Tamingthesru
Ground Rounds Summary 8/19/15
Simulation - Clonidine Overdose
- 30 yo FM presents after having taking a handful of pills with the following VS: HR 45, BP 83/60, RR 8, 100% RA, T 98. FS101. It gets better—there's a baby behind that baby bump.
- Ddx for AMS, hypotension and bradycardia? Tox, hemoperitoneum, spinal shock, myxedema coma, and a quite atypical sepsis.
- By EMS report this lady reportedly took a handful of unknown pills in an effort to harm herself. Remember to consider clonidine overdose in addition to beta blockers and calcium channel blockers. This lady found herself a bottle of clonidine and a near successful suicide attempt.
Grand Rounds Summary 8/12/15
VISITING LECTURER SERIES WITH DR. MATT DAWSON
1) On Technology, Emergency Medicine, and New Frontiers
Today’s tech explosion is leading to health innovations that may make some big differences leading to big changes. Here’s a sneak peak:
In the near future drones may roam the sky to deliver life saving epi pens, defibrillators and instructions of how to use them. Until SkyLab takes over...
Portable ultrasound? Pocket VL? (Hey don't we already have those...)
CHEER Trial: Too young to die? Try ECMO. Australia did and in a trial of 26 people, 14 went on to live and many with excellent neurologic recovery.
TEE: A small number of point of care ED docs are using this successfully to better evaluate causes of shock with good results, low risks (0.03% perf rate), and little training
Thromboelastography aka The TEG
What is TEG?
Thromboelastography (TEG) measures the dynamics of clot development, stabilization/strength, and dissolution. Assuming the body’s ability to achieve hemostasis is a function of these clot properties, TEG provides specific, real-time indicators of a patient’s in vitro hemostatic state. This is in contrast to routine screening coagulation tests such as aPTT and PT/INR which are run with blood plasma alone and therefore do not take into account the cellular components of clotting.