Grand Rounds Recap 1.17.24

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Grand Rounds Recap 1.17.24

Join us as we recap another fantastic Grand Rounds session. We started off with our longitudinal leadership curriculum, specifically focusing on recruitment and building a team. This was led by two prominent leaders in our very own emergency department- Drs. Fermann and LaFollette. Next, we join Dr. Finney on a journey as she reflects on the relationships we build with our patients and their families, as well as providing insight on how to cope with the grief that we may face following the most difficult cases. Lastly, Drs. Chhabria, Davis, and Gobble, help us prepare for the upcoming ITE exam by providing us with useful quick hits relating to orthopedic injuries, PEM, and toxicology.

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Grand Rounds Recap 1.10.24

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Grand Rounds Recap 1.10.24

We started off the day strong with a R4 Case Follow Up lecture presented by Dr. Yates who led an excellent discussion on psychosis, including maintaining a broad differential for secondary psychosis and appropriate management. We then transitioned to an R1 Clinical Knowledge lecture where Dr. Segev guided us through interstitial lung disease and fibrosis ranging from epidemiology to diagnosis and treatment. This then followed by a hand-on high acuity low opportunity procedure review including esophageal balloon tamponade, transvenous pacemaker placement, and chest wall escharotomy. The hands-on sessions continued into the afternoon where our CCHMC colleagues led a simulation on neonatal shock. Overall, a great day at UCEM Grand Rounds!

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Grand Rounds Recap 1.3.24

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Grand Rounds Recap 1.3.24

We are back and ready for our first grand rounds of the year! We had a great variety in lectures today. Dr. Wosiski-Kuhn shared her capstone on violence against healthcare workers. Dr. Martella followed up a case of a patient with a spontaneous coronary artery dissection and their puzzling ED clinical presentation. Dr. Guillaume helped us troobleshoot and optimize our options for vascular access including EJ cannulation, ultrasound-guided IVs and all things PICC line. Dr. Haffner took us through a pathophysiology and treatment review of a patient with a very large calcium channel blocker overdose. The R2 team of Drs. Della Porta and Hajdu presented their protocol on alcohol withdrawal in the ED. We learned about the use of panorex as a new study for certain dental patients in conjunction with oral surgery from Dr. Urbanowicz. Finally, Dr. Baez dropped some protips to be confident and competent at a busy community ED site.

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Grand Rounds Recap 12.20.23

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Grand Rounds Recap 12.20.23

This week we started off with a riveting M&M presented by Dr. Kletsel, where we discussed massive GI bleeds, renal abscesses, and more. This was followed by a face off for the ages between Drs. Beyde and Bonomo on an uncommon presentation of thyrotoxicosis. Finally, a group of R4s led us through an educational simulation of BRASH syndrome and some informational oral boards style cases.

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Grand Rounds Recap 12.6.23

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Grand Rounds Recap 12.6.23

What a great Wednesday at UCEM Grand Rounds! To start off the morning, we had the absolute honor to host NFL Players Association Medical Director Dr. Thom Mayer who guided us through a lesson on leadership via examples in the NFL. We then transitioned to our quarterly EMS grand rounds where we discussed updated Southwest Ohio EMS protocols with EMS fellow Dr. Weekley. Following this, we brought out our competitive sides by participating in a game of sports medicine jeopardy led by Dr. Betz, one of our sports medicine trained faculty members. Dr. Fabiano then gave an insightful capstone lecture on reflecting on what you want to do with your life, particularly outside of our careers. We then transitioned back to the clinical space for Dr. Snyder’s informative lecture on prosthetic valve emergencies. Finally, we wrapped up the day with a quality improvement and knowledge translation lecture about spontaneous intracerebral hemorrhage.

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Grand Rounds Recap 11.29.23

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Grand Rounds Recap 11.29.23

This week’s grand rounds was packed with education! We started off the day with our morbidity and mortality conference which was led by chief resident, Dr. Stark. She discussed multiple high yield cases including immunosuppressed patients with fever, subarachnoid hemorrhage, complex trauma resuscitations, stridor in the adult, posterior circulation stroke, and finally an interesting case of Lemierre syndrome. Following M&M, Dr. Wolski took on Dr. Broadstock in an epic clinical pathologic case where the ultimate diagnosis in a child with abdominal pain was a bezoar. This was then followed by Dr. Newton’s R1 Diagnostic and Therapeutics lecture on Troubleshooting tubes in the ED including G-tubes, foley catheters, and suprapubic catheters. Finally, we wrapped up the day with R3 small group sessions. Dr. Harward led a session on ***. Meanwhile, Dr. Moulds discussed pharmacotherapy. Last but certainly not least, Dr. Sobocinski reviewed ***. All around, an excellent day at UCEM Grand Rounds!

