Welcome to another Grand Rounds Recap. This week Dr. Sayal, a visiting lecturer from North York General Hospital in Toronto, Canada, started us off with some pearls and pitfalls for the patient presenting with musculoskeletal complaints. Next up was Dr. Thompson who provided us some tips on how to prevent the most common patient and consultant complaints in the emergency department. Dr. Habib then led us through an interesting case involving an internal degloving injury. We then ended the day with small groups and a simulation led by Drs. Baez, Shaw, and Summers involving emergency obstetrical presentations. Be sure to check out the video of Dr. Isaac Shaw’s peri-mortem c-section simulation. See you next week.Read More
In this week's Grand Rounds, Dr. McDonough spearheaded a discussion of the art of breaking bad news in the Emergency Department. Drs Dang, Renne and Teuber led us through a focused management of obstetric emergencies: placental abruption, difficult deliveries and the pregnant traumatic arrest patient.Read More
This week's Grand Rounds started off with a stress-inducing sim written by the R4s that included a pregnant trauma patient with a positive FAST, an imminent delivery and neonatal resuscitation! Drs. Paulsen and Continenza faced off in a great CPC and Dr. DeVries walked us through the history of US use in ED patients. Dr. Golden rounded out our day with a lecture focused on foot and ankle injuries.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