This week at UCEM Grand Rounds we had our annual Disaster Day run by the Division of EMS. We discussed our local resources and then participated in a two hour simulated disaster exercise in which a dirty bomb exploded. Dr. Calhoun then closed things out with a discussion on radiation injuries and Hazmat precautions.
Read MoreThis week’s Grand Rounds was kicked off with our W. Brian Gibler visiting professor series with Dr. Ali Raja M.D., MBA, MPH, and Vice Chair of Emergency Medicine at Massachusetts General Hospital. He gave us his insights on how to help move our specialty towards evidence based practice, as well as his tips on leadership within the context of academic emergency medicine. This was followed by our monthly Morbidity and Mortality Conference with Dr. Titone. Dr. Shah then gave his R4 Clinical Soap Box on the utility of ultrasound in cardiac arrest, and the conference finished with Dr. Whitford giving his R3 Taming the SRU case follow up.
Read MoreHemolytic Disease of the Fetus and Newborn (HDFN) is an alloimmune disease which develops in a fetus when a women’s immune system is sensitized, developing antibodies which cross the placenta and attack fetal RBCs.
While there is a spectrum of the disease, in severe cases the fetus can ultimately develop hydrops fetalis which is often fatal.
As Emergency Physician’s we are classically taught that we can help to prevent HDFN by recognizing sensitizing events in Rh-negative women and subsequently providing RhoGAM. But which patients really need RhoGAM? The evidence seems to be lacking and recommendations are often inconsistent.
Read MoreThe Global Health case series highlights interesting cases residents experienced while abroad and takes a dive into how to identify the pathology that is crucial know to care for patients both abroad and returning. Dr. Banning discusses challenges associated with treatment of a rash she frequently encountered while on a recent trip to Tanzania.
Read MoreThis week we got a refreshing look at soft tissue ultrasound from our US guru Dr. Stolz. We then moved to the opposite end of modern imaging with the rarely indicated but intermittently very useful KUB by Dr. Skrobut. Drs Kiser and Ventura battled it out in a CPC case of pyloric stenosis then the R4s ran a simulation and small group on global health pathologies.
Read MoreIs the KUB a relic of an era of simpler diagnostics or a viable alternative to the cost and radiation of cross-sectional imaging? Join Dr. Skrobut as he parces through the indications, pathologies and literature of the abdominal plain film.
Read MoreAir Care Series is back! This time with one of the most feared procedures in pre-hospital medicine: the Resuscitative Hysterotomy (aka peri-mortem c-section). Pregnant patients scare us, but coding pregnant patients scare us even more. Read on to learn not only when to perform this procedure, but how to perform it properly and safely.
Read MoreAnd lo, as the gellid depths of winter give way to the fairer climes of spring, another issue of the Annals must too follow. The spring issue focuses primarily on perplexing neurological maladies that plague our patients, including a case series on meningitis as well as Dr. Makinen's phenomenal write-up of a fascinating presentation of Creutzfeldt-Jakob disease. Also be on the look-out for an excellent review of anticoagulant reversal agents and my own piece on a caustic laundry pod ingestion. So take a moment to stop and smell the roses as we welcome another edition of #AoBP!
Read MoreThis week we learned from Dr. Palmer the key skills of dealing with failure - how do we recognize it and how do we shape our behaviors because of it. Dr. Shah, Peds EM fellow then discussed a differential of stridor in the pediatric patient.
Read MoreWhat's in a name? That which we call Creutzfeldt-Jakob disease by any other name would be as devastating. And how, do neurologists ever love their names! CJD - also known as "spongiform encephalopathy" and the comically grim "mad cow disease" - is an uncommon but uniformly fatal form of rapidly progressive dementia. In this case, Dr. Makinen takes us through the presenting features, definite diagnosis, and emergent management of the prion-mediated encephalopathy we call CJD. An entity which would, were it not CJD call'd, retain its dear morbidity.
Read MoreIf nothing else, the "Tide Pod challenge" has demonstrated that these versatile detergents truly excel in their intended purpose, cleaning not only dirt and sweat from your clothes but also purging the naive, vain preadolescent innocence from society. Join me - Dr. Scanlon - as I detail a fascinating case of a caustic ingestion, exploring the natural history, emergent management, and ultimate sequelae of this potentially devastating exposure.
Read MoreNot every swollen knee is an emergency, but treatments can vary between NSAIDs and an operative wash-out. Drs LaFollette and Stolz walk through the use of bedside ultrasound to focus our ED care.
Read MoreOur Minor Care Series continues with another case of the red eye! This time we discuss uveitis. But what exactly is the uvea? Is uveitis the same as iritis? And what do these patients need in the ED? Read on to answer these questions and more!
Read MoreThis week's Grand Rounds opened with Dr. Ludmer giving Morbidity and Mortality conference. Sports Medicine Dr. Betz then took on the common chief complaint of ankle pain, and described the evidence-based management and common ankle sprain mimics. Dr. Shaw discussed basics on tracheostomies and Dr. Renne closed out Grand Rounds with his approach to the judicious use of IV fluids in septic shock.
Read MoreThis is Case #2 of our Air Care Orientation Curriculum! This curriculum is designed to help prepare our rising R2's for their new responsibility as flight physicians. These cases are discussed amongst our training flight docs and this is the resultant learning points. In this case, we discuss a critical patient with a head injury. What interventions need to be performed? In what order? Who should do them? Read on to find out.
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.
