We are back with an excellent grand rounds session, where we heard about a case of resuscitative hysterotomy from Dr. Stark, BRASH syndrome, and HIV screening in the ED. We also heard some life lessons from the Peace Corps and how they relate to emergency medicine.
Read MoreWhat a packed week! We reviewed a harrowing case of massive bee envenomation (with insects in the airway) w/ Dr. Yates, R4 wisdom and philosophies with Dr. Mullen, an overview of hydrocephalus with Dr. Stothers, a CPC of a brain tumor presenting with aphasia with Dr. Glenn, a dive into hyperviscosity syndromes with Dr. Beyde, and a wonderful series of lectures on the Language of Being Well & Embracing Fear in EM with visiting professor Dr. Arlene Chung.
Read MoreEarly recognition and resuscitation of patients in septic shock are critical skills for an emergency medicine physician. Many clinical decision-making tools have been developed and validated in their use to identify and define those who are in sepsis or septic shock, as well as predict a patient’s overall risk of morbidity and mortality, including tools like the SIRS criteria and SOFA score. The diastolic blood pressure is determined by vascular tone, and thus it can be assumed that a decrease in the diastolic blood pressure should correlate with the pathologic vasodilation in septic shock. As a result, the authors of this study hypothesized that the relationship between heart rate and the diastolic blood pressure (i.e. the diastolic shock index) could provide providers a tool to quickly identify patients that are at risk for unfavorable outcomes.
Read MoreWe are back with a special grand rounds with visiting professor Dr. Arun Nagdev discussing a variety of ultrasound guided nerve blocks in the ED, CPC with Drs. Harward and Roche, and a review of multiple etiologies and management of pediatric seizure with our CCHMC PEM colleagues.
Read MoreEver palpate the scalp of an altered patient to find a VP shunt you weren’t expecting? Have a febrile patient and wondering if it could be the cause? Join Dr. Cody Stothers as he dives into a case-based review of Hydrocephalus and VP Shunts
Read MoreCheck out this week’s MASSIVE recap with Dr. Connelly’s poignant lessons from her time with Sydney HEMS, Dr. Broadstock’s R4 case follow up of HIV myositis, Dr. De Castro’s extensive Vitamin deficient review, Small Groups on task saturation and ITE review and a Palliative Medicine lecture by dual trained Dr. Kiser.
Read MoreThis week in Grand rounds, we had some case reflection from R4 Dr.Zalesky reminding us to avoid anchoring, be aware of our biases for or against patients, and avoid creating a rude work environment. Dr. Moulds and Dr. Goel had a CPC showdown with a case of Cecal Diverticulitis, while Dr. Artiga gave us the low down on Lung Ultrasound in the ED. We wrapped up the day with an R4 lead simulation on a case of Thyrotoxicosis.
Read MoreNeed a quick reminder of what the MA means as you’re watching your TEG tick by? Join Dr. Della Porta for a quick hit review of Thomboelastography, aka TEG.
Read MoreDuring Grand Rounds this week, we had the pleasure of hosting our Brian Gibler visiting lecturer Dr. John Deleda who Spoke about Henry Ford Hospitals COVID-19 response and the leadership lessons he learned over his career. Dr. Della Porta then gave us the rundown on different blood products and using TEG. We discussed PPROM, Breech delivery, and neonatal resuscitation with Dr. Crawford. The CPC showdown with Dr. Minges and Dr. Brower ended as a case of Hyperleukocystosis and Leukostasis. We ended the day with a talk from our PEM colleagues on inborn errors of metabolism.
Read MoreAbscess? Cyst? Hematoma? Join Dr. Tillotson and review the unique images obtained that led to a diagnosis of a radial pseudoaneurysm!
Read MoreJoin us for our 1.11.23 Recap with Dr. Wolski covering caustic skin injuries, Dr Shaw taking on Dr. Hughes with a CPC case of trophoblastic disease with thyrotoxicosis and finally peds sim cases with our CCHMC PEM colleagues
Read MoreSpontaneous subarachnoid hemorrhage (SAH) is a can’t miss diagnosis for patients presenting to the emergency department with a headache. The diagnosis is associated with a 30% mortality at 30 days, and approximately 30% of survivors may have long-term neurocognitive deficits (Rincon et al., 2013). The majority of spontaneous SAH are secondary to a ruptured arterial aneurysm (80%) while non-aneurysmal SAH are often due to low pressure venous bleeds, arteriovenous malformations, and other more rare causes. This post will recap the existing literature on the diagnosis of aSAH and will focus on breaking down a recently published paper by Vincent, et al which may inform our future practice.
Read MoreChemical burns are also an evolving pathology, with thousands of new chemicals added to the market each year (4). Since 2000, both assault and warfare with chemical weapons have increased, although these pathologies vary based on practice location (1). For instance, chemical burns can comprise up to 14% of burns in the developing world, compared to 3% in the US and Europe (2, 5). It is therefore important to understand your local chemical burn patterns, in much the same way providers learn local patterns of antibiotic resistance.
Read MoreJoin us this week as we cover Morbidity and Mortality report cases with Dr. Broadstock, a discussion of law enforcement in the ED with Dr. Crawford, brainstem stroke syndromes with Dr. Arnold, and Air Care grand rounds with Drs. Goff and Winslow.
Read MoreThis week, we reviewed new EMS protocols, learned about rare pathologies like tumor lysis syndrome and anterior cord syndrome, simulated a case of an aortic dissection, and practiced visual diagnoses in pediatric patients.
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.
