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Annals of B-Pod: Baclofen Pump Failure
Muscle relaxants see a wide variety of uses in the emergency department. From the treatment of sprains and strains to the management of spasticity in patients with upper motor neuron disease, agents like baclofen, cyclobenzaprine, and methocarbamol are well-established elements of an emergency physician’s armamentarium. With prolonged utilization, however, patients may develop dependence on these agents. Furthermore, this dependence may progress to potentially life-threatening withdrawal symptoms should the muscle relaxants be abruptly discontinued. In this article, Dr. Gottula walks us through the presentation and management of a patient suffering from a severe baclofen withdrawal following the failure of her intrathecal pump, including a discussion of the underlying pathophysiology and diagnostic considerