Grand Rounds Recap 8.22.18

Grand Rounds Recap 8.22.18

The week started off with our AirCare team discussing indications for procedures performed pre-hospital. The AirCare team continued by taking us through several cases in our quarterly AirCare M&M. We then got some oral boards practice with Drs. McDonough and LaFollette. The day finished with a simulation led by Dr. Hill covering patients who wish to leave AMA as well as the terrifying lengthening QTc.

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Grand Rounds Recap - 1/14/15

Grand Rounds Recap - 1/14/15

Oral Boards with Dr. Roche

Case 1 - 37 yo F, G3P2, no prenatal care, somewhere around 3rd trimester, presents with vaginal bleeding. She endorses feeling weak and dizzy and had 1 syncopal episode at home. On arrival, she is tachycardic and hypotensive (80s/60s), has cool extremities with weak peripheral pulse. Fundus is a few cm below xyphoid process. On a sterile speculum exam she has a large amount of bleeding and cervix is dilated to 3 cm. US shows IUP with good cardiac activity. She requires blood rescuscitation and admission to OB for delivery due to placenta previa.

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“I Don’t Care What You Say. I’m Out of Here Doc…”

“I Don’t Care What You Say. I’m Out of Here Doc…”

You take a big breath and walk out of the SRU.  After having just spent the last hour and a half caring for a hypotensive, actively vomiting variceal bleeder, a full arrest that you had to pronounce, and a GSW to the chest that went quickly to the OR, you are dreading to see the state of your Pod.  As you are just about to sneak into your workstation to get your bearings, you’re flagged down by Mr. Finch, the patient in bed 2.

“What can I help you with sir?” <you>

“What do you mean, what can you help me with?  Man just get my paperwork and let me get out of here.  I’ve had it with this place.  I’m tired of being a pin cushion and I’m not going to take this crap anymore.” <Mr. Finch>

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Grand Rounds Recap - 11/19/2014

Grand Rounds Recap - 11/19/2014

Mortality and Morbidity Conference with Dr. Gozman

Thrombocytopenia

Always consider medications as a key cause of throbocytopenia

Recommendations for platelet transfusion currently include:

  • Patients on chemotherapy with <10K
  • Patients requiring central venous access with <20K
  • Patients requiring an LP with <50K
  • Patients requiring non-neurologic surgical interventions with <50K
  • Patients requiring CNS surgical intervention with <80K

There is not data to support platelet transfusion in patients with intracerebral hemorrhage on an antiplatetlet agent

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