Grand Rounds Recap 4.24.19

Grand Rounds Recap 4.24.19

This week’s grand rounds started off strong with Morbidity and Mortality led by Dr. Baez. She discussed a wide variety of topics including stress testing in the ED, precautions, hearing loss, aspiration, and tamponade. Dr. Randolph followed this up with an insightful discussion on high risk ED discharges. The Global Health Team then shared some of the fascinating cases they encountered overseas. Dr. Sabedra reflected on how much we learn from each other by giving a heartfelt talk on what she has learned from her fellow R4’s. We continued with Dr. Gawron reviewing the many cervical spine rules and how to properly apply them. To conclude, Drs. Skrobut and Roche went head to head in this weeks CPC. Who wins? Read on to find out.

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The Return of Droperidol...

The Return of Droperidol...

Have you heard the news! Droperidol is back and available in the United States.  After a prolonged hiatus the medication has been picked up by a new manufacturer and may be finding its way to a hospital pharmacy near you.  Since it has been some time since the medication has been in common use, and since the memory of its effectiveness may be buoyed by a sense of nostalgia or otherwise viewed through rose colored glasses, now is as good a time as any to take a stroll through the literature and learn a bit more about the effectiveness and side effect profile of the medication.

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Grand Rounds Recap 4.17.19

Grand Rounds Recap 4.17.19

Enjoy this weeks Grand Rounds Summary. We had a great small group session on conflict resolution presented by Dr. McDonough and Leenellett of the leadership curriculum team. Next, Drs. Iparraguirre and Li taught us about an evidence-based approach to epistaxis. We completed our morning going through a great simulation on Acute Myocardial Infarction requiring Thrombolysis with Drs. Colmer, Mckee, Harrison, and Continenza.

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Grand Rounds Recap 4.10.19

Grand Rounds Recap 4.10.19

Have fun reading this week’s Grand Rounds Recap! Dr. McDonough provided an insightful talk on Physician Depression and Wellness to start our morning. Following this, we had an excellent session on TEG’s multitude of uses in the ED. We had a variety of ophthalmology pearls shared by Drs. Owens, Scanlon, Ventura, and Harty. Then, Dr. Krack, one of Cincinnati Children’s Hospital’s Pediatric EM fellows shared helpful hints in taking care of pediatric patients with Congenital Heart Disease. Next, Dr. Pulvino shared her clinical diagnostics lecture on Platelet Disorders. Dr. McKee finished our day with an exciting talk on medical ethics and how they apply to the Emergency Department. Enjoy!

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The A Fib Chicken and Egg - III Recap

The A Fib Chicken and Egg - III Recap

This is the first in a series of 3 blog posts recapping our residency’s most recent asynchronous small group exercise.  For these posts, we’ll start with a case vignette and then highlight some key aspects of the presentation and cover some key learning points. You can also take a listen to the accompanying podcast for a slightly more in depth look at the case.

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Grand Rounds Recap 3.27.19

Grand Rounds Recap 3.27.19

Enjoy this week’s Grand Round’s Recap. Dr. Murphy started us off with a great Morbidity and Mortality conference with a variety of fascinating cases. Next, Dr. LaFollette taught us some pearls for HEENT emergencies if you are out in the community. Dr. Hunt took us through transfusion reactions and how to manage them, followed by Dr. Hall discussing the management pearls of Nonconvulsive Status Epilepticus. Next, Dr. Connelly taught us how we can incorporate alternative EKG leads into our practice, and Dr. Klaszky finished our day with a nuanced take of how to manage refractory septic shock. It was a jam packed day full of great learning!

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Telling Tall Tales: Dogma in Emergency Medicine

Telling Tall Tales: Dogma in Emergency Medicine

In our training and education as Emergency Medicine providers, we often come to accept certain practice patterns as fact. When these established “facts” come along with fantastical clinical claims (don’t give your corneal abrasion patients tetracaine, it’ll melt their corneas; don’t use lido with epi for digital blocks, their finger will fall off; don’t use beta-blockers in patients on cocaine, their BP will skyrocket due to unopposed alpha-effects), we should probably look to question their supporting evidence.

