This week’s Grand Rounds started with 2 hours of M&M tips with Dr. Broadstock, Small groups followed with Thoracentesis with Dr. Milligan, Lung Ultrasound with Dr. yates and Trach Management with Dr. Gillespie. Functional Movement Disorders with Dr. Eltatawy rounded out a great Grand Rounds!
Read MoreJoin us as we dive in to some terrifying cases of gynecologic pathologies in the ED followed by tips and tricks on lifelong learning from the amazing clinician and medical educator Dr. Jenny Beck-Esmay through our visiting lecture series! We then continue our journey to always be improving patient care and have some excellent discussion in our monthly Morbidity and Mortality Conference with Chief Resident, Dr. Colleen Laurence. Don’t miss all the incredible nuggets of wisdom from this week’s Grand Rounds!
Read MoreNothing is scarier than the patient that you suspect is going to decompensate in front of you, and nothing will make that case more than seeing a clot in transit on bedside echo. Join Dr. Wolochatiuk as she discusses the signs of right heart strain and management of a patient with clot in transit.
Read MoreDuring this week’s Grand Rounds, Dr. Urbanowicz presented Morbidity and Mortality, Dr. Ijaz discussed the diagnosis and management of aortic dissection, Dr. Walsh shares tips for thoracentesis and dosing for systemic tPA, and Dr. Oteng joins us to share his experiences in global emergency medicine.
Read MoreThe treatment of Acute Ischemic Stroke is a rapidly evolving field with critical care transport medicine playing an increasing role in the treatment of these patients. Dr. Irankunda explores CCTM specific management and historical musts when treating this unique patient population. Dr. Gottula provides a brief review of the literature supporting IV alteplase and endovascular thrombectomy.
Read MoreJoin us as we review a number of fascinating pathologies in morbidity and mortality conference with Dr. Shaw. This is followed by Dr. Adeoye’s discussion of the history and controversy surrounding tPA. Check out the great discussion!
Read MoreDr. Betham started off Grand Rounds with this month's Morbidity and Mortality Conference, where we learned about Gout, ITP, Stroke, and Hyperkalemia in ESRD patients. Dr. Teuber walked us through the varying recommendations regarding ED Thoracotomy and Dr. Banning taught us how to handle neonatal urgencies. Leadership Curriculum wrapped up this week's conference with a session on how to pitch an idea.
Read MoreApproximately 1 month ago we presented and talked through a particularly challenging patient flight scenario. As a refresher, if you don’t recall, check out the post here. Following the posting of the case, I sat down with ACMC Medical Director Dr. Bill Hinckley and Resident Assistant Medical Director for Air Care, Dr. Andrew Latimer, and recorded a podcast with their reaction to the case and to some of the curveball scenarios posed in the question and discussion section.
Read MoreIn this week's grand rounds we covered the complications of sedation in alcohol withdrawl, the nuances of decreased door-to-needle time in acute ischemic stroke, bicarbinate use in metabolic acidosis and a case follow-up or respiratory depression in new onset myesthenia gravis
Read MorePre-hospital stroke care begins with a quick, simple assessment tool used to help identify patients that are suffering a stroke. In Southwest Ohio, this tool is the Cincinnati Pre-hospital Stroke Scale (CPSS). There are three simple components of the CPSS – facial droop, arm drift, and slurred speech. When assessing for facial droop, it is best to ask patients to bear their teeth. Arm drift is assessed by asking the patient to hold both arms outstretched in front of them with their palms facing up. If one arm drifts down or one hand rotates to a palm-down position, this aspect of the scale is positive. Lastly, ask the patient to repeat a sentence to assess for slurred speech or any other type of speech abnormality.
Read MoreIt is late on a blustery grey and rainy day in November and you are the dedicated flight doc on Air Care One (the “UH”) nearing the end of your shift. Your pilot has had to turn down two flights already due to high winds and reduced visibility as bands of storms moved through the area. Against your better judgment, you are standing in the sushi line in the hospital cafeteria to grab dinner when you hear “Air Care One Pilot, weather check for a patient coming back to the U” squawk out over your portable radio. Your excitement rises as “we can do that” echoes over the radio and you hear the tones drop for your flight. You grab the blood cooler and meet your crew for takeoff on the roof...
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The patient is a 74 year-old African-American female with a history of hypertension, coronary artery disease status post drug-eluting stent ×1, former cigarette smoker, and iron deficiency anemia presenting with left-sided vision loss. Patient states that approximately two days ago she woke up with painless peripheral vision loss of her left eye only. She describes it as darkness in the lateral portion of her left eye. She reports that her vision returned to baseline throughout that day; only to return when she awoke the next morning. Since that time she endorses persistent vision loss in the left periphery. She denies blurry vision, eye pain, headaches, recent trauma, flashes, and floaters. Furthermore, she also denies dizziness, numbness weakness, dysarthria, dysphagia, fever, chills nausea, vomiting, chest pain, shortness of breath, and palpitations. She reports adherence to her antihypertensive and anti-platelet medications...
Read MoreTracheostomy Exchange/Replacement:
Dealing with tracheostomies and their associated tubes can be daunting. Keeping a few things in mind can make life much easier. Have a basic familiarity with the components of the trach and have a few questions in mind to ask...
Read MoreSeveral months ago, I sat down and talked about the management of neurologic emergencies in the prehospital environment with Dr. Erin McDonough, an Emergency Physician and Neurointensivist who attends both in the ED and the Neurosciences ICU, and is a member of the Cincinnati Stroke Team. In the brief podcast found below and on iTunes, we covered a wide range of topics including blood pressure management in spontaneous ICH, aneurysmal SAH, and ischemic stroke and some of the more rare complications associated with tPA administration.
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.
