Tamingthesru

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

Grand Rounds Recap 11/4

A Walk Down the Difficult Airway with Dr. Carleton

Case 1: Morbidly obese young female presents after overdose - tachycardic and unresponsive to sternal rub but maintaining saturations at 92% on a non-rebreather.

Difficulties in the morbidly obese and implications for airway management...

Use your rules for airway assessment

  • 2 fingers of mouth opening - remainder of 3-3-2 cannot be determined due to habitus
  • both MOANs for BVM and RODS for EGD predict difficulty with ventilation due to the restrictive physiology of her habitus
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Diagnostics, Grand Rounds Jeffery Hill, MD M.Ed Diagnostics, Grand Rounds Jeffery Hill, MD M.Ed

Respiratory Monitoring - An Introduction to Pulse Ox and Capnography

First a bit of physics....

Both pulse oximetry and capnometry rely on the Beer-Lambert Law. 

  • In 1760, Johann Heinreich Lambert proved that the absorbance of light through a material is proportional to the thickness of the material.  
  • In 1852, August Beer proved that the absorbance of light through a material is proportional to the concentration of the attenuating substance in the material.
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Grand Rounds, Journal Club Josh Denney Grand Rounds, Journal Club Josh Denney

Grand Rounds Recap 10/21

Morbidity and Mortality Conference with Dr. Curry

Acute Coronary Syndrome in Pregnancy

Epidemiology

  • Incidence reported at about 6/100,000 deliveries
  • Maternal mortality is between 5-9%
  • 75% are STEMI
  • 2/3rds are anterior wall MI (LAD or LM as the culprit vessel)

Risk Factors

Many of these are typical ACS risk factors but are less prevalent in the pregnant population

  • Older age (>35 years old for pregnancy is considered older age....yikes)
  • Hypertension
  • Diabetes
  • Obesity
  • Smoking
  • Dyslipidemia
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