This week’s grand rounds started with Dr. Colmer reviewing some fascinating cases in this months Morbidity and Mortality. We then split up into groups and did the quarterly sim focusing on informed consent led by Drs. LaFollette and Lang. This was followed by some challenging oral boards cases chosen by Drs. McDonough and Hill. Look forward to next week!Read More
There are many groups of patients that alter how we must evaluate and interpret our diagnostic studies in the setting of baseline chronic laboratory abnormalities, which is often challenging. One especially challenging patient population are patients with chronic liver disease, and in this post Dr. Jarrell will take us into how their disease process creates chronic and acute on chronic derangements of which we need to be aware in daily and emergent management of these patients.Read More
Morbidity and Mortality Learning Points with Dr. Stull
1. Should Post-ROSC patients get cardiac cath?
- Cardiac arrest patients who have STEMI on EKG after ROSC tend to have good outcomes (overall survival and intact neurologic survival) if they get cath'ed.
- According to latest Australian study (all patients with ROSC from OHCA, not STEMI) OR for overall survival is 2.77 and OR 2.2 for good neurologic outcome
- VT/VF cardiac arrest patients who do not have a STEMI on EKG: improved survival and likelihood of good neurologic outcomes if cath'ed within 24 hours.
- Our cardiology department wants all post-ROSC VF/VT patients to have cath lab activation. All other post-ROSC cases, call cardiology to discuss need for cath lab
- All post-ROSC STEMI should go to cath lab no matter what their neuro status is