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Grand Rounds Recap 2.2.22
In this week’s Grand Rounds, Dr. Laurence led us through an incredible and education Morbidity and Mortality Conference, Drs. Gillespie and Continenza worked through a dramatic case combining vision changes and rash, Dr. Wright reminded us to not forget the esophagus in our patients with chest pain and Dr. Connelly gave a fantastic overview of EMS provider education and systems structure in her R4 Capstone. Finally, our incredible visiting professor, Dr. Megan Rybarcyzk gave us insight into building an emergency medicine education program in the midst of a pandemic and provides tips and tricks for those seeking a career in global health.
Grand Rounds Recap 1.26.22
This week, we started off with an excellent journal club led by Drs. Ijaz and Mullen discussing interventions aimed at improving access to primary care from the Emergency Department and then followed along with Drs. Ferreri and Skrobut as they battled out a case of mysterious altered mental status during the crowd favorite, CPC. Dr. Pulvino reminded us that not all rashes are simple through her case follow up and Dr. Gobble took us on a deep dive of the diagnosis and management of gastroparesis and cyclic vomiting syndrome. Finally, we closed out the day with lessons in nasal endoscopy and cricothyrotomy from the airway guru himself, Dr. Steven Carleton.
All that Pukes: Cyclic Vomiting Syndrome, Gastroparesis and More
Nausea and vomiting accounts for one of the most frequent chief complaints we see in the emergency department. For those presenting with another complaint, N/V is often an associated symptom. Treatment of these symptoms not only improves patient satisfaction, but also decreases associated complications, like dehydration and electrolyte abnormalities.
The etiology behind a patient’s N/V is highly variable, with a broad differential that stretches across all organ systems. Although often an acute presentation, N/V is increasingly being linked to set of chronic disorders, such as gastroparesis (GP), cyclic vomiting syndrome (CVS) and cannabinoid hyperemesis syndrome (CHS). While the work-up and initial evaluation in the ED is similar for all, specifically ruling out potentially life-threatening diagnosis or complications, the clinical presentation and management vary subtly between these syndromes.