Thyroid studies, often lying in the depths of any medical student differential, are an important tool in the Emergency Physician's toolkit, and knowing what to order when is a key part of using them wisely. This week, Dr. Makinen gives us a breakdown of thyroid pathology and testing.
Read MoreGrand rounds this week started off with a review of the EMTALA law with Dr. Hinckley, as well as some case discussion. This was followed by a presentation from our clinical pharmacists, PharmD's Nicole Harger and Madeline Stephens, on anti-epileptic medications and their uses, as well as an update on our medication supplies in the ED. Drs. Murphy-Crews and Scanlon then presented their evidenced based algorithm for the management of STEMI, followed by our combined peds EM lecture with Dr. Kevin Overmann on the evaluation of the pale child and pediatric anemia. This was followed by Dr. Ludmer's R4 case follow up/best of residency cases. The day finished up with Dr. Sim Mand presenting her clinical diagnostics lecture on the assessment and management of the non-pregnant patient with abnormal uterine bleeding.
Read MoreThis is our inaugural edition of the Ultrasound Case of the Month. In this case we examine an early pregnancy ultrasound with an unusual finding. Read on to learn about a measurement we are often not doing in the ED and what we may be missing.
Read MoreThe first grand rounds of 2018 started out with an R4 Simulation that highlighted the clinical presentation, diagnosis, and management of salicylate toxicity. This was followed by a guest lecture by Dr. Richard Sears, who discussed the benefits of wellness and mindfulness, and how we can apply them in the workplace. Dr. Hall then went over the utility and application of various labs used to evaluate patients with sickle cell disease who present in vaso-occlusive crisis. We then finished the conference with a case based discussion on septic bursitis led by Dr. Mike Klaszky.
Read MoreIn the chilling Winter edition of Annals of B-Pod, we're getting visceral. Delve into the nuances of hematologic emergencies with Dr. Shaw's phenomenal discussion of disseminated intravascular coagulopathy or Dr. Baez's fascinating case of thrombotic thrombocytopenic purpura. Keep your hand on the pulse as Dr. Klaszky discusses ulnar artery pseudoaneurysm. Keep an eye out for these excellent articles and more as we delve into the gritty inner-workings of the human machine in the latest edition of #AoBP!
Read MoreIt's been a busy night in the SRU. You've already sent two traumas to the OR, given tPA to an acute stroke, and sent a post-arrest patient up to the MICU. As you walk back to your computer to finally take a sip of now cold coffee, you notice there's a new patient in A2. The chief complaint, conjunctivitis. You sigh as you try to recall the differential for the red eye. You think to yourself, I wish they actually covered eyes in medical school. Read on to learn how to care majorly about a “minor” complaint. And no, all is not solved by some antibiotic drops.
Read MoreGiven the morbidity of sickle cell disease, these patients frequently present to the emergency department, raising questions of: what laboratory testing is needed in these patients? And, how do we interpret commonly ordered labs in these patients? This article will discuss the basic principles of these commonly ordered studies in hopes of delineating when they are necessary and how they can help in the evaluation of the sickle cell patient presenting to the emergency department.
Read MoreDIC is a much dreaded dysregulation of the body's natural coagulation infrastructure associated with very high morbidity and mortality. DIC is a diagnosis that emergency providers cannot miss, and in his case Dr. Shaw walks us through the timely identification and treatment of DIC in the emergency department while simultaneously shedding light on much of the controversy that surrounds DIC. Do blood products help correct the coagulopathy? Find out inside!
Read MorePseudoaneurysms are a potentially deadly complication of any traumatic injury to or manipulation of a patient's vascular structures, and are highly morbid when not identified and treated appropriately by medical personnel. In this fascinating case, Dr. Klaszky walks us through the presentation, diagnosis, and management of a traumatic pseudoaneurysm.
Read MoreTTP, ITP, HUS, DIC - the category of hematologic emergencies is rife both with three-letter acronyms and potentially devastating complications for those patients afflicted with them. Told from the perspective of an internist, this article by medicine chief resident Dr. Baez details a case of thrombotic thrombocytopenic purpura (TTP) through the entirety of the patient's care, beginning with its presentation in the ED and ending with patient's ultimate recovery. In this article, Dr. Baez also details the newly minted, clinically-validated PLASMIC score, a scoring system that can be used in the ED to facilitate diagnosis of TTP. Check it out!
Read MoreThe final Grand Rounds of 2017 opened with Morbidity and Mortality led by Dr. Kari Gorder. Drs. Liebman, Banning, and Owens then shared exciting Global Health cases from their travels to Tanzania and Guatemala. Dr. Grace Lagasse gave her soapbox lecture on firearm violence and the Emergency Department. Finally, our dentistry colleagues Drs. McMahon and Dagher refreshed our techniques and skills in the management of dental trauma.
Read MoreIn the penultimate Grand Rounds of 2017 Drs. Klaszky and Spigner gave us an in-depth look of the evidence behind treatment of asthma in the ED and walked up through their new QI/KT pathway. Dr. Summers provided a great review of the resuscitation of the burn victim. We closed things out with our quarterly PEM-EM combined simulation sessions which included cases of children with difficulty breathing, seizure and stridor.
Read MoreWe had a jam packed Grand Rounds this week kicked off by Dr. Carleton's airway lecture discussing tools to maximize fiberoptic intubation success. Next Drs. Roche and Plash led us through wilderness medicine small groups discussing plant ingestions and creative extrication techniques. Drs. Murphy-Crews and Bryant participated in a CPC case with a seizing neonate followed by Dr. O'Brien's discussion of blunt neck trauma. Next Dr. Cotton presented data on physician burnout and how to combat it while Dr. Li wrapped things up with an overview of Kawasaki's disease.
Read MoreIt's late into your shift when a 12 month-old rolls into your trauma bay and have reproducible abdominal pain. Do you go straight to CT? LFTs? UA? Dr. Shan Modi takes us through the literature and utility of laboratory studies and EKGs in pediatric trauma.
Read MoreLast week we introduced to you a primer on the interpretation and detection of heart blocks on EKGs. Now you can test out your knowledge with some cases based on the information in the previous post!
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.
