July is coming like a freight train. Just when we are finally comfortably cruising in our ruts, everything is about to change. R1s are about to run their own pod, fly solo and step into the SRU....
Read MoreIf the chief complaint of your patient is abdominal pain, altered mental status, overdose, generalized weakness chances are you at least considered ordering a hepatic panel. In fact, studies show that the hepatic panel is the third most common laboratory test ordered in the emergency department only behind the CBC and renal panel. If emergency medicine physicians are so quick to order this test, it is important to also know how to interpret all the little red arrows that often accompany your results. For this we will review each component and even (wait for it) … a little biochemistry!
Read MoreGrand Rounds kicked off this week with Dr. Axelson's final M&M of the year where we learned about hypertensive emergencies, 2nd & 3rd trimester vaginal bleeding, the care of the sick asthmatic, which bronchiolitics can go home and how exactly to treat the many forms of UTIs. Drs. Kircher and Murphy-Crews continued the learning with a case follow-up about intubating patients with airway stents and pediatric head injury, respectively. Our joint EM-Peds lecture rounded out the day with visual diagnoses in peds.
Read MoreThis week in Grand Rounds: We started with a grab bag of oral boards cases, Whitney Bryant lead us in a discussion of the broad scope of global health and why it should be important to emergency physicians, and Dr. Bernardoni lead us through a case of hyperkalemia and A fib with RVR.
Read MoreThis week's Grand Rounds served as our annual EMS Disaster day, where we tried on our HazMat gear, ran a mock mass casualty incident (MCI), and heard from Dr. Otten about his experience with multiple MCIs over the course of his career.
Read MoreWorking in the Emergency Department, we often encounter patients with either pre-existing renal disease or an acute compromise of their renal function who also have a disease process necessitating a contrasted radiology study. So what do we do with that patient with a creatinine of 1.8 who has a possible vascular dissection/traumatic injury/infection? What is the risk of contrast to that patient? Should you compromise your diagnostic evaluation to avoid a harm to the patient's renal function? Dr. Nick Ludmer, Dr Michael Miller, and Dr. Amanda Polsinelli recap 3 articles recently published looking into contrast induced nephropathy. Take a listen to the podcast and read the blog post to get yourself acquainted with the current state of the literature.
Read MoreDr. McKean kicked off this week with another great M&M where he taught us about the utility of stress testing to predict coronary artery disease, otomastoiditis, and much more. Dr. Brenkert joined us for an hour on pediatric musculoskeletal ultrasound and then Dr. Mudd reviewed transfusion strategies in upper GI bleeding. Dr. Ventura taught us about CSF analysis and Drs. Stettler and Whitford rounded out the day with a CPC about acid-base disturbances.
Read MoreMusic is everywhere: from the rhythmic sounds of the ocean, to the cadence of a foreign language, to the guitarist on the corner. The ubiquity is evident; in one way or another, music is a part of our daily experience, and wrought with meaning in all cultures...
Read MoreLumbar punctures are common procedures to the Emergency Medical provider. Obtaining the fluid is just part of the battle however with this procedure. With the flood of results often comes a fair bit of confusion as to how to interpret them. After reading this post, you'll be able to:
This week kicked off with a Tox filled R4 Simulation where we learned about ASA, digoxin, and hydrofluoric acid toxicities. This was followed by lectures on cardiac disease in diabetes, pediatric pain management strategies, physician burnout and hypothermic cardiac arrest.
Read MoreThis week in Grand Rounds: lessons learned in mass casualty from our recent experience with a mass shooting, a case of abdominal pain in a patient with a TIPS, understanding the UA, the importance of diagnosing HIV in the emergency department, dental emergencies, point of care ultrasound in pediatrics, and a deep dive into the literature about management of low risk PE.
Read MoreAmongst the various diagnostic studies that can be obtained in the ED, urinalysis is a virtually ubiquitous test. Urine itself reflects the functioning of the human body in both health and disease and the values it comprises can give us information regarding a myriad of conditions from infections, metabolic or endocrine derangements, and toxidromes to neoplastic processes and pregnancy. Despite this, many of the elements of even the standard urinalysis are often overlooked and underappreciated. In this talk we will explore some of these values and hopefully gain a renewed respect for the “golden cup of answers” and all that it may reveal.
Read MoreThis week we'll be recapping the discussion of our most recent journal club where Dr. Christian Renne, Dr. Anita Goel, and Dr. Maika Dang led us in a discussion centering on the use of vasopressin both in sepsis and in vasoplegic shock states. Take a listen to the podcast below and read the brief summaries of their articles to boost your understanding of Vasopressin. Should you reach for it first or is it a second class pressor?
Read MoreDr. Grosso kicked off Grand Rounds this week with March M&M by diving deep into some core content, including BB and CCA overdoses, influenza, massive transfusion, post-intubation hypotension, and neurological catastrophes causing cardiac arrest. Dr. O'Brien broke down coagulopathy of liver disease and DIC for us while Dr. Golden taught us about febrile seizures. Drs. McKee and Colmer talked through the evidence behind their CPQE pathway on vent management in obstructive lung disease. Drs. Liebman and Powell went head to head in a CPC case about sternal osteomyelitis to round out another excellent week of learning.
Read MoreCare of the acutely ill patient in the austere setting is a hallmark of Global Health Medicine. These videos highlight three different examples of how to apply core concepts of Emergency Medicine to a resource limited environment. Dr. Lagasse describes how to make a homemade tourniquet to control life-threatening hemorrhage, Dr. Teuber shows us alternatives to intravascular volume resuscitation, and Dr. Roche outlines how to manage pneumothorax, hemothorax, and hemopneumothorax with and without vacuum assistance
Read MoreSRU (pronounced "shrew") = Shock Resuscitation Unit
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
