We had another exciting week of Grand Rounds! We covered topics including our new hypoglycemia protocol with Drs. Beyde and Wolski to traumatic cardiac tamponade with Dr. Glenn to syncope roles with Dr. Kotei. We enjoyed a visiting lecture from our Ohio ACEP team talking about the role of ACEP in residency and beyond. We finished strong with a lecture from our program director Dr. McDonough talking about her take on wellness in residency!
Read MoreJoin 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.
Read MoreJoin us as we explore our EMS Grand Rounds with Dr. Gray, discussion of pain management in pediatrics with Dr. Bryant, and the evidence-based approach to pericarditis treatment with Drs. Stevens and Jensen. Drs. Chuko and LaFollette then go head-to-head in our beloved CPC, Dr. Martella takes us through the diagnosis and management of myasthenia gravis, and Dr. Berger outlines the importance of taking care of our critically ill patients with humanity and kindness in his R3 Taming the SRU lecture. Lastly, Dr. Gottula wraps up with a discussion on how to excel at the little things during his R4 Capstone.
Read MoreThis week Dr. Klaszky started us off with a great M&M of reviewing tPA and sumitriptan indications, EMTALA background and more. Dr. Chuko led a small group discussion of syncope rules based on his post from earlier in the week, Dr. Roblee tried to stump a faculty during her CPC of a syphilis case. Check it all out in this week’s GR Recap!
Read MoreSyncope is a common presenting complaint to the emergency department. Estimates suggest that 1- 3 percent of ED visits are for syncope.(1) While the large majority of these episodes are often benign, they can suggest underlying life-threatening etiologies such as arrhythmias, pulmonary embolism, and stroke. The disposition of these patients can represent a difficult quandary at times. In fact, emergency physicians are only able to establish a clear underlying diagnosis in approximately 50% of syncope patients after obtaining an HPI, physical exam and ECG. (2)
Should these patients be observed in the ED? And, if so, for how long? Should they be admitted to the hospital for further workup and observation? Should they instead be discharged home with close follow-up?
Read MoreThis week's Grand Rounds started out with another installment of our leadership curriculum led by Dr. Stettler, where we discussed how to identify and manage finance in leadership. This was then followed by Dr. Makinen's small group session on thyroid diagnostics in the ED. Drs. Gauger and Loftus then went head-to-head on a case of syncope, found to have a massive PE. Dr. Miller then gave a great summary of current thoughts and future approaches to sepsis, followed by Dr. Murphy discussing post-ENT procedure bleeds in the ED. Dr. Curry then finished off the conference with his "Mastering Minor Care" segment on epistaxis.
Read MoreThis week, we started things off with a great Quarterly Sim led by our faculty. The oral boards cases, led by Drs Stettler and Roche, involved an acute presentation of holiday heart, a post-partum patient with flash pulmonary edema, and a very questionable spider bite. The simulation, led by Drs Fernandez, Hill and Stolz, focused on two patients that were in shock: one due to a ruptured ectopic pregnancy and one due to a pericardial tamponade. We then moved on to the pediatric side of things, where Dr. Gleimer discussed neonatal rashes, and we took a look at pediatric syncope with Dr. Fananapazir.
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.
