A Headache with Consequences - Temporal Arteritis

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A Headache with Consequences - Temporal Arteritis

This will mark the third and final recap of the March 2019 asynchronous small group cases.  Feel free to take a look and listen back at Parts 1 and 2.  This post we’ll be covering the presentation fo a middle aged female with a headache.  The differential is broad and fraught with a number of life/limb/sight threatening diagnoses.  As with the previous recaps, we recorded a podcast where we walk through the presentation, initial work up and management.

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Grand Rounds Recap 4.24.19

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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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Air Care Series: A Case of Massive Clot

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Air Care Series: A Case of Massive Clot

Shan Modi, MD walks us through a critically ill patient with pulmonary embolism then breaks down the literature surrounding the management of Pulmonary Embolism both in the Emergency Department and Critical Care Transport Environment. We will cover fluid support, vasopressor usage, ventilatory management, vasodilators, ECMO and more!

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The Return of Droperidol...

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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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Diagnostics: C-Spine Rules

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Diagnostics: C-Spine Rules

Clearance of cervical spine is more within the house of Emergency Medicine than anywhere else, so it implores that when we clear a cervical spine using our rules, we take a second to consider the sensitivity, specificity and even more importantly the exclusions that were used in the derivation and validations in these studies. Dr. Gawron takes a look through these rules for our review

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Grand Rounds Recap 4.17.19

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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

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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

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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

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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

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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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Diagnostics: Alternative EKG Leads

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Diagnostics: Alternative EKG Leads

Ever have a patient that looks more concerning than their EKG? Perhaps their ischemia is in that anatomically difficult to access right ventricle or even posterior. Join Dr. Connelly in looking at the utility of right sided, posterior and Lewis leads and bring something new to your next chest pain patient.

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Grand Rounds Recap 3.20.19

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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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