Tamingthesru
Grand Rounds Recap 5.8.19
Welcome to another installment of the Grand Rounds Recap! We had an excellent series of lecturers that we are very excited to share with you. We started off the day with our visiting lecturer Dr. Noble who presented a some excellent pearls on how to better incorporate lung ultrasound in the management of our patients in the ED. Next up Dr. Mand and Dr. Lagasse went head to head in our clincopathologic case series. Dr. Lagasse nailed the diagnosis of Dengue hemorrhagic fever and Dr. Mand then educated us on how it can progress to shock. To follow came Dr. Pulvino who lead us through some small group cases on the utilization of the PERC criteria and Wells score in the evaluation of patient with a potential pullmonary embolism. Next was Dr. Connelly who presented on the evaluation and management of patients with conditions resulting from ascent to high altitudes. To wrap up the day Dr. Lipshaw demystified the pediatric rash patient.
PERCs of the Wells Score
Pulmonary embolism (PE) is one of the big “can’t miss” diagnoses in the emergency department. Unfortunately, presenting symptoms are often vague, and definitive diagnostic testing is expensive and comes with risks of radiation and contrast to the patient. In order to avoid missing a PE while mitigating the risks associated with overtesting, some clinical decision tools have been created to aid in the diagnostic process. We will focus on two of these commonly used decision tools: the PERC rule and the WELLS score for PE.
Grand Rounds Recap 5.1.19
We had an exciting Grand Rounds this week. We started off with our visiting lecturer, Dr. Jennifer Wiler, who gave us an excellent overview of the dollars and cents behind the care that we provide in the emergency department. Afterwards we practice some oral board style cases. Dr. Betz led a challenging triple patient encounter where we had to simultaneously manage a knee dislocation, aortic dissection with involvement of the right coronary artery, and pneumonia in the setting of HIV. Dr. Curry led a riveting case of preeclampsia where identifying the critical history of a recent delivery was critical to initiating the correct management. We wrapped up the day with a simulation led by Drs. Hill, LaFollette, and Lang on in-flight emergencies!