The Approach to Neuromuscular Weakness

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The Approach to Neuromuscular Weakness

Weakness is a common, though sometimes vague, presenting symptom in the ED. Neuromuscular (NM) weakness can have various causes, ranging from common and relatively easy to diagnose conditions (such as strokes and trauma) to less common and more difficult to diagnose ones (such as vascular pathologies, infections, autoimmune diseases, and neoplasms). This post focuses on how to localize weakness to differentiate types of NM weakness and presents classic cases of diffuse weakness caused by three diseases.

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Grand Rounds Recap 1.24.24

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Grand Rounds Recap 1.24.24

This week at Grand Rounds we started off with a lively discussion of some unique case presentations during M&M presented by Dr. Yates. Drs. Wosiski-Kuhn and Stothers then walked us through the most pressing research papers in our Mini-Lit Blitz, followed by Dr. Benoit talking us through ideal Post-ROSC Care. Finally, our QI/KT on necrotizing soft tissue infections was expertly presented by Drs. Schor and de Castro.

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Grand Rounds Recap 9.27.23

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Grand Rounds Recap 9.27.23

It was a stellar week here at UCEM Grand Rounds! We kicked off the day with a lecture from our colleague at CCHMC, Dr. Dean, about management of pediatric airways. We then transitioned to a review of landmark studies in EM, specifically with regards to targeted and systemic thrombolysis for MI, stroke, and PE. We continued our day by discussing evidence based medicine and the implementation of this in the prehospital setting with EMS faculty, Dr. Richards. Next, Drs. de Castro and Thompson faced off in an epic battle of CPC where we covered the diagnosis and management of euglycemic DKA. This was then followed by Dr. Vaughan’s R1 diagnostics and therapeutics lecture on pneumothoracies. Finally, we wrapped up the day with Dr. Gillespie’s R4 capstone lecture.

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Grand Rounds Recap 8.2.23

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Grand Rounds Recap 8.2.23

We had a jam packed grand rounds this week, which was started off strong by Dr. Knight taking us through identifying sick vs. not sick patients. Drs. Della Porta and Kimmel then battled it out in this years first CPC. Next we were taken through acute ischemic stroke updates with the stroke team duo Drs. Demel and Kreitzer, followed by a quick hit lecture on AV blocks for the EM physician by Dr. Lang. We finished off the day with our R4 capstone reviewing over-testing in the ED with Dr. Yates followed by a review of what data to trust with Dr. Freiermuth and Sucharew for Research Grand Rounds.

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Grand Rounds Recap 5.25.22

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Grand Rounds Recap 5.25.22

Join 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!

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Grand Rounds Recap 11.3.21

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Grand Rounds Recap 11.3.21

During 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.

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Grand Rounds Recap 9.8.21

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Grand Rounds Recap 9.8.21

Join us as we recap another informative week of grand rounds, exploring opiate use disorder and medication assisted therapy, cerebral venous sinus thrombosis, caring for immunosuppressed heme-onc patients with new therapies, high-value care, perforated peptic ulcers, and laryngectomy tubes!!

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Grand Rounds Recap 9.1.21

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Grand Rounds Recap 9.1.21

Another excellent week of Grand Rounds reflection and learning. Check out the recap here as Dr. Curry shares insights from his work with OH-TF1 on the Surfside Building Collapse, Drs. Kein and Stark provide evidence-based recommendations for management of NSTEMI patients, Dr. Hunt discusses a case of basilar stroke in a patient with SLE, Dr. Milligan challenges Dr. Benoit with a pediatric acute urinary retention case, and Drs. Goff, Ramsey, and Zalesky provide quick hit wisdom in the “There will be blood” edition of the R3 small groups.

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Grand Rounds Recap 04.07.21

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Grand Rounds Recap 04.07.21

This week in Grand Rounds we discussed the management of early pregnancy loss with OBGYN, things you don’t know you don’t know when you graduate with Dr. Paulsen, a case of tumor lysis syndrome with Dr. Laurence, an R4 case follow up with Dr. Hall, and our quarterly simulation with a myxedema coma case.

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Grand Rounds Recap 01.20.2021

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Grand Rounds Recap 01.20.2021

This week’s edition of grand rounds featured some amazing lectures! We practiced pitching ideas in our leadership curriculum then the newest QI/KT pathway was revealed by Drs. Chuko and Goff. Dr Gawron taught us about medical causes of trauma and Dr. Kein gave us an amazing lecture on cyanotic congenital heart diseases. We finished off with Dr. Shewakramani giving an amazing wellness lecture about his BAYLEAF method for dealing with stress in the ED.

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Grand Rounds Recap 01.06.2021

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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 10.21.20

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Grand Rounds Recap 10.21.20

Dr. Freiermuth kicked off this week’s Grand Rounds with a recap of how to approach research in EM. Dr. Leech demonstrated the value to hemorrhage control and fistula complications. Drs. Harty and Comiskey faced off in a CPC case of DRESS syndrome and finally Drs. Gottula and Skrobut gave our quarterly Air Care Grand Rounds on HEMS stroke management.

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Grand Rounds Recap 09.16.20

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Grand Rounds Recap 09.16.20

Join 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.

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Grand Rounds Recap 8.26.2020

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Grand Rounds Recap 8.26.2020

This week we have domgalysis with Dr. Hall, discussing rectal exams in trauma, skeletal traction and repeat head imaging in TBI. We also have a fantastic set of learning pearls from M&M cases with Dr. Li and a case of myesthenic crisis with Dr. Urbanowicz. Finally we have a literature review surrounding the impending Qi/KT algorithm on peritonitis with Drs. Ramsey and Mullen

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