Show Love to Strangers

Show Love to Strangers

To provide a fuller education, our curriculum should occasionally bend from the scientific and technical and include matters of the heart.  This is a case from the early 1990s, a time in this fair land when ultrasound was not part of emergency practice, when RSI was still a relatively fresh concept, when the treatment of shock was non-systematic, and when consultation was a matter of pleading on the telephone. 

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Surrounded by Mysteries We Cannot Hope to Understand

Surrounded by Mysteries We Cannot Hope to Understand

I.C. Cordes submissions arise spontaneously whenever I have something on my mind.  Usually they are concrete lessons in airway management, but recently I have done a lot of airway training and that tank is a little dry.  Hence, this is another foray into metaphysics as I stumble toward the twilight and navigate Erikson’s 8th stage of psychosocial development.

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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 10.24.18

Grand Rounds Recap 10.24.18

It was an exciting week of Grand Rounds where Dr. Colmer presented our monthly Morbidity and Mortality conference. We had a fantastic guest lecturer, Dr. Reuben Strayer (@emupdates), who discussed opioid abuse and airway management. Finally, our consultant of the month was Dr. Amy Makley who discussed blunt abdominal trauma. Take a look!

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The Last Gasp

The Last Gasp

It is undoubted that effective airway management is a critical link in the care of patients with both in-hospital cardiac arrest and out-of-hospital cardiac arrest.  But how exactly should one manage the airway?  What results in the best outcomes for our patients? Should we be aiming to intubate every patient? Or, are extraglottic devices as effective (or more effective)? What about the good old bag-valve mask?  In our most recent Journal Club we explored the evidence surrounding airway management in cardiac arrest, covering 3 high impact articles.  We also touch on an abstract presented at the 2018 SAEM Academic Assembly which should add significantly to the body of literature when it is published in full.  Take a listen to our recap podcast below and/or read on for the summaries and links to the articles.

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Grand Rounds Recap 6.6.18

Grand Rounds Recap 6.6.18

This week we were led through the evaluation and management of the difficult pediatric airway with Dr. Carleton in our quarterly airway grand rounds, and discussed cranial nerve abnormalities with Dr. Neel in our recurring EM-neuro combined conference. Dr. Jarrell presented an interesting case of a child with a cough and weight loss, and Dr. Jensen walked us through the clinical utility of BNP. Finally, Dr. Miller presented an interesting case of a patient with multisystem organ failure and cecum perforation. 

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Grand Rounds Recap 8.23.17

Grand Rounds Recap 8.23.17

Dr. Carleton started things off with a review of oral fiberoptic intubation and a step by step guide to trach recanalization. Next we headed off to EM-Neuro combined conference where Dr. Neel discussed headaches that kill, headaches that maim and headaches that annoy. Dr. Thompson walked us through a case of vertebral artery dissection and Dr. Liebman kicked off our wellness curriculum. Dr. Roche finished things up with a discussion the nuances of toxicology in the community. 

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Airways, like Martinis, are Best "Dry"

Airways, like Martinis, are Best "Dry"

Have you ever looked down the blade of a laryngoscope and said to yourself, “Damn!  This airway is just too dry!”  I thought not.  Rather, we often look down the blade into a mucky swamp of secretions that drip from the pharyngeal walls like drool from a big, sloppy dog, and often obscure familiar landmarks and goop-up our optical and video adjuncts.  Is there no solution?  There is!  Let us review an illustrative case...

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Protect Me! "Flights" #4 Recap

Protect Me! "Flights" #4 Recap

Welcome to the Final Recap of our “Flights” Case Series!

Thanks to all those who participated in the discussion and to those who tuned into the “Flights” cases throughout the spring and summer.  The final "Flights" cases centered in on several challenging airway scenarios.  Penetrating neck trauma with a tracheal injury; GSW to the face with significantly altered anatomy; and a tracheostomy displaced and a patient with critical hypoxia - airway management in the field requires a nimble mind and knowledge of one's own equipment.  Take a look at our thoughts on the cases and see what you might do in similar situations.

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Grand Rounds Recap - 6/15/16

Grand Rounds Recap - 6/15/16

This week the airway guru Dr. Steve Carleton outlines trends in airway management and makes a compelling case for keeping blind nasotracheal intubation in the toolkit of your aircraft. Dr. Plash gives us a difficult case of LVAD complications. Dr. Lagasse discusses acute aortic complications and Drs. Thompson and Gorder discuss their protocol for post-ROSC care.

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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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