This academic year’s penultimate Grand Rounds started with Guest Faculty Lecturer Dr. Richard Levitan lecturing on airway tips, tricks, and trouble shooting. Drs. Harrison, Sabedra, and Summers then led small group sessions focused on unique applications of ultrasound. Dr. Hughes discussed TB management in the ED and Dr. Thompson closed out Grand Rounds with pearls on patient management.Read More
Lumbar punctures can be mercurial procedures. There are certainly patients in whom it can be predicted that a lumbar puncture will be challenging. Obesity, patients with known degenerative changes, and agitated patients all present unique challenges when it comes to successfully completing a lumbar puncture. There are patients, however, who throw you a bit of a curveball. Sometimes cooperative patients with good landmarks, in whom you had every expectation that you would find success, become seemingly impossible to successfully complete a lumbar puncture.
For the provider, knowing how to troubleshoot the unexpectedly difficult lumbar puncture can be the difference between success and failure.Read More
Dr. Ludmer kicked things off with this month's Morbidity & Mortality conference where we discussed C. Diff, spinal cord compression, LP in the setting of anticoagulation and cardiac arrest with an LVAD. Dr. Stettler led the next segment of our longitudinal leadership curriculum with a look at the mentor/mentee relationship. We finished up with a soapbox lecture by Dr. Titone on conflict resolution and an R3 follow up by Dr. Bernardoni who discussed the crashing patient with right ventricular failure and pulmonary arterial hypertension.Read More
Lumbar punctures are common procedures to the Emergency Medical provider. Obtaining the fluid is just part of the battle however with this procedure. With the flood of results often comes a fair bit of confusion as to how to interpret them. After reading this post, you'll be able to:
- Use cell counts, protein, and glucose to distinguish between various etiologies of meningitis and determine when to order further testing
- Understand markers of bleeding in CSF and methods of distinguishing SAH from traumatic tap