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Grand Rounds Recap 3.20.19

Grand Rounds Recap 3.20.19

Enjoy this week’s Grand Rounds Recap! Dr. Jordan Bonomo started us off with a fascinating talk on brain death, and how therapeutic hypothermia in the post-arrest patient can make this diagnosis more challenging. Next up, Dr. Harrison taught us some pearls on management of the bradycardic peri-arrest patient. Dr. Nagle shared with a us how to rescuscitate a patient with acute aortic dissection. Lastly, Dr. Summers talked to us about PRES and how to recognize and treat this rare disorder.

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Grand Rounds Recap 3.13.19

Grand Rounds Recap 3.13.19

This week’s Grand Rounds began with a practical discussion of the CBC and differential by Dr. Hassani. Dr. Hughes and Thompson led a fantastic CPC on a case of myxedema coma, and Dr. Whitford discussed CT over-utilization in the emergency department. We finished the day with our pediatrics colleagues who walked us through anxiety-provoking cases of aortic coarctation, bacterial tracheitis, and neonatal jaundice. Check it out!

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Grand Rounds Recap 3.6.19

Grand Rounds Recap 3.6.19

From surgical airways to the undifferentiated shock patient, this week’s Grand Rounds was packed full of clinical pearls. Dr. Carleton started with a discussion of a tachycardia-inducing failed airway requiring cricothyrotomy. Drs. Jensen and Makinen presented a very detailed review of the literature and their proposed algorithm on infective endocarditis. Dr. Harty reviews a fascinating case of cecal volvulus that was identified early with the aid of a RUSH exam, while Dr. Liebman walked us through an approach to the patient with inhalation injuries. Finally, Dr. Roblee led an excellent review of SBP. The discussion was full of information you might use on your next shift!

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The CBC and the Man Behind the Curtain

The CBC and the Man Behind the Curtain

It’s been called “the refuge of the intellectually destitute (physician)” by Amal Muttu. The CBC is a much maligned test that is nevertheless one of the the most frequently ordered diagnostic tests in the ED. To truly know how to interpret this test, one must understand its individual components, the possible causes of variations from normal for those components, and how it integrates into the clinical presentation of the patient. Also, it can’t help but to know and understand some of the historical background…

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Pneumonia Alphabet Soup

Pneumonia Alphabet Soup

Pneumonia. It’s one of the first conditions we learn to diagnose as medical students. It was probably the cause of the first really sick, septic geriatric patient you saw in residency. Conversely you have also probably sent a fair share of patient’s home with an outpatient course of antibiotics and PCP follow-up.  While determining the appropriate treatment and disposition for patients on the extreme ends of illness severity is quite straight forward; that pesky majority in the middle can be a conundrum at times. Who can go home? Who needs broad spectrum? Who needs step-down? Over the last two decades there has been a smorgasbord of pneumonia related acronyms used in clinical practice to predict severity, guide therapeutics and recommend disposition. During our most recent resident Journal Club, we took a look at a handful of the more familiar acronyms as well as some new ones coming down the pipeline.

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Grand Rounds Recap 2.20.19

Grand Rounds Recap 2.20.19

This week’s grand rounds started with Dr. Colmer reviewing some fascinating cases in this months Morbidity and Mortality. We then split up into groups and did the quarterly sim focusing on informed consent led by Drs. LaFollette and Lang. This was followed by some challenging oral boards cases chosen by Drs. McDonough and Hill. Look forward to next week!

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Grand Rounds Recap 2/13/19

Grand Rounds Recap 2/13/19

This week, we started Grand Rounds with ED-critical care research brought to us by UC Alumnus Dr. Brian Fuller. He discusses ventilator management in the ED and how ED sedation may affect patient outcomes. Dr. Harrison then presented an overview and common utilization errors of ED observation from his year as a Resident Assistant Medical Director, followed by Dr. McKee’s case of inhalational chlorine exposure. Dr. Alwan discussed updates to the less than 60 day fever protocol at CCHMC and Dr. Zozula walked through the dispatcher assistance protocols to give us an idea of what happens before they enter the ED doors.

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Grand Rounds Recap 2/6/19

Grand Rounds Recap 2/6/19

It was an exciting week of Grand Rounds! We had the honor of hearing from legendary UCEM graduate Dr. Susan Stern who was the Dr. Gibler Visiting Professor. She discussed hemorrhage in trauma and the changing landscape of leadership in medicine. This was followed by operations updates with Dr. Palmer, and Dr. Laurence discussed AIDS-defining illnesses in her clinical knowledge lecture. The day concluded with a review of some Air Care cases. Check it out!

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