Grand Rounds Recap 3.27.19

Grand Rounds Recap 3.27.19

Enjoy this weekโ€™s Grand Roundโ€™s Recap. Dr. Murphy started us off with a great Morbidity and Mortality conference with a variety of fascinating cases. Next, Dr. LaFollette taught us some pearls for HEENT emergencies if you are out in the community. Dr. Hunt took us through transfusion reactions and how to manage them, followed by Dr. Hall discussing the management pearls of Nonconvulsive Status Epilepticus. Next, Dr. Connelly taught us how we can incorporate alternative EKG leads into our practice, and Dr. Klaszky finished our day with a nuanced take of how to manage refractory septic shock. It was a jam packed day full of great learning!

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Grand Rounds Recap 8.22.18

Grand Rounds Recap 8.22.18

The week started off with our AirCare team discussing indications for procedures performed pre-hospital. The AirCare team continued by taking us through several cases in our quarterly AirCare M&M. We then got some oral boards practice with Drs. McDonough and LaFollette. The day finished with a simulation led by Dr. Hill covering patients who wish to leave AMA as well as the terrifying lengthening QTc.

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Grand Rounds Recap 1.10.18

Grand Rounds Recap 1.10.18

Grand rounds this week started off with a review of the EMTALA law with Dr. Hinckley, as well as some case discussion.  This was followed by a presentation from our clinical pharmacists, PharmD's Nicole Harger and Madeline Stephens, on anti-epileptic medications and their uses, as well as an update on our medication supplies in the ED.  Drs. Murphy-Crews and Scanlon then presented their evidenced based algorithm for the management of STEMI, followed by our combined peds EM lecture with Dr. Kevin Overmann on the evaluation of the pale child and pediatric anemia.  This was followed by Dr. Ludmer's R4 case follow up/best of residency cases.  The day finished up with Dr. Sim Mand presenting her clinical diagnostics lecture on the assessment and management of the non-pregnant patient with abnormal uterine bleeding. 

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Grand Rounds Recap - 7/20/2016

Grand Rounds Recap - 7/20/2016

This week Dr. Knight taught us about the management of seizures and about how to manage our own fear. We were schooled on the hypotensive LVAD patient by Drs. Boyer, DeVries and Winders. We learned about oncologic emergencies from Dr. Continenza. Dr. Gorder tamed the SRU and taught us about chemical asphyxiation and burn injuries in the process.

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Grand Rounds Recap 9/9

Grand Rounds Recap 9/9

Case Follow up with Dr. Winders

The Sick Patient with Pulmonary Artery Hypertension (PAH)

  • PAH defined as right heart catheterization with mPAP > 25mmHg, which can be estimated by echo
  • Readily associated with right ventricular failure, measured by TAPSE < 1.8 with M mode over tricuspid annulus
  • EKG can also help identify these patients with right axis deviation or right atrial enlargement
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Grand Rounds Recap - 3/18/15

Grand Rounds Recap - 3/18/15

Evidence-Based Emergency Medicine: Vent Management with Drs. Axelson & Scupp

The term Acute Lung Injury (ALI) is being phased out and instead Acute Respiratory Distress Syndrome (ARDS) is now graded mild, moderate, and severe depending on the PaO2:FiO2 ratio

The median onset of ARDS after presentation to the ED was 2 day but could be anywhere from 5 hours to 5 days

ARDS Net was a foundational trial in ventilator management and was a triall of tidal volume and plateau pressures.  The primary end point, mortality, was reduced by >20% when folks were on a low TV (6cc/kg) and lower PP (25-30 mm Hg).

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