QI/KT: Cardiac Arrest

QI/KT: Cardiac Arrest

The first of a new series of posts with associated podcasts looking at the literature behind what we do every day in the ED with takeaways of tangible algorithms to guide every day practice. This month Drs Gauger and Harty lead us in a discussion of cardiac arrest, the drugs we use, the ultrasound we dabble with and the future interventions that could become standard of care.

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Grand Rounds Recap 4.25.18

Grand Rounds Recap 4.25.18

This week’s Grand Rounds was kicked off with our W. Brian Gibler visiting professor series with Dr. Ali Raja M.D., MBA, MPH, and Vice Chair of Emergency Medicine at Massachusetts General Hospital. He gave us his insights on how to help move our specialty towards evidence based practice, as well as his tips on leadership within the context of academic emergency medicine. This was followed by our monthly Morbidity and Mortality Conference with Dr. Titone. Dr. Shah then gave his R4 Clinical Soap Box on the utility of ultrasound in cardiac arrest, and the conference finished with Dr. Whitford giving his R3 Taming the SRU case follow up.

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Grand Rounds Recap 4.18.18

Grand Rounds Recap 4.18.18

This week we got a refreshing look at soft tissue ultrasound from our US guru Dr. Stolz. We then moved to the opposite end of modern imaging with the rarely indicated but intermittently very useful KUB by Dr. Skrobut. Drs Kiser and Ventura battled it out in a CPC case of pyloric stenosis then the R4s ran a simulation and small group on global health pathologies.

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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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Grand Rounds Summary 10.11.17

Grand Rounds Summary 10.11.17

Dr. Stolz started Grand Rounds off with a great talk on lung ultrasound. Our consultant of the month, Dr. Hebbeler-Clark, gave a talk on patient safety and swarms. Dr. Lipshaw, a Peds-EM fellow, discussed the differential, evaluation, and management of congenital heart disease babies in the Emergency Department. Finally, Dr. Teuber ended with an interesting discussion on priapism. 

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Grand Rounds Summary 9.27.17

Grand Rounds Summary 9.27.17

Dr. Titone held a great in-depth M&M this month with cases from tuberculosis to typhilitis (which is a thing). Drs. Baez and Goel took us through cases of coding Torsades and coding Pine Sol ingestions, followed by Dr. Skrobut who delicately closed the day with a discussion of testicular complaints in the ED.

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Grand Rounds Recap 8.9.17

Grand Rounds Recap 8.9.17

This week's Grand Rounds began with Quarterly Sim led by Dr. LaFollette who walked us through a case of cardiogenic shock and neutropenic fever. Dr. Curry led us through an oral boards triple case with an unstable MCC, a FB ingestion and perforated viscous. Dr. Hill presented an eOrals case of thyroid storm. Lastly was PEM-EM combined conference, led by Dr. Wurster Ovalle, which focused on the treatment of pediatric DKA with a special focus on cerebral edema. 

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Grand Rounds Summary 01.18.2017

Grand Rounds Summary 01.18.2017

This week's Grand Rounds started off with a stress-inducing sim written by the R4s that included a pregnant trauma patient with a positive FAST, an imminent delivery and neonatal resuscitation! Drs. Paulsen and Continenza faced off in a great CPC and Dr. DeVries walked us through the history of US use in ED patients. Dr. Golden rounded out our day with a lecture focused on foot and ankle injuries. 

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Grand Rounds Recap 9.21.2016

Grand Rounds Recap 9.21.2016

This week we learned about all the hardware that can go into our patient's CNS and how it can go wrong. We also heard about complications of Varicella infection, set out to optimize visualization of a needle on US, learned to give better feedback to the difficult learner, heard about ED super-utilizers and strategized about ventilator management. 

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Ultrasound in HEMS

Ultrasound in HEMS

Critics out there may slight the use of ultrasound in the prehospital environment, saying it is just going to delay patient transfer and won’t add much to your decision making.  However, when used properly, the ultrasound should never delay patient care and, when used in the correct patient population, it could help greatly in both decision making and treatment. Let’s first talk about when to use it.  The logistics of this may be a bit tricky. 

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