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Grand Rounds Recap 11.8.23

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Grand Rounds Recap 11.8.23

We start off the day with our quarterly Airway Grand Rounds, where Dr. Carleton discussed the intricacies of performing an awake look intubation. We then transitioned into a brief operations update on the department, followed by a great discussion regarding heavy metal toxicity with Dr. Boyer during his R1 Clinical Knowledge lecture. We were then honored to host Dr. Curran, an associate professor in the Division of Hematology Oncology and specialist in acute hematologic malignancies, for our consultant corner where we discussed acute leukemia. Finally, we wrapped up the day with combined grand rounds with our pediatric colleagues where we practiced a case of DKA during simulation as well as discussed pediatric EKGS and airways. Lots to learn this Wednesday!

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Grand Rounds Recap 11.1.23

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Grand Rounds Recap 11.1.23

This week Grand Rounds kicked off with a range of complicated cases including of choledocholithiasis, syphilis, and hyperthermic-associated toxidromes. Dr. Bryant than presented on burns in a low resource setting for our global health lecture. Drs. Goel and Thompson discussed the decision rules for head and C-spine imaging. And Drs. Gallen, Brower and Finney finished off our resident lectures for our core content.

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Serratus Anterior Plane Blocks for Rib Fractures in the ED

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Serratus Anterior Plane Blocks for Rib Fractures in the ED

Rib fractures occur in up to 10% of all traumatically injured patients and these fractures are frequently associated with respiratory complications such a pneumonia. In the ED, our typical protocol to decrease the incidence of these respiratory complications is early initiation of aggressive pain control and pulmonary hygiene. These patients often will receive systemic analgesia with opiates to decrease the incidence of these respiratory complications, which leads to its own set of opiate associated-complications, including constipation, delirium and dependence.

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Sound Waves for Shoulder Dislocations

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Sound Waves for Shoulder Dislocations

Shoulder injury and dislocations are common reasons for patients to present to the emergency department (ED) for evaluation. As ED physicians we often must determine whether the shoulder is fractured, dislocated, or both. Most of the time this is done through the use of physical examination in addition to the use of a plain film radiograph of the shoulder.

 The use of ultrasound in the diagnosis and management of musculoskeletal injuries is becoming more common. While it currently does not supplant the use of radiographs, it can be a useful adjunct to the management of these patients.

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The Lever Test for Diagnosing ACL Injuries

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The Lever Test for Diagnosing ACL Injuries

The anterior cruciate ligament (ACL) is one of the most commonly injured knee ligaments, with nearly 200,000 injuries annually in the US, with ~100,000 requiring reconstruction. The ACL prevents anterior translation of the tibia relative to the femur and is a secondary restraint to tibial and varus/valgus rotation. Accurately diagnosing ACL injuries in the ED after an acute knee injury remains difficult. The diagnosis is complicated because clinical tests are performed on an acutely injured knee, which is likely swollen and painful, leading to muscle contractures and patient apprehension. As Emergency Medicine physicians, we must have some confidence in suspicion of an ACL tear because not all patients can or should be referred for prompt orthopedic follow-up. 

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Grand Rounds Recap 10.4.23

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Grand Rounds Recap 10.4.23

This week’s Grand Rounds kicked off with a series of involved cases including endocarditis strokes, Tasotsubo cardiomyopathy and more. Dr. Freiermuth gave us an update on the landscape of research and move to adaptive designs. Drs. Sookdeo and Diaz gave talks on RCVS, PRES and compartment syndrome for some core content.

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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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Twists and Turns: Identifying Maisonneuve Fractures in the ED

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Twists and Turns: Identifying Maisonneuve Fractures in the ED

A Maisonneuve fracture is a specific ankle fracture pattern that involves the medial malleolus, syndesmosis and proximal fibula. It can be easily missed if a provider does not routinely evaluate the proximal fibula as part of their ankle examination, as x-rays of the ankle can often appear normal. Disruption of these structures yields an unstable ankle fracture, thus making close follow up for operative management imperative. It is key to identify this fracture when patients present to the Emergency Department with ankle injuries to ensure definitive management and prevention of complications down the line. 

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