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March Issue - Annals of B Pod
Spring is here and new beginnings are right around the corner. Step-ups are looming and we will find out the names of our new interns any day. It is time for interns to polish their efficiency, for the R2s to finish their off-service rotations in anticipation of the great variety of the SRU, the R3s to finishing refining their ability to run an effective team. The R4s #fillintheedges of their careers as residents so they can go forth as prepared attendings. In anticipation of these new beginnings, this issue of Annals of B Pod focuses on cases that #fillintheedges.
Grand Rounds Summary 3/9/2016
Back Pain with Dr. Summers
Of the more than 2.5 million ED cases of back pain every year, roughly 5% of these actually have an emergent cause. Conventional red flags include:
- Age >50 or <20 yo
- History of cancer
- Immunocompromised
- HIV
- Steroid use
- IV Drug Use
- Known aortic aneurysm
- Motor neurologic deficit
- Urinary retention, bowel incontinence, or saddle anesthesia
Grand Rounds Summary 3/2/16
OB-GYN Emergencies with Dr. McKinney
Case 1: 18 wk patient with vaginal spotting who is Rh- but antibody+
Bedside U/S shows fetal abnormality due to Rh alloimmunization with fetal hydrops. Positive antibody screening on gravid female should warrant obstetric consultation. Rhogam administration within 72 hours of bleeding is important.
Case 2: 40 wk female with gestational DM present with crowning fetus who fails to immediately deliver secondary to shoulder dystocia.
Treatment: stop pushing and avoid traction. Initially attempt hyperflexion of legs and suprapubic pressure to release (McRoberts maneuver). Then consider episiotomy because subsequent maneuvers involve twisting the baby to get shoulder into a different plane.