Tamingthesru
Logistics are Critical
Not much gets me as fired-up anymore as trying to optimize them. While I like to think that it’s because they are integral to our mission and are the ultimate weapon in our quest to go from “good to best”, it’s really just my borderline OCPD (just kidding…sort of).
Long story short, I spend a lot of time thinking about clinical and operational logistics in HEMS – it’s become my thing. My goal with this post is to share some of that thinking with others who might want to build off of our ideas in hopes that those colleagues (i.e. you) will share their ideas that they are really excited about with us at some point.
Grand Rounds Recap - 7/16/14
Oral Boards Case with Dr. Blomkalns
The pt is a 70 yo M who presents with AMS, weakness and nausea for 1-2 days. He complains of diffuse weakness and feeling "sick". His hx is significant for HTN, HLD, CHF and he takes digoxin. Vital signs on arrival are BP 90/60 with HR 47. There is concern for digoxin toxicity, so dig level is obtained and is 2.4
(normal is less than 1.2).
His K is 6 and Cr is 1.9. EKG shows LBBB.
Isn't that CT Enough? - Water Cooler Breakdown of CT vs CT/LP for SAH
Why Should You Care?
- Headache approximates 2% of presenting complaints to the ED, and SAH is identified in approximately 1% of those patients with headache in the ED.
- Overall mortality of SAH is high, estimated at 25-50% of patients dying within 6 months
- If not fatal, SAH leaves approximately 33% of survivors with some appreciable neurological deficit affecting their ADLs.