Grand Rounds Recap 4.24.19

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Grand Rounds Recap 4.24.19

This week’s grand rounds started off strong with Morbidity and Mortality led by Dr. Baez. She discussed a wide variety of topics including stress testing in the ED, precautions, hearing loss, aspiration, and tamponade. Dr. Randolph followed this up with an insightful discussion on high risk ED discharges. The Global Health Team then shared some of the fascinating cases they encountered overseas. Dr. Sabedra reflected on how much we learn from each other by giving a heartfelt talk on what she has learned from her fellow R4’s. We continued with Dr. Gawron reviewing the many cervical spine rules and how to properly apply them. To conclude, Drs. Skrobut and Roche went head to head in this weeks CPC. Who wins? Read on to find out.

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A Pain in the Neck

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A Pain in the Neck

There are some areas in our practice where the literature grants us a somewhat sure path forward in the evaluation of our patients.  The decision whether or not to pursue cervical spine imaging studies following a traumatic mechanism of injury is one of these areas.  The NEXUS criteria and Canadian C-Spine Rule are useful guides for the evaluation of these patients.  What comes after the imaging can be a bit more challenging.  What do we do with patients who have persistent pain but negative imaging? To what extent do we pursue the possibility of a ligamentous injury? Must we wait for all patients to be sober so that we can "clinically clear" them in addition to our radiographic clearance.   The 3 articles below seek to answer some of these challenging questions.  Take a listen to the podcast and read the summaries to familiarize yourself with some of the latest literature addressing these challenging patient care scenarios.

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Interpretation of Cervical Spine CT's

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Interpretation of Cervical Spine CT's

It's 6pm in the ED on a sunny summer afternoon- you're working as a single coverage physician at a level 3 trauma center.  You are noticing an uptrend in the trauma patients being brought in over the past few hours. While log rolling yet another patient, an EMS provider tells you that they have been making runs nonstop- all of the hospitals downtown are overloaded, and it doesn't look like it will slow down anytime soon. Your modest trauma bay is already full, and you're starting to sweat about the state of the department- there are 4 patients in the pod you haven't even seen yet, 2 with abnormal vital signs.

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