Grand Rounds Recap 11.28.18

Grand Rounds Recap 11.28.18

Check out this week’s recap of Grand Rounds! Dr. Tim Murphy took us through some fascinating cases with Morbidity and Mortality Conference. Next, we got to dive deep into toxicology. Dr. Kelli Jarrell led us through a case she had of a TCA overdose, Dr. Shawn Hassani taught us about Beta Blocker and Calcium Channel Blocker overdose, and Dr. Woods Curry took us through a oral boards session during Quarterly Sim reviewing Aspirin toxicity. Quarterly Simulation also had an oral boards case discussing inferior STEMI complicated by complete heart block, as well as an awesome simulation teaching the fundamentals of teamwork and closed loop communication by having a lucky R3 run a code with a blindfold on. We’re excited to share the learning highlights with you!

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Grand Rounds Recap 6.13.18

Grand Rounds Recap 6.13.18

In this week’s Grand Rounds, Dr. Polsinelli started us off with the diagnosis and management of aortoenteric fistula. We then discussed burnout and failure in our wellness curriculum in a small group setting, and heard from our colleagues in pharmacy about high-dose insulin therapy for calcium channel and beta blocker overdose. Dr. Roche led us in our Mastering Minor Care curriculum with a discussion of all things arthrocentesis, and we closed with a great combined PEM/EM simulation session and oral boards practice.

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Grand Rounds Recap 3.21.18

Grand Rounds Recap 3.21.18

This week's Grand Rounds opened with year directives focused on residents as teachers for the junior residents and life as a junior faculty for the senior residents. Next Dr. Fermann discussed implementation of our PE response team (PERT). Dr. Li led a great group discussion on EKG toxicology, Dr. Golden then unsuccessfully tried to stump Dr. Hill with his CPC on phenytoin toxicity, and finally Dr. Gorder gave a fantastic discussion on NSTEMIs.

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EKG Toxicology

EKG Toxicology

Emergency medicine physicians frequently assess and treat patients who have accidental or intentional poisonings. United States poison centers receive over two million case referrals per year. And, about 20% of these poisonings present to an Emergency Department for evaluation. Evaluation of these patients always includes a history and physical, but further testing can provide valuable information. Blood work is often be needed, but an EKG is a faster, cheaper tool that can provide key pieces of information prompting early interventions. 

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Grand Rounds Recap 3.7.18

Grand Rounds Recap 3.7.18

The first Grand Rounds of March opened with guest lecturer and UCEM alumni Dr. Matthew Valento discussing his career in toxicology as well as synthetic cannabinoids. Drs. Habib and Ham then discussed the evidence-based workup, management, and treatment of mammalian bites. Drs. Baez, Bernardoni, Randolph, and Shaw lead various small group sessions focused on high yield urological clinical knowledge, procedures, and trouble shooting techniques. Dr. Titone continued the midday genitourinary theme with her approach to the management of patients with indwelling urological drains and stents. Dr. Koehler ended the day with a discussion of high yield toxins.

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Grand Rounds Recap 1.31.18

Grand Rounds Recap 1.31.18

In this week's grand rounds, Dr. Stolz discussed all things DVT and the modified two-point compression study for lower extremity clots. In our recurring EM-neuro combined conference, Dr. Stettler discussed the recent DAWN trial results, and how to incorporate CT perfusion studies into our acute ischemic stroke decision trees. In our Quarterly Sim, we discussed the management of the crashing patient from a house fire, and practiced our escharotomy skills. In our mock oral boards, we went through cases on STEMI, carbon monoxide exposure and limb ischemia. Finally, Dr. Lane discussed the workup of acute diarrhea in the adult population, and Dr. Shah went through a particularly unique toxidrome presentation in his R4 Case Follow Up. 

