Grand Rounds Recap 11.29.23

Grand Rounds Recap 11.29.23

This week’s grand rounds was packed with education! We started off the day with our morbidity and mortality conference which was led by chief resident, Dr. Stark. She discussed multiple high yield cases including immunosuppressed patients with fever, subarachnoid hemorrhage, complex trauma resuscitations, stridor in the adult, posterior circulation stroke, and finally an interesting case of Lemierre syndrome. Following M&M, Dr. Wolski took on Dr. Broadstock in an epic clinical pathologic case where the ultimate diagnosis in a child with abdominal pain was a bezoar. This was then followed by Dr. Newton’s R1 Diagnostic and Therapeutics lecture on Troubleshooting tubes in the ED including G-tubes, foley catheters, and suprapubic catheters. Finally, we wrapped up the day with R3 small group sessions. Dr. Harward led a session on ***. Meanwhile, Dr. Moulds discussed pharmacotherapy. Last but certainly not least, Dr. Sobocinski reviewed ***. All around, an excellent day at UCEM Grand Rounds!

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Grand Rounds Recap 01.06.2021

Grand Rounds Recap 01.06.2021

The first grand rounds of 2021 offered many learning points to help us ring in the New Year! Dr. Neel from the Department of Neurology gave us some great tips on the neurologic exam and some quick hits on neuromuscular diseases. The residents then worked together to come up with some challenging diagnoses. The day was rounded off with oral boards preparation with cases of: pediatric appendicitis, stroke in a non-stroke center, and a PE with an underlying malignancy.

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Grand Rounds Recap 04.15.20

Grand Rounds Recap 04.15.20

We had another exemplary installment of Grand Rounds this week that started with Attending Case Followup with Drs. Lang, Baez, and Paulsen. Then we had some top-notch review of core curriculum with Dr. Winslow and the Alvarado Score for appendicitis, Drs. Meigh and Klaszky on food impactions and esophageal foreign bodies, and Drs. Comiskey and Nagle on D-dimer. Finally, Dr. Nagle gave us an overview of the foundations of evidence-based medicine with his R4 capstone.

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Grand Rounds Recap 11.20.19

Grand Rounds Recap 11.20.19

Dr. 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.

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Grand Rounds Recap 8.14.19

Grand Rounds Recap 8.14.19

This week we had a great mix of lectures on both pediatric and adult topics. Topics covered included pediatric ear, nose, and throat emergencies with Dr. Smith, pediatric GI bleeding with Dr. Bensman, anticholinergic poisoning and treatment of the critically ill seizing patient with Dr. Gleimer, a fascinating case of disseminated gonnorhea during of CPC with Drs. Berger and Baez, how to interpret volatile acid testing including the osmolar gap, and finally a great summary on the current standard of the diagnosis of subarachnoid hemorrhage with Dr. Murphy Crews.

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Grand Rounds Recap 03.15.17

Grand Rounds Recap 03.15.17

This week, Dr. Boyer led us through his R4 case follow up. Drs. Baez and Summers dove deep into the literature on sepsis. Dr. Gauger reviewed toxicologic syndromes. Dr. Axelson hit us with some trauma pearls and we worked through sick respiratory cases during our combined Peds-EM sim. 

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CSF Evaluation in Subarachnoid Hemorrhage

CSF Evaluation in Subarachnoid Hemorrhage

So, what constitutes a “positive” tap when evaluating for subarachnoid hemorrhage?

Traditional teaching is that a positive tap is Xanthochromia or blood in the CSF

What exactly is Xanthochromia?

The word xanthochromia is simply Greek for “yellow color.”  It refers to the yellow color that CSF can take in certain situations.  Some of these situations are listed below:

  • Elevated CSF protein            
  • Jaundice
  • Hypervitaminosis A
  • Rifampin Therapy
  • Elevated Bilirubin
  • Oxyhemoglobin

What we are especially interested in when evaluating for subarachnoid hemorrhage is bilirubin and oxyhemoglobin.

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