This weeks grand rounds started off with our monthly Morbidity and Mortality with Dr. Lagasse. We then discuss in Aircare grand rounds led by Drs. Dang and Renne the always harrowing complex patient transfers including LVAD, EKOS and more.Read More
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.Read More
This week Dr. Knight taught us about the management of seizures and about how to manage our own fear. We were schooled on the hypotensive LVAD patient by Drs. Boyer, DeVries and Winders. We learned about oncologic emergencies from Dr. Continenza. Dr. Gorder tamed the SRU and taught us about chemical asphyxiation and burn injuries in the process.Read More
OB-GYN Emergencies with Dr. McKinney
Case 1: 18 wk patient with vaginal spotting who is Rh- but antibody+
Bedside U/S shows fetal abnormality due to Rh alloimmunization with fetal hydrops. Positive antibody screening on gravid female should warrant obstetric consultation. Rhogam administration within 72 hours of bleeding is important.
Case 2: 40 wk female with gestational DM present with crowning fetus who fails to immediately deliver secondary to shoulder dystocia.
Treatment: stop pushing and avoid traction. Initially attempt hyperflexion of legs and suprapubic pressure to release (McRoberts maneuver). Then consider episiotomy because subsequent maneuvers involve twisting the baby to get shoulder into a different plane.Read More