Grand Rounds Recap 12.5.2018

Grand Rounds Recap 12.5.2018

We had another excellent Grand Rounds this week! Dr. Carleton started us off with some thrilling airway cases in his continuing Airway Grand Rounds series. Next, we were transported to Africa for a case based discussion on Global Health with Drs Owens, Sabedra, Ventura, and Murphy-Crews. Dr. Skrobut and Chris Shaw then took us through a deep dive of the current literature on the management of upper GI bleeds. Dr. Ham then taught us about ACE-I induced angioedema through the lens of an amazing case of a patient who required a cricothyrotomy to save her life! Next up, we had Dr. Gleimer go up against Dr. Faryar in our Clincal Pathological Case series where we a classic presentation of Addison’s disease in a pediatric patient. Dr. Hunt then led us through small group discussions on the application of the HEART Score in patients presenting to the ED with chest pain. We wrapped up the day with Dr. Isaac Shaw who presented a the management of SVT in a complicated patient.

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Grand Rounds Recap 11.9.16

Grand Rounds Recap 11.9.16

This week we got put in the hot seat with oral boards on AAA rupture, SVT and eclampsia, a simulation with end-of-life discussions, a critical beta blocker overdose from Dr. Lagasse and some Peds EM tips on conscious sedation from Cincinnati Children's PEM Fellow Dr. Lee. Click to check out more highlights from this week's Grand Rounds!

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Grand Rounds Summary 3/9/2016

Grand Rounds Summary 3/9/2016

Back Pain with Dr. Summers

Of the more than 2.5 million ED cases of back pain every year, roughly 5% of these actually have an emergent cause. Conventional red flags include:

  • Age >50 or <20 yo
  • History of cancer
  • Immunocompromised
  • HIV
  • Steroid use
  • IV Drug Use
  • Known aortic aneurysm
  • Motor neurologic deficit
  • Urinary retention, bowel incontinence, or saddle anesthesia
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Grand Rounds Recap 10/7

Grand Rounds Recap 10/7

Evidence Based Medicine on Tachydysrhythmias with Drs. Ludmer and Miller

  • SVT is an umbrella term that includes AVNRT, atrial fibrillation and flutter, and polymorphic multifocal atrial tachycardia (MAT)
  • AVNRT (AV Node Re-entrant Tachycardia) is the correct term for what is commonly diagnosed as SVT, 
  • MAT usually occurs in critically ill elderly patients with respiratory failure and is a poor prognostic sign, associated with 60% in hospital mortality. Treatment is to treat the causative pathology.
  • REVERT Trial: Modified valsalva vs standard valsalva performed in 10 EDs with 428 patients in England. Findings included a 17% conversion with standard methods and 43% with the modified valsalva. 
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Annals of B-Pod: Pediatric SVT Case and Expert Discussion

Annals of B-Pod: Pediatric SVT Case and Expert Discussion

Neonatal SVT

The patient is a healthy 3 week old male with no past medical history. He was born full term via uncomplicated Cesarean Section who presents with increased fussiness. His mother states the patient has simply not been acting like himself.  He was taken home on hospital day 1 without issues, but in the last 24 hours, he has been quite fussy.  His mother became concerned when he was unable to take his bottle today.  The child has been refusing to eat and has been increasingly difficult to console. He has also had less wet diapers than normal today. Mom has not noticed cyanosis during feeding, recent illnesses or fevers. She also denies the presence of emesis, diarrhea, rashes, congestion, or cough.

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