This week’s grand rounds started with excitement with an operations update and a scavenger hunt in the new ED, congrats Team 7 on the win! This was followed by forward thinking didactics on a new protocol for manual vacuum aspirations in the ED,
Read MoreWe had an outstanding week in Grand Rounds, led off by a visiting lecturer and UC EM Class of 2013, Dr. Renee Salas. Dr. Salas is currently Assistant Professor at Harvard Medical school and a Yerby Fellow at the Center for Climate, Health, and Global Environment. Her talk was entitled “Climate Crisis and Clinical Practice - Implications for Emergency Medicine.” Next, Dr. Baez presented a fascinating Ultrasound Grand Rounds with Ultrasound M&M. Drs. Frederick and Walsh led us through their new clinical pathway for Non-Pregnant Vaginal Bleeding in their QI/KT. Dr. Klaszky gave his R4 Clinical Capstone lecture on how to make effective presentations.
Read MoreWe had another great week at Grand Rounds to wrap up the month of October. Dr. Betham ran the gamut of medical knowledge in her M&M, teaching us from organophosphate poisoning to rhabdomyolysis. Drs. Merriam and Curry battled in a CPC about submassive and massive PE. Dr. Shewakramani taught us about all things dental and Dr. Scupp brought it home with his soapbox about the importance of balance in IV fluid resuscitation.
Read MoreCase 1: 18 wk patient with vaginal spotting who is Rh- but antibody+
Bedside U/S shows fetal abnormality due to Rh alloimmunization with fetal hydrops. Positive antibody screening on gravid female should warrant obstetric consultation. Rhogam administration within 72 hours of bleeding is important.
Case 2: 40 wk female with gestational DM present with crowning fetus who fails to immediately deliver secondary to shoulder dystocia.
Treatment: stop pushing and avoid traction. Initially attempt hyperflexion of legs and suprapubic pressure to release (McRoberts maneuver). Then consider episiotomy because subsequent maneuvers involve twisting the baby to get shoulder into a different plane.
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.
