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Grand Rounds Summary 10.4.17
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Grand Rounds Summary 10.4.17

This week Drs. Jarrell and Nagel kicked off Grand Rounds with their evidence based review of the hypertension management in the ED. Drs. Gorder, Lagasse, O'Brien, and Polsinelli discussed the difficult management of the patient in both cardiogenic and septic shock, reviewed heart murmurs, and endocarditis. Dr. Bryant made us squirm with her Global Health quick hit case review of parasitology, Dr. Lane led a great group discussion about the utility of procalcitonin in adults, and Drs. Habib and Roche ended Grand Rounds with a great CPC case!

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Pro's and Con's of Procalcitonin
Diagnostics, Grand Rounds Jeffery Hill, MD M.Ed Diagnostics, Grand Rounds Jeffery Hill, MD M.Ed

Pro's and Con's of Procalcitonin

Procalcitonin was reviewed on Taming the SRU in the context of other biomarkers (ESR, CRP) last year with a grand rounds discussion of its utility in the setting of a febrile 7 week old. As procalcitonin has continued to gain traction in the world of pediatric EM – receiving evaluation as part of proposed protocols for management of febrile infants (1) and for its utility as an aid to diagnosis of Serious Bacterial Infection (2,3) – we turned our attention this year to procalcitonin’s use in adults. Procalcitonin testing has been studied and available for decades (as St. Emlyn’s noted in an update earlier this year), but has not really established itself in widespread use in adults (as EMDocs noted in a sepsis update in 2014). In this blog post, we take the approach of going back to what is known (and is NOT known) about the biochemical basics of this molecule to give context to the sometimes confusing smorgasbord of proposed applications for procalcitonin testing that exists in the literature.

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Grand Rounds Summary 9.27.17
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Grand Rounds Summary 9.27.17

Dr. Titone held a great in-depth M&M this month with cases from tuberculosis to typhilitis (which is a thing). Drs. Baez and Goel took us through cases of coding Torsades and coding Pine Sol ingestions, followed by Dr. Skrobut who delicately closed the day with a discussion of testicular complaints in the ED.

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