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Grand Rounds Recap 12.6.17

Grand Rounds Recap 12.6.17

We had a jam packed Grand Rounds this week kicked off by Dr. Carleton's airway lecture discussing tools to maximize fiberoptic intubation success. Next Drs. Roche and Plash led us through wilderness medicine small groups discussing plant ingestions and creative extrication techniques. Drs. Murphy-Crews and Bryant participated in a CPC case with a seizing neonate followed by Dr. O'Brien's discussion of blunt neck trauma. Next Dr. Cotton presented data on physician burnout and how to combat it while Dr. Li wrapped things up with an overview of Kawasaki's disease. 

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Grand Rounds Summary 9.27.17

Grand Rounds Summary 9.27.17

Dr. Titone held a great in-depth M&M this month with cases from tuberculosis to typhilitis (which is a thing). Drs. Baez and Goel took us through cases of coding Torsades and coding Pine Sol ingestions, followed by Dr. Skrobut who delicately closed the day with a discussion of testicular complaints in the ED.

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Grand Rounds Recap 8.23.17

Grand Rounds Recap 8.23.17

Dr. Carleton started things off with a review of oral fiberoptic intubation and a step by step guide to trach recanalization. Next we headed off to EM-Neuro combined conference where Dr. Neel discussed headaches that kill, headaches that maim and headaches that annoy. Dr. Thompson walked us through a case of vertebral artery dissection and Dr. Liebman kicked off our wellness curriculum. Dr. Roche finished things up with a discussion the nuances of toxicology in the community. 

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Grand Rounds Recap 6.14.17

Grand Rounds Recap 6.14.17

Dr. Ventura discusses the value of head CT and risk factors of CNS complications in HIV. Dr. Goel discussing the cognitive biases that drive decision making in EM. Dr. Stettler taught us that framing feedback can be as important as giving it and finally our CCHMC colleagues run through some difficult tox and airway cases. Plenty of learning to go around this week!

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Grand Rounds Recap 4.19.2017

Grand Rounds Recap 4.19.2017

This week kicked off with a Tox filled R4 Simulation where we learned about ASA, digoxin, and hydrofluoric acid toxicities. This was followed by lectures on cardiac disease in diabetes, pediatric pain management strategies, physician burnout and hypothermic cardiac arrest. 

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Grand Rounds Recap 11.9.16

Grand Rounds Recap 11.9.16

This week we got put in the hot seat with oral boards on AAA rupture, SVT and eclampsia, a simulation with end-of-life discussions, a critical beta blocker overdose from Dr. Lagasse and some Peds EM tips on conscious sedation from Cincinnati Children's PEM Fellow Dr. Lee. Click to check out more highlights from this week's Grand Rounds!

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Grand Rounds Recap 10.26

Grand Rounds Recap 10.26

We had another great week at Grand Rounds to wrap up the month of October.  Dr. Betham ran the gamut of medical knowledge in her M&M, teaching us from organophosphate poisoning to rhabdomyolysis.  Drs. Merriam and Curry battled in a CPC about submassive and massive PE.  Dr. Shewakramani taught us about all things dental and Dr. Scupp brought it home with his soapbox about the importance of balance in IV fluid resuscitation.

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Grand Rounds Recap 10.5.2016

Grand Rounds Recap 10.5.2016

This week we had a Grand Rounds jam packed with clinical knowledge. When was the last time you considered the differential diagnosis of an elevated troponin? It's not just ACS! Read on to learn more about thyroid storm, refractory Vfib and Vtach, lithium toxicity, inflammatory markers, and more. As well as a special clinical soapbox about how Ohio became the epicenter of the nation's heroin epidemic.

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The Urine Drug Screen - Know Thy Limitations

The Urine Drug Screen - Know Thy Limitations

We are all guilty of ordering them in the ED, but do we really know what we’re ordering?

The Implications of the Urine Drug Screen

1 literature review looked at 7 different retrospective studies describing a total of 1,405 patients and found the urine drug screen did not affect the management of any of these patients while in the emergency department.  However, the data from the UDS can affect a patient’s clinical care outside of the Emergency Department.  For example, if a patient requires psychiatric inpatient care, initial knowledge of drug abuse could affect this patient’s etiology of illness or rehabilitation plan.

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