Grand Rounds Recap 1.9.19

Grand Rounds Recap 1.9.19

We are excited to share our latest installment of the Grand Rounds Recap with you! Dr. Stettler opened the day with a discussion on leadership styles and how they affect our practice in the emergency department. Next up was Dr. Sabedra with a riveting case of new onset heart failure and acute ischemic stroke in a patient in his twenties. Dr. Berger then gave us a shot to the gut, in a good way, with a lecture on colitis. We then delved into the world of pediatrics with a lecture by Dr. Gray who helps us standardize our approach to evaluating for the possibility of child abuse. Dr. Hughes and Dr. Gottula then ended the day with a practice changing summary of the current literature and a new pathway for the management of NSTEMI.

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Grand Rounds Summary 9.13.17

Grand Rounds Summary 9.13.17

'Twas a fantastic grand rounds.  Drs. Banning and Golden started it off taking us through the most recent evidence for management of sub-massive and massive PE, as well as presenting their algorithm to be published on Emergency KT.  This was followed by a global health lecture given by Dr. Lagasse, which covered a range of re-emerging infectious diseases.  Next, Dr. Bryant took us through multiple pediatric cases, and discussed her approach in determining whether to discharge, transfer, or treat pediatric patients with common / representative complaints.  Dr. Adeoye then took us through the history and development of our current approach to the management of acute ischemic stroke.  Dr. LaFollette then took us through an evidence based approach to removing things from where they shouldn't be in his edition of mastering minor care, discussing approaches to removing retained objects from ears and skin.  We then finished the conference with two interesting cases:  One presented by Dr. Sabedra that was followed by a discussion on the diagnosis and management of massive hemoptysis, and the other presented by Dr. Dang illustrating the differences and similarities hyperthermic toxidromes including NMS and serotonin syndrome as well as their management.  

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Grands Rounds Summary 01.25.2017

Grands Rounds Summary 01.25.2017

Dr. Betham started off Grand Rounds with this month's Morbidity and Mortality Conference, where we learned about Gout, ITP, Stroke, and Hyperkalemia in ESRD patients. Dr. Teuber walked us through the varying recommendations regarding ED Thoracotomy and Dr. Banning taught us how to handle neonatal urgencies. Leadership Curriculum wrapped up this week's conference with a session on how to pitch an idea. 

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Grand Rounds Recap 5/18

Grand Rounds Recap 5/18

In this week's grand rounds we covered the complications of sedation in alcohol withdrawl, the nuances of decreased door-to-needle time in acute ischemic stroke, bicarbinate use in metabolic acidosis and a case follow-up or respiratory depression in new onset myesthenia gravis

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Pre-Hospital Stroke Care

Pre-Hospital Stroke Care

Pre-hospital stroke care begins with a quick, simple assessment tool used to help identify patients that are suffering a stroke.  In Southwest Ohio, this tool is the Cincinnati Pre-hospital Stroke Scale (CPSS).  There are three simple components of the CPSS – facial droop, arm drift, and slurred speech.  When assessing for facial droop, it is best to ask patients to bear their teeth.  Arm drift is assessed by asking the patient to hold both arms outstretched in front of them with their palms facing up.  If one arm drifts down or one hand rotates to a palm-down position, this aspect of the scale is positive.  Lastly, ask the patient to repeat a sentence to assess for slurred speech or any other type of speech abnormality.

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Grey Matters - Flights Case 3

Grey Matters - Flights Case 3

It is late on a blustery grey and rainy day in November and you are the dedicated flight doc on Air Care One (the “UH”) nearing the end of your shift. Your pilot has had to turn down two flights already due to high winds and reduced visibility as bands of storms moved through the area. Against your better judgment, you are standing in the sushi line in the hospital cafeteria to grab dinner when you hear “Air Care One Pilot, weather check for a patient coming back to the U” squawk out over your portable radio. Your excitement rises as “we can do that” echoes over the radio and you hear the tones drop for your flight. You grab the blood cooler and meet your crew for takeoff on the roof...

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Annals of B-Pod: Acute Vision Loss

Annals of B-Pod: Acute Vision Loss

Thinking about the other left lower quadrant

 

The patient is a 74 year-old African-American female with a history of hypertension, coronary artery disease status post drug-eluting stent ×1, former cigarette smoker, and iron deficiency anemia presenting with left-sided vision loss. Patient states that approximately two days ago  she woke up with painless peripheral vision loss of her left eye only. She describes it as darkness in the lateral portion of her left eye. She  reports that her vision returned to baseline throughout that day; only to return when she awoke the next morning. Since that time she endorses persistent vision loss in the left periphery. She denies blurry vision, eye pain, headaches, recent trauma, flashes, and floaters. Furthermore, she also denies dizziness, numbness weakness, dysarthria, dysphagia, fever, chills nausea, vomiting, chest pain, shortness of breath, and palpitations. She reports adherence to her antihypertensive and anti-platelet medications...

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