This week we continued our leadership curriculum with Dr. Pancioli’s lecture on the intersection of leadership and finance. This was followed by Dr. Klaszky with his R4 case follow up of a patient with cardiac tamponade, and then Drs. Baez and Continenza faced off for the most recent installment of our Great Debate series as they discussed chemical vs electrical cardioversion for atrial fibrillation. Finally, our colleagues from Cincinnati Children’s presented learning pearls about causes of and interventions for hypoxia in pediatrics emergency medicine.Read More
Check out this week’s recap of Grand Rounds! Dr. Tim Murphy took us through some fascinating cases with Morbidity and Mortality Conference. Next, we got to dive deep into toxicology. Dr. Kelli Jarrell led us through a case she had of a TCA overdose, Dr. Shawn Hassani taught us about Beta Blocker and Calcium Channel Blocker overdose, and Dr. Woods Curry took us through a oral boards session during Quarterly Sim reviewing Aspirin toxicity. Quarterly Simulation also had an oral boards case discussing inferior STEMI complicated by complete heart block, as well as an awesome simulation teaching the fundamentals of teamwork and closed loop communication by having a lucky R3 run a code with a blindfold on. We’re excited to share the learning highlights with you!Read More
This week we had our annual Critical Care Symposium where we invited our own critical care trained faculty and a special guest to have a day chock full of critical care goodness.
Refractory septic shock with Dr. David norton
Dr. David Norton, Assistant Professor of Medicine and Director of the UCMC Medical Intensive Care Unit
Definition of Refractory Shock:
No clear definition exists, but we are generally describing a state of decreased vascular responsiveness despite high vasopressor infusion.Read More
Of the injuries that one will care for in the pre-hospital setting, traumatic brain injury is one of the most challenging. Quite often, more than one organ system has been injured and they require rapid, thoughtful, and precise management of their airway and hemodynamics. In addition, TBI patients require frequent reassessment to detect progression of the primary neurologic injury. This is easier said than done in the dynamic, unpredictable, and resource-limited prehospital environment.
To help simplify their care, the following “Code of Care” forms the core principles that characterize optimal TBI care:
- NO Hypoxia (SpO2 < 90%) – therefore, apneic oxygenation for all TBI patients
- NO Hypotension (sBP < 90 mmHg) – greatest iatrogenic risk is with induction and provision of positive pressure ventilation
- Blown pupil -> Hyperosmotic therapy + Hyperventilate