Tamingthesru
Grand Rounds Recap 10/21
Morbidity and Mortality Conference with Dr. Curry
Acute Coronary Syndrome in Pregnancy
Epidemiology
- Incidence reported at about 6/100,000 deliveries
- Maternal mortality is between 5-9%
- 75% are STEMI
- 2/3rds are anterior wall MI (LAD or LM as the culprit vessel)
Risk Factors
Many of these are typical ACS risk factors but are less prevalent in the pregnant population
- Older age (>35 years old for pregnancy is considered older age....yikes)
- Hypertension
- Diabetes
- Obesity
- Smoking
- Dyslipidemia
Grand Rounds Recap 10/14
Simulation with Dr. Hill
Case 1: 45 yo male comes to the ED after being found down at the mall s/p defib x2 for a V fib arrest per EMS with a King Airway in place and undergoing active CPR. In the ED you achieve ROSC after defib x1 for Vfib and then PEA with multiple arounds of epinephrine. EKG shows inferior STEMI.
Case 2: EMS calls with advanced noticed for GI bleed presents tachycardic and hypotensive, actively bleeding with melanotic stool and hematemesis.
Sepsis Under Fire
This is our first of 2 cases exploring the care of patients with sepsis in the Emergency Department. Similar to our "Out on a Limb" case series, the case presented is followed by a series of questions, with a discussion in the comment section facilitated by the post authors. In approximately 1 month (November 11th), the authors of the post will conduct a combined simulation/small group session reinforcing the learning points from the posts during Grand Rounds. Around this time, they will also curate the comments from the discussion and publish a post highlighting these learning points. Looking forward to a great discussion!