Annals of B-Pod: Mastering Minor Care
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Fingertip injury is a common presentation with a lot of practice pattern variation. we tapped the guru himself, Dr. Trott, to teach us the latest in caring for nailbed injuries.
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Grand Rounds Recap - 5/25
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Another month, another M&M, where this month we learned despite a great clinical rationale, there will always be cases that are a wolf in sheep's clothing. Also be sure to check out a review of chest CT indications in pregnancy, pregnancy-induced hypertension, lactate utilization in the ED and a basics course of ECMO - coming soon to an ED near you...
Read MoreGrey Matters - Recap of Flights Case 3
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Welcome to the Recap of the 3rd case in our Air Care and Mobile Care Flight Orientation Curriculum!
Approximately 1 month ago we presented and talked through a particularly challenging patient flight scenario. As a refresher, if you don’t recall, check out the post here. Following the posting of the case, I sat down with ACMC Medical Director Dr. Bill Hinckley and Resident Assistant Medical Director for Air Care, Dr. Andrew Latimer, and recorded a podcast with their reaction to the case and to some of the curveball scenarios posed in the question and discussion section.
Read MorePeer-Peer Community Building: One of the Strongest Preventers of Burn-Out
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It’s nearing the end of the year, when the fourth years are moving on to real paychecks or slightly improved with fellowship, and everyone else is preparing for their new roles ahead. The end of the academic year can feel like a period of stagnation and possibly regret. Fear not, however, there are easy solutions and ways to prevent burn-out, the term people like to say frequently to EM physicians. I’m not burned out! I’m just toasty sometimes!
Read MoreAnnals of B-Pod: A Dangerous Case of Foot Pain
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A woman in her 50s and a history of uncontrolled diabetes presents with a draining wound from her heel. Your first thought should be this... Read on for an update on the latest information on the diagnosis and treatment or necrotizing faciitis.
Read MoreClinical Concepts in CT Imaging of the Chest
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A 45 yo Female presents to the ED with sudden onset of chest pain, described as worse when taking a deep breath. She is significantly short of breath and appears distressed. She recently underwent a total right knee arthroplasty and reports having been bedridden secondary to pain. Physical exam is remarkable for a right lower extremity with surgical incisions that clean, dry, intact; however, her left lower extremity is swollen with significant tenderness along the popliteal fossa and calf.
Vitals: Temp 99.2HR 120RR: 28 BP: 130/80 SpO2 90% on RA.
A CTPA is ordered...
Read MoreAnnals of B-Pod: Quick Hit Case
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A male in his 30s came in after trying to break up a fight in a bar. No good deed goes unpunished, but what is wrong with this knee?
Read MoreGrand Rounds Recap 5/18
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In this week's grand rounds we covered the complications of sedation in alcohol withdrawl, the nuances of decreased door-to-needle time in acute ischemic stroke, bicarbinate use in metabolic acidosis and a case follow-up or respiratory depression in new onset myesthenia gravis
Read MoreOut of Hospital Cardiac Arrest - Part 2
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The UC Division of EMS has recorded a series of podcasts to celebrate EMS Week 2016. We are honored to be able to engage EMS Providers throughout the world with this forum. If you practice pre-hospital medicine, we would like to say thank you and that we appreciate everything you do to provide a high level of care to ill and injured patients in a wide variety of austere environments. For this podcast, we were joined by Dr. Dustin Calhoun, Associate Director of the UC Division of EMS, as well as two of this year’s UC EMS Fellows, Dr. Mike Bohanske and Dr. Justin Benoit.
Read MoreOut of Hospital Cardiac Arrest - Part 1
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The UC Division of EMS has recorded a series of podcasts to celebrate EMS Week 2016. We are honored to be able to engage EMS Providers throughout the world with this forum. If you practice pre-hospital medicine, we would like to say thank you and that we appreciate everything you do to provide a high level of care to ill and injured patients in a wide variety of austere environments. For this podcast, we were joined by Dr. Dustin Calhoun, Associate Director of the UC Division of EMS, as well as two of this year’s UC EMS Fellows, Dr. Mike Bohanske and Dr. Justin Benoit.
Read MorePre-Hospital Trauma Care – Lessons Learned From the Front
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The UC Division of EMS has recorded a series of podcasts to celebrate EMS Week 2016. We are honored to be able to engage EMS Providers throughout the world with this forum. If you practice pre-hospital medicine, we would like to say thank you and that we appreciate everything you do to provide a high level of care to ill and injured patients in a wide variety of austere environments. For this podcast, we were joined by Dr. Jay Johannigman, Chief of the Division of Trauma and Critical Care at the University of Cincinnati. Dr. Johannigman has over thirty years of military experience which includes 6 deployments to Iraq and Afghanistan. Dr. Johannigman joined us to discuss how the military experience has changed civilian trauma care in the United States.
Read MorePre-Hospital STEMI Care
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The UC Division of EMS has recorded a series of podcasts to celebrate EMS Week 2016. We are honored to be able to engage EMS Providers throughout the world with this forum. If you practice pre-hospital medicine, we would like to say thank you and that we appreciate everything you do to provide a high level of care to ill and injured patients in a wide variety of austere environments. For this podcast, we were joined by Dr. Tim Smith, an Interventional Cardiologist and Director of the Cardiovascular Intensive Care Unit at the University of Cincinnati Medical Center. Dr. Smith joined us to discuss our region’s partnership with the American Heart Association’s Mission Lifeline program to bring a regionalized system of care for STEMI patients to our area.
Read MorePre-Hospital Stroke Care
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Pre-hospital stroke care begins with a quick, simple assessment tool used to help identify patients that are suffering a stroke. In Southwest Ohio, this tool is the Cincinnati Pre-hospital Stroke Scale (CPSS). There are three simple components of the CPSS – facial droop, arm drift, and slurred speech. When assessing for facial droop, it is best to ask patients to bear their teeth. Arm drift is assessed by asking the patient to hold both arms outstretched in front of them with their palms facing up. If one arm drifts down or one hand rotates to a palm-down position, this aspect of the scale is positive. Lastly, ask the patient to repeat a sentence to assess for slurred speech or any other type of speech abnormality.
Read MoreGrand Rounds Recap 5/4
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Acetaminophen Toxicity Sim - Drs. LaFollette, Nelson and Toth
Take a read through our Cases If It Bleeds it Leads..., Seeing is Believing..., and Belly Pain Bonanza. Curated commentary to follow
Acetaminophen Toxicity
- 60,000 poisonings / year
- ~500 deaths per year, evenly split therapeutic / suicide
- Mechanism - acetaminophen to NAPQI by P450, overwhelming gluthathione stores
- Alcohol, phenytoin, isoniazid all induce P450 and may increase NAPQI production. Chronic alcohol use will worsen toxicity when acute ingestion will competitively inhibit and can be preventative at producing the toxic metabolite
Clinical Concepts in Pelvic Ultrasound
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Your patient is a well appearing, otherwise healthy 22 year old female who presents with lower abdominal pain x3 days. She is unsure of her LMP, but thinks she had some spotting about a month ago. Vital signs: Temp 99.3F, HR 92, BP 102/70, RR 20, 98% on RA. She has a benign, non-gravid abdomen. Urine pregnancy is positive. You fire off a quantitative hCG and don’t expect that result to come back for a while. What do you do next?
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