Tamingthesru

Grand Rounds Ryan LaFollette, MD Grand Rounds Ryan LaFollette, MD

Grand Rounds Recap - 5/25

Another month, another M&M, where this month we learned despite a great clinical rationale, there will always be cases that are a wolf in sheep's clothing. Also be sure to check out a review of chest CT indications in pregnancy, pregnancy-induced hypertension, lactate utilization in the ED and a basics course of ECMO - coming soon to an ED near you...

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Grand Rounds Ryan LaFollette, MD Grand Rounds Ryan LaFollette, MD

Grand Rounds Recap 5/18

In this week's grand rounds we covered the complications of sedation in alcohol withdrawl, the nuances of decreased door-to-needle time in acute ischemic stroke, bicarbinate use in metabolic acidosis and a case follow-up or respiratory depression in new onset myesthenia gravis

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Grand Rounds Ryan LaFollette, MD Grand Rounds Ryan LaFollette, MD

Grand Rounds Recap 5/4

Acetaminophen Toxicity Sim - Drs. LaFollette, Nelson and Toth

Take a read through our Cases If It Bleeds it Leads..., Seeing is Believing..., and Belly Pain Bonanza. Curated commentary to follow

Acetaminophen Toxicity

  • 60,000 poisonings / year
  • ~500 deaths per year, evenly split therapeutic / suicide
  • Mechanism - acetaminophen to NAPQI by P450, overwhelming gluthathione stores
  • Alcohol, phenytoin, isoniazid all induce P450 and may increase NAPQI production. Chronic alcohol use will worsen toxicity when acute ingestion will competitively inhibit and can be preventative at producing the toxic metabolite
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