Tamingthesru

Grand Rounds Josh Denney Grand Rounds Josh Denney

Grand Rounds Summary 8/5

Taming the SRU Case Follow-Up: GSW to the Head with Dr. Grosso

  • In one census: 66% of violent deaths are suicide, with 30k suicide deaths annually in the US
  • ~50% of suicide attempts include firearms
  • GSW to head mortality is 80%, and 71% die on scene
  • ~40% of those who survive to hospital have favorable outcomes
  • Favorable prognosis: GCS>8, normal pupillary reaction, absence of coagulopathy of trauma/hemodynamic instability
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Grand Rounds Peter Toth Grand Rounds Peter Toth

Grand Rounds Summary - July 29th, 2015

Morbidity and Mortality Pearls with Dr. Curry

Nephrolithiasis

Incidence in the US is 0.5-1% (lifetime risk 10-15%). There is a 2:1 male predominance and the recurrence rate is fairly high (37% at 1 year, 50% at 10 years and 75% at 20 years).

Patients at risk for poorer outcomes with ureterolithiasis are those with risk factors for diminished renal function, history of difficulty with stones/urologic intervention and symptoms of infection.

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Grand Rounds Andrew Latimer, MD Grand Rounds Andrew Latimer, MD

Moonlighter - Recap

This is our final recap of our "Out on a Limb" Case Series!  If you missed the initial "Moonlighter" case and discussion you can check it out here.  There were a number of great responses to the questions which we'll recap below.

Q1 - What are your options in handling this situation?

You have a few options in handling this situation. As many of the respondents chimed in, the wound definitely needs to be cleaned out and closed and the patient requires antibiotics as soon as is reasonably and safely possible, especially since the injury is already 6 hours old. The first option is to complete a sedation and multilayer repair in the ED yourself. As many people point out, this is not an excellent proposition unless there are extreme extenuating circumstances.

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