Grand Rounds Recap 10.30.24

/
Grand Rounds Recap 10.30.24

Join us for another great week of Grand Rounds! We started out with a great discussion of the changing workforce and how the differences between generations and leadership styles impacts our interactions with our colleagues. Then we discussed the nuances of managing a dysfunctional tracheostomy with Dr. Adan. We were taken through the pathophysiology and clinical presentation of patients with pneumomediastinum and mediastinitis with Dr. Valles. Finally, Drs. Artiga, Beyde and Vaishnav gave us hands on practice with the different types of nerve blocks that can be used in the ED!

Read More

Grand Rounds Recap 8.07.2024

/
Grand Rounds Recap 8.07.2024

Join us for another week of Grand Rounds! We had a visit from Dr. Melissa Platt of the ABEM Board of Directors discussing the upcoming changes to the ABEM certification exam. Dr. Lawton presented to us about frequent fliers in the Emergency Department. Dr. Shewakramani spoke to us about sepsis metrics and operational changes that have been made in our department, and we closed with an exciting R3 Taming the SRU lecture with Dr. Artiga discussing difficult intubations.

Read More

Grand Rounds Recap 12.15.21

/
Grand Rounds Recap 12.15.21

Join us for a recap of this week’s robust Grand Rounds. We have a wide array of topics including biliary pathology, ED operations and how are decisions impact boarding, congenital long QT and Boerhaave syndrome, TTP, and pediatric stridor.

Read More

A New Schema for Extraglottic Devices

/
A New Schema for Extraglottic Devices

Airway devices abound both in the ED and in the prehospital environment. Over the past few decades the use of extraglottic devices has increased significantly. In this post, Dr. Andrew Cathers recaps a recent article from Annals of Emergency Medicine where the authors sought to categorize these devices by the ways in which they are placed and to then apply that categorization to a cohort of deceased patients to hopefully shed light on the use and failures of these devices.

Read More

Swelling out of the Blue - Angioedema in the ED

/
Swelling out of the Blue - Angioedema in the ED

Angioedema is like urticaria in that both are transient swelling of well-demarcated areas. However, angioedema involves swelling of deeper tissues, producing nonpitting edema of the dermis and subcutaneous layers. It is most often seen in the eyelids and lips, and sometimes in the mouth and throat. While it is not pruritic it may be painful. In the US, angioedema accounts for approximately 100,000 ER visits annually (1). Across the world, 35% of prescriptions written for hypertension are for ACE-inhibitors (>40 million people). With a reported incidence of angioedema in 0.1–0.7% of those patients on ACEI, there are approximately 40,000 cases of ACEI-associated angioedema worldwide annually (2).

Read More

Show Love to Strangers

/
Show Love to Strangers

To provide a fuller education, our curriculum should occasionally bend from the scientific and technical and include matters of the heart.  This is a case from the early 1990s, a time in this fair land when ultrasound was not part of emergency practice, when RSI was still a relatively fresh concept, when the treatment of shock was non-systematic, and when consultation was a matter of pleading on the telephone. 

Read More

Surrounded by Mysteries We Cannot Hope to Understand

/
Surrounded by Mysteries We Cannot Hope to Understand

I.C. Cordes submissions arise spontaneously whenever I have something on my mind.  Usually they are concrete lessons in airway management, but recently I have done a lot of airway training and that tank is a little dry.  Hence, this is another foray into metaphysics as I stumble toward the twilight and navigate Erikson’s 8th stage of psychosocial development.

Read More

Grand Rounds Recap 12.5.2018

/
Grand Rounds Recap 12.5.2018

We had another excellent Grand Rounds this week! Dr. Carleton started us off with some thrilling airway cases in his continuing Airway Grand Rounds series. Next, we were transported to Africa for a case based discussion on Global Health with Drs Owens, Sabedra, Ventura, and Murphy-Crews. Dr. Skrobut and Chris Shaw then took us through a deep dive of the current literature on the management of upper GI bleeds. Dr. Ham then taught us about ACE-I induced angioedema through the lens of an amazing case of a patient who required a cricothyrotomy to save her life! Next up, we had Dr. Gleimer go up against Dr. Faryar in our Clincal Pathological Case series where we a classic presentation of Addison’s disease in a pediatric patient. Dr. Hunt then led us through small group discussions on the application of the HEART Score in patients presenting to the ED with chest pain. We wrapped up the day with Dr. Isaac Shaw who presented a the management of SVT in a complicated patient.

Read More

Grand Rounds Recap 10.24.18

/
Grand Rounds Recap 10.24.18

It was an exciting week of Grand Rounds where Dr. Colmer presented our monthly Morbidity and Mortality conference. We had a fantastic guest lecturer, Dr. Reuben Strayer (@emupdates), who discussed opioid abuse and airway management. Finally, our consultant of the month was Dr. Amy Makley who discussed blunt abdominal trauma. Take a look!

Read More

The Last Gasp

/
The Last Gasp

It is undoubted that effective airway management is a critical link in the care of patients with both in-hospital cardiac arrest and out-of-hospital cardiac arrest.  But how exactly should one manage the airway?  What results in the best outcomes for our patients? Should we be aiming to intubate every patient? Or, are extraglottic devices as effective (or more effective)? What about the good old bag-valve mask?  In our most recent Journal Club we explored the evidence surrounding airway management in cardiac arrest, covering 3 high impact articles.  We also touch on an abstract presented at the 2018 SAEM Academic Assembly which should add significantly to the body of literature when it is published in full.  Take a listen to our recap podcast below and/or read on for the summaries and links to the articles.

Read More

Grand Rounds Recap 6.6.18

/
Grand Rounds Recap 6.6.18

This week we were led through the evaluation and management of the difficult pediatric airway with Dr. Carleton in our quarterly airway grand rounds, and discussed cranial nerve abnormalities with Dr. Neel in our recurring EM-neuro combined conference. Dr. Jarrell presented an interesting case of a child with a cough and weight loss, and Dr. Jensen walked us through the clinical utility of BNP. Finally, Dr. Miller presented an interesting case of a patient with multisystem organ failure and cecum perforation. 

Read More