This week in grand rounds started off with Dr. Humphries reviewing the evidence of various interventions in traumatic cardiac arrest and providing a clear algorithm to follow in patients who suffer blunt traumatic cardiac arrest. We then had an in depth discussion on the approach to the encephalopathic patient in the Emergency Department. Dr. Bryant then presented some interesting cases that she had on her most recent trip to Guyana, followed by Dr. Ramsey’s in depth review of the emergent complications of acute leukemia. We finished off the day with our pediatric Emergency Medicine colleagues who led us through a simulation and oral boards cases.