The Global Health case series highlights interesting cases residents experienced while practicing abroad and takes a dive into how to identify the pathology that is crucial know to care for patients both abroad and returning. Dr. Colmer continues this year's case series with a case of an adult patient with a "textbook" rash he saw while in Tanzania.
Read MoreThis weeks grand rounds started off with our monthly Morbidity and Mortality with Dr. Lagasse. We then discuss in Aircare grand rounds led by Drs. Dang and Renne the always harrowing complex patient transfers including LVAD, EKOS and more.
Read MoreThere are some areas in our practice where the literature grants us a somewhat sure path forward in the evaluation of our patients. The decision whether or not to pursue cervical spine imaging studies following a traumatic mechanism of injury is one of these areas. The NEXUS criteria and Canadian C-Spine Rule are useful guides for the evaluation of these patients. What comes after the imaging can be a bit more challenging. What do we do with patients who have persistent pain but negative imaging? To what extent do we pursue the possibility of a ligamentous injury? Must we wait for all patients to be sober so that we can "clinically clear" them in addition to our radiographic clearance. The 3 articles below seek to answer some of these challenging questions. Take a listen to the podcast and read the summaries to familiarize yourself with some of the latest literature addressing these challenging patient care scenarios.
Read MoreThe first installment of our new AirCare series! We start off with one of the most anxiety provoking scenarios we encounter on AirCare: the pediatric airway. Read on to learn how to calmly and methodically manage this difficult patient.
Read MoreThis weeks Grand Rounds was started off with our guest lecturer, Dr. Esther Choo, who gave a compelling talk regarding gender disparities in medicine and the effects of gender bias in our profession and every day practice. This was followed by Dr. Owens and Ventura giving their evidence based approach to the management of A-Fib, as well as previewing their upcoming algorithm for Tamingthesru.com. Our pediatric EM colleague Dr. Valentino then walked us through current recommendations on the approach to the febrile infant. In the last hour, Dr. Iparraguirre gave us a lecture on the approach to rashes in the ED. The conference then concluded with an R4 clinical soap box lecture by Dr. Dang on the history of cannabis and medical marijuana, as well as the research behind its current use.
Read MoreLumbar punctures can be mercurial procedures. There are certainly patients in whom it can be predicted that a lumbar puncture will be challenging. Obesity, patients with known degenerative changes, and agitated patients all present unique challenges when it comes to successfully completing a lumbar puncture. There are patients, however, who throw you a bit of a curveball. Sometimes cooperative patients with good landmarks, in whom you had every expectation that you would find success, become seemingly impossible to successfully complete a lumbar puncture.
For the provider, knowing how to troubleshoot the unexpectedly difficult lumbar puncture can be the difference between success and failure.
Read MoreUltrasound Case of the Month is Back! This month, a patient with several months of progressive dyspnea. Not acute, so not an ED problem? Think again! Read on to see what you might have missed if you didn't pick up an ultrasound probe...
Read MoreThis week Dr. Carleton kicked off a lecture series on the pediatric airway by discussing some anatomic and physiologic challenges as well as predictors of difficulty. In the latest installment of our Global Health lecture series, Dr. Lagasse gave us a great review on the unique uses of point of care ultrasound in a resource limited setting. Our R1 Diagnostics curriculum was continue by Dr. Gleimer who discussed the use of PFTs in the ED setting and Drs. Ham & Wright finished things up with an altered mental status CPC presentation.
Read MoreMore on the red eye! This time we discuss episcleritis and scleritis, two conditions that are often mistaken for each other. One of these conditions, however, can have detrimental consequences if missed. Read on to learn how to tell the difference and what to do about it once you've made the diagnosis.
Read MoreWhile formal pulmonary function testing is not often (if ever) performed in the ED, many patients with a history of COPD, asthma, CHF, sarcoidosis, etc, have had pulmonary function testing performed in the past. Having an understanding of the underlying pathophysiology of these conditions, physiology of the lungs and respiration, and understanding of how the testing is performed is critical to being able to appropriately interpret the results of these test and apply the test results to our patients.
Read MoreYou are working an busy overnight shift at your rural community ER when a nurse comes to notify you of a new patient in the lobby - there are no open beds currently, but she thinks he looks ill.
You go out to evaluate the patient quickly - He is complaining of severe generalized abdominal pain that started a few hours ago and is worsening. He looks pale and slightly diaphoretic, has severe abdominal tenderness with peritonitis. Concerned, you wheel him back to your trauma bay...
Read MoreIn this week's grand rounds, Dr. Stolz discussed all things DVT and the modified two-point compression study for lower extremity clots. In our recurring EM-neuro combined conference, Dr. Stettler discussed the recent DAWN trial results, and how to incorporate CT perfusion studies into our acute ischemic stroke decision trees. In our Quarterly Sim, we discussed the management of the crashing patient from a house fire, and practiced our escharotomy skills. In our mock oral boards, we went through cases on STEMI, carbon monoxide exposure and limb ischemia. Finally, Dr. Lane discussed the workup of acute diarrhea in the adult population, and Dr. Shah went through a particularly unique toxidrome presentation in his R4 Case Follow Up.
Read MoreThis past month has seen the appearance and peaking of seasonal influenza in the Northern Hemisphere. This year, a particularly early strain of flu has been causing widespread illness across all 50 of the United States. The start (or height) of any flu season is a good time to refresh our understanding of the influenza virus, prevention strategies, testing methods, and treatment modalities. This year, however, we also sit exactly 100 years removed from the most deadly global pandemic ever seen by humanity. Try your hand at some flu-based trivia and take a listen to the podcast below (or on iTunes).
Read MoreThis week's Grand Rounds started off with our monthly Morbidity and Mortality conference with Dr. Titone. This was followed by a lecture on pediatric bloody diarrhea with Dr. Shan Modi. Dr. Claire O'Brien then gave her Clinical Soap Box lecture on cost and waste within the healthcare system. Dr. Kreitzer then gave an evidence based lecture on current research in sepsis and refractory septic shock, followed by our consultant of the month lecture with Dr. Anthony Blanchard from podiatry discussing foot wounds and osteomyelitis.
Read MoreThe Global Health case series highlights interesting cases residents experienced while abroad and takes a dive into how to identify the pathology that is crucial know to care for patients both abroad and returning. Dr. Sabedra kicks off this year's case series with a case of pediatric abdominal pain she saw while in Tanzania.
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.
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