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 MoreVentricular dysrhythmias are commonly caused by coronary ischemia which is most frequently caused by acute coronary artery occlusions in the setting of coronary artery disease. It would seem somewhat logical that patients who suffer a V fib or V Tach cardiac arrest would benefit from a trip to the cardiac catheterization lab to identify and treat these possible acute coronary artery occlusions. Patient’s with EKGs showing ST-elevations following ROSC already go to the Cath lab. Since the EKG is not terrifically sensitive for MI, should V fib V Tach cardiac arrest patients without ST-elevations make a trip to the Cath lab? In this breakdown of our most recent journal club we look at several papers covering this topic. In the podcast below we also talk with Justin Benoit, MD the site PI for the ongoing ACCESS trial which is also looking into this question.
Read MoreCome check-out our Grand Rounds Summary for 12.19.18! We started the morning with some fascinating cases in Morbidity and Mortality Conference with Dr. Baez. Next, we learned the importance and efficacy of mindfulness with Dr. Bernardoni. Dr. Makinen and Dr. Curry went head-to-head on a Clinical Pathologic Conference about a patient with hyperthermia due to sympathomimetic overdose. Lastly, Dr. Frederick taught us the evidence behind PECARN!
Read MoreFrom epi drips to peds fracture tips, it was an eventful Grand Rounds. We began with a debate on the utility and method of epinephrine during cardiac arrest. Dr. Murphy then discussed hemodialysis access complications followed by Dr. Palmer’s operations update. Dr. Shah led a discussion on the recognition and management of pediatric fractures. We concluded by covering a variety of other pediatric topics during the R3 small group session. Take a look!
Read MoreThe first of a new series of posts with associated podcasts looking at the literature behind what we do every day in the ED with takeaways of tangible algorithms to guide every day practice. This month Drs Gauger and Harty lead us in a discussion of cardiac arrest, the drugs we use, the ultrasound we dabble with and the future interventions that could become standard of care.
Read MoreThis week’s Grand Rounds started with Dr. Gorder’s expertly delivered Morbidity and Mortality lecture. Dr. Gottula then went over drugs of abuse, including the gabapentinoids. Dr. Shaw then talked about a case of sympathetic acute crashing pulmonary edema (SCAPE). Finally, Dr. Edmunds spoke about pediatric renal emergencies.
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.
