Tamingthesru

Grand Rounds Mike Bohanske, MD Grand Rounds Mike Bohanske, MD

Grand Rounds Recap - 7/23/14

n general, the best way to learn is to challenge yourself.  Teaching styles should take into account different learner types and levels

Learner levels:

  • Beginner: early 3rd year medical student
    • Can be an observer initially but transition these learners to the next stage
    • Keeps you on point as you have to really know what you are talking about
    • Incorporate them into your H+P
    • Transitional: ask them to perform supervised H+Ps as this prevents them from developing bad habits
    • Advanced:OMP (one minute preceptor) or SNAPPS model
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Grand Rounds Mike Bohanske, MD Grand Rounds Mike Bohanske, MD

Grand Rounds Recap - 7/16/14

Oral Boards Case with Dr. Blomkalns

The pt is a 70 yo M who presents with AMS, weakness and nausea for 1-2 days. He complains of diffuse weakness and feeling "sick". His hx is significant for HTN, HLD, CHF and he takes digoxin. Vital signs on arrival are BP 90/60 with HR 47. There is concern for digoxin toxicity, so dig level is obtained and is 2.4

(normal is less than 1.2).

His K is 6 and Cr is 1.9. EKG shows LBBB.

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Grand Rounds Jeffery Hill, MD M.Ed Grand Rounds Jeffery Hill, MD M.Ed

Grand Rounds Recap 7/9/2014

Central Line Complications w/ Dr. Bill Knight

  • Rate of adverse events during central line placement is 2-26%.
  • Common complications
    • Early: mechanical, ie misplacement, pneumothorax
    • Late: infection, thrombosis, occlusion
    • 50% of femoral lines are misplaced during cardiac arrest
    • 20% DVT risk with femoral vein puncture
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