Grand Rounds Recap 2.7.24

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Grand Rounds Recap 2.7.24

Join us we recap another week of Grand Rounds. We start off with a CPC case, where Dr. Rodriguez challenges Dr. Benoit to a case involving a young child with recurrent syncopal episodes. Next up, Dr. Knudsen-Robbins teaches us all the tips/tricks to performing LPs in the ED. If you ever felt nervous about an pediatric airway, our airway expert, Dr. Carleton, walks us through all the nuances of a pediatric intubation. Meanwhile, Dr. Milligan reflects on her four years as a resident and shares her insight about making the hard decisions during training. One of our very own SRU tamers, Dr. Davis, teaches us how to expertly manage symptomatic bradycardia. Lastly, Drs. Broadstock and Ramachandran help us add nerve blocks to our growing toolbox used for treating acute pain in the ED.

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Diagnostics and Therapeutics: The Who, What, Where, When and Why of Lumbar Punctures

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Diagnostics and Therapeutics: The Who, What, Where, When and Why of Lumbar Punctures

Lumbar punctures can be a high stress and difficult procedure for many. Dr. Knudsen-Robbins walks us through the optimal setup, performance, and troubleshooting of this procedure, including the ultrasound-assisted LP! Check out this article before your next LP attempt to breeze through this procedure with ease.

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Grand Rounds Recap 6.20.18

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Grand Rounds Recap 6.20.18

This academic year’s penultimate Grand Rounds started with Guest Faculty Lecturer Dr. Richard Levitan lecturing on airway tips, tricks, and trouble shooting. Drs. Harrison, Sabedra, and Summers then led small group sessions focused on unique applications of ultrasound. Dr. Hughes discussed TB management in the ED and Dr. Thompson closed out Grand Rounds with pearls on patient management.

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When the Easy LP Isn't Easy

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When the Easy LP Isn't Easy

Lumbar punctures can be mercurial procedures.  There are certainly patients in whom it can be predicted that a lumbar puncture will be challenging.  Obesity, patients with known degenerative changes, and agitated patients all present unique challenges when it comes to successfully completing a lumbar puncture.  There are patients, however, who throw you a bit of a curveball.  Sometimes cooperative patients with good landmarks, in whom you had every expectation that you would find success, become seemingly impossible to successfully complete a lumbar puncture.  

For the provider, knowing how to troubleshoot the unexpectedly difficult lumbar puncture can be the difference between success and failure.

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Grand Rounds 10.25.17

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Grand Rounds 10.25.17

Dr. Ludmer kicked things off with this month's Morbidity & Mortality conference where we discussed C. Diff, spinal cord compression, LP in the setting of anticoagulation and cardiac arrest with an LVAD. Dr. Stettler led the next segment of our longitudinal leadership curriculum with a look at the mentor/mentee relationship. We finished up with a soapbox lecture by Dr. Titone on conflict resolution and an R3 follow up by Dr. Bernardoni who discussed the crashing patient with right ventricular failure and pulmonary arterial hypertension. 

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What's in a Tap: CSF Analysis

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What's in a Tap: CSF Analysis

Lumbar punctures are common procedures to the Emergency Medical provider.  Obtaining the fluid is just part of the battle however with this procedure.  With the flood of results often comes a fair bit of confusion as to how to interpret them.  After reading this post, you'll be able to:

  • Use cell counts, protein, and glucose to distinguish between various etiologies of meningitis and determine when to order further testing
  • Understand markers of bleeding in CSF and methods of distinguishing SAH from traumatic tap

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