Tamingthesru

Grand Rounds, Intern Radiology Videos Jeffery Hill, MD M.Ed Grand Rounds, Intern Radiology Videos Jeffery Hill, MD M.Ed

The Approach to the Foot X-ray

Any way you slice it, foot x-rays are a pain to read.  Complicated by a number of overlapping bones, joints, the presence of multiple sesamoid bones, and multiple radiographic views, it's easy to get lost in the weeds trying to sort out normal variant from pathology.  Take a look at this short Blendspace module by PGY-1 Lauren Titone, MD and get a better understanding of the normal anatomy and a systematic approach to reading foot x-rays.

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Grand Rounds Jeffery Hill, MD M.Ed Grand Rounds Jeffery Hill, MD M.Ed

Grand Rounds Recap - 2/11/15

Repeat 6 Hour Head CT in Mild TBI Patients with Dr. Kreitzer

Mild TBI = GCS > or = 13

  • Incidence of NSG intervention 0.9%
  • Mortality 0.1%

Why Consider a 6 hour CT scan?

  • Pros: quicker disposition, avoidance of unnecessary admission
  • Cons: extra radiation, does not address post concussive symptoms

ACEP policy: mild TBI patients with normal head CT and normal mental status can be discharged home

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Grand Rounds Jeffery Hill, MD M.Ed Grand Rounds Jeffery Hill, MD M.Ed

Grand Rounds Recap: Critical Care Symposium - 2/4/15

Pressor Primer with Dr. Hebbeler-Clark

  • Norepinephrine seems to be on top in terms of vasopressor of choice currently (consider it your "easy button")
  • Per Surviving Sepsis Guidelines, Norepi has level 1B evidence as a first line pressor, while Epi is your second line with level 2B evidence and Vasopressin is currently ungraded in terms of evidence level
  • There have been 4 RCT's confirming that Norepi has no mortality difference from Epi and given it's safer side effect profile, use it regularly
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