Grand Rounds Recap 11.15.23
/We had another excellent Wednesday at UC Grand Rounds. Dr. Lewis kicked us off with ear emergencies and their ED management.
Read Moreemergency medicine tamed
Taming the SRU. The SRU is the "Shock Resuscitation Unit." It is a crucible of clinical training for the residents of the University of Cincinnati Emergency Medicine Residency training program.
We had another excellent Wednesday at UC Grand Rounds. Dr. Lewis kicked us off with ear emergencies and their ED management.
Read MoreWe had a jam packed grand rounds this week, which was started off strong by Dr. Knight taking us through identifying sick vs. not sick patients. Drs. Della Porta and Kimmel then battled it out in this years first CPC. Next we were taken through acute ischemic stroke updates with the stroke team duo Drs. Demel and Kreitzer, followed by a quick hit lecture on AV blocks for the EM physician by Dr. Lang. We finished off the day with our R4 capstone reviewing over-testing in the ED with Dr. Yates followed by a review of what data to trust with Dr. Freiermuth and Sucharew for Research Grand Rounds.
Read MoreThis week we start off with Drs Davis and Paulsen in a CPC of an infected thyroglossal duct cyst. We then had two tox presentations on ethylene glycol poisoning as well as a trip through all those poisonous plants you knew once. Drs. Zalesky and Wosiski-Kuhn then take a trip around the latest research in EM!
Read MoreJoin us as Dr. Frederick discusses a case of massive upper GI bleeding, Dr. Kletsel challenges Dr. Ham to a battle of wits in CPC, Dr. Chhabria spills the salt on ‘dysnatremias’, Dr. Frankenfeld discusses posterior strokes, and Our CCHMC PEM colleagues brief us on pediatric broken bones!
Read MoreThis week Dr. Freiermuth showed us how to create a research project. Drs. Tillotson and Makinen discussed the evidence on open fracture management. The R2 CPC between Drs. Ramsay and Nagle taught us an important lesson on HIV and ITP. Finally, Drs. Iparraguirre, Li, Makinen, and Mand created a simulation to teach management of a pediatric nicotinic poisoning.
Read MoreGrand Rounds this week started with airway QI and COVID-19 airway management per the consummate expertise of Dr. Carleton. Dr. Mullen then taught the pearls and pitfalls of urine drug screens, Dr. Paulsen arose victorious from CPC vs. Dr. Wolochatiuk, and Dr. Ijaz gave a stellar review of ear pathology in the ED. Finally, Drs. Golden, Ham, and Spigner took us on a tour de force remote simulation of structural collapse with crush syndrome complicated by hyperkalemic arrest.
Read MoreIn this week’s Grand Rounds we discussed spinal fractures and imaging of knees and hips with our R1s, Drs. Kimmel and Gressick. Dr. Hassani from the R2 class took on Dr. LaFollette with a case of thyrotoxicosis presenting as a-fib with RVR in his CPC, and Dr. Koehler from the R3 Class taught us about heroin/naloxone-induced pulmonary edema. Dr. Golden from the R4 class discussed Fournier’s Gangrene complicated by sepsis-induced cardiomyopathy, and finally our trauma surgery colleague Dr. Pritts discussed some hot topics in trauma.
Read MoreThis week in grand rounds we discussed all types of critically ill patients, first covering the spectrums of hypothermia and shock. We then had a fascinating case follow up on a patient who developed torsades des pointes, and learned how to perform the HINTS exam and incorporate it into our practice. We then discussed pediatric osteomyelitis and it’s subtle presentation, and finally covered musculoskeletal ultrasound of the shoulder, knee, and ankle.
Read MoreThis week’s Grand Rounds opened with Dr. Koehler leading small group discussions on the applications and limitations of VBGs. Dr. Bonomo expertly identified the correct test of choice and diagnosis in Dr. Spigner’s CPC. Dr. Soria then gave an interesting talk on the history behind naloxone as well as common uses. Finally, the Air Care team led a great hands-on procedure workshop!
Read MoreThis week's Grand Rounds started out with another installment of our leadership curriculum led by Dr. Stettler, where we discussed how to identify and manage finance in leadership. This was then followed by Dr. Makinen's small group session on thyroid diagnostics in the ED. Drs. Gauger and Loftus then went head-to-head on a case of syncope, found to have a massive PE. Dr. Miller then gave a great summary of current thoughts and future approaches to sepsis, followed by Dr. Murphy discussing post-ENT procedure bleeds in the ED. Dr. Curry then finished off the conference with his "Mastering Minor Care" segment on epistaxis.
Read MoreThis week Drs. Jarrell and Nagel kicked off Grand Rounds with their evidence based review of the hypertension management in the ED. Drs. Gorder, Lagasse, O'Brien, and Polsinelli discussed the difficult management of the patient in both cardiogenic and septic shock, reviewed heart murmurs, and endocarditis. Dr. Bryant made us squirm with her Global Health quick hit case review of parasitology, Dr. Lane led a great group discussion about the utility of procalcitonin in adults, and Drs. Habib and Roche ended Grand Rounds with a great CPC case!
Read MoreThis week's grand rounds started off with our EMS team represented by Dr. McMullan updating us on new EMS stroke protocols, an upcoming trial for pre-hospital ketamine use, as well as a refresher on notification calls. This was followed by Dr. Shaw, who made his grand rounds lecture debut discussing the diagnostic and clinical utility of lactate. Drs. Harty and Toth then went mano-a-mano in another installment of the CPC lecture series, during which they discuss the presentation, workup and management of carotid cavernous fistula. Dr. Gorder then presented her clinical soap box, using the example of NG tube placement for SBO as a platform for addressing the impact of dogma within medicine. Our peds EM colleagues then steered the ship for the final 2 hours, discussing 2 oral boards cases (fussiness in a newborn and HSP) as well as putting on a pediatric trauma simulation.
Read MoreThis week in Grand Rounds: lessons learned in mass casualty from our recent experience with a mass shooting, a case of abdominal pain in a patient with a TIPS, understanding the UA, the importance of diagnosing HIV in the emergency department, dental emergencies, point of care ultrasound in pediatrics, and a deep dive into the literature about management of low risk PE.
Read MoreThis week in Grand Rounds: A case of Thyrotoxic Periodic Paralysis, Cardiac Biomarkers, Takotsubo Cardiomyopathy in a head bleed, and pearls of airway management during Air Care Grand Rounds including needle cricothyroidotomy.
Read MoreThis week we had the distinct privilege to learn about empathy from Dr. Ope Adeoye who explored what empathy looks like from the patient's perspective - and why it's difficult to be truly empathic as a young physician. We puzzled over a CPC case of severe chest pain in a young woman. Dr. Harty taught us about the not-so-elusive TACO and TRALI among other transfusion reactions. Finally, Dr. Wurster-Ovalle gave us some pointers on management of unvaccinated children with fever in the ED.
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.