October US Case of the Month - Multi-organ US for Diagnosing PE

October US Case of the Month - Multi-organ US for Diagnosing PE

PE is often a considered and easily risk-stratified diagnosis, however what about when you take away your definitive test of the CTPA? Dr. Ham examines the 60/60 sign and other ultrasonographic tests you can use to determine the acuity of right ventricular strain which is addition to the clinical and hemodynamic evaluation can help you triage additional strategies to traditional anticoagulation.

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Grand Rounds Recap 1.31.18

Grand Rounds Recap 1.31.18

In this week's grand rounds, Dr. Stolz discussed all things DVT and the modified two-point compression study for lower extremity clots. In our recurring EM-neuro combined conference, Dr. Stettler discussed the recent DAWN trial results, and how to incorporate CT perfusion studies into our acute ischemic stroke decision trees. In our Quarterly Sim, we discussed the management of the crashing patient from a house fire, and practiced our escharotomy skills. In our mock oral boards, we went through cases on STEMI, carbon monoxide exposure and limb ischemia. Finally, Dr. Lane discussed the workup of acute diarrhea in the adult population, and Dr. Shah went through a particularly unique toxidrome presentation in his R4 Case Follow Up. 

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Vascular Ultrasound - Aorta & Lower Extremity Veins

Vascular Ultrasound - Aorta & Lower Extremity Veins

It's a frosty Easter morning and the ED is "q!&%t," all except for the 2 patient's turned over to you by the night ranger.  You greet the first patient, a 75 yo M complaining of flank pain - probably a kidney stone you think to yourself as you walk in to the room.  Walking into the room, you see the patient rolling around on the stretcher (as one would expect from those with a stone jammed in the UVJ), but something about his presentation strikes you as odd - a bit of diaphoresis, clammy pale skin.  It could just be pain, but the specter of a ruptured abdominal aortic aneurysm still looms large in your differential diagnosis.  You quickly exit the room, grab the ultrasound machine and head back in to take a look at his aorta...

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Grand Rounds Recap - 3/25/15

Grand Rounds Recap - 3/25/15

Mortality & Morbidity Conference with Dr. Bohanske

Remember that sometimes the thing a patient needs most is a specialist (i.e surgeon), especially trauma patients

  • Sharps in hectic situations, such as any resuscitation, are dangerous not just for the patient but also for providers as this is one of the most common situations leading to bloodborne pathogen exposures
  • Remove sharps from the field anytime you do not need them and always be responsible for your own sharps to keep your team safe
  • Keep in mind that early predicators of hemorrhagic shock are pulse and mental status/anxiety as BP changes are later indicators
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