Tamingthesru

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

Grand Rounds Recap - 4/8/15

AirCare Grand Rounds

1. Indications for T pod

  • Blunt trauma + unstable pelvis
  • Blunt trauma + shock + pelvic tenderness to compression
  • Blunt trauma + shock + AMS/inability to evaluate pelvic pain

In patients with blunt trauma who are in shock and have AMS, incidence of pelvic fractures is 10%. In patients who die of blunt trauma during transport, open book pelvis fracture is the #1 cause of death (according to our own QI data)

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

The Cognitive Autopsy

We are in a thinking profession.  

An outsider looking in on our profession may see procedures and action as the defining characteristics of the practice of Emergency Medicine.  But, reflecting on the attributes of the best EM docs I’ve worked with, their procedural excellence isn’t what stands out.  Thinking back on the great physicians I have met and worked with, the ones I strive to be like every day, it is their ability to think, lead, and educate that sticks with me the most.  

And, it turns out I’m not the only one who might see it like this…

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Grand Rounds, Intern Radiology Videos Jeffery Hill, MD M.Ed Grand Rounds, Intern Radiology Videos Jeffery Hill, MD M.Ed

Vascular Ultrasound - Aorta & Lower Extremity Veins

It's a frosty Easter morning and the ED is "q!&%t," all except for the 2 patient's turned over to you by the night ranger.  You greet the first patient, a 75 yo M complaining of flank pain - probably a kidney stone you think to yourself as you walk in to the room.  Walking into the room, you see the patient rolling around on the stretcher (as one would expect from those with a stone jammed in the UVJ), but something about his presentation strikes you as odd - a bit of diaphoresis, clammy pale skin.  It could just be pain, but the specter of a ruptured abdominal aortic aneurysm still looms large in your differential diagnosis.  You quickly exit the room, grab the ultrasound machine and head back in to take a look at his aorta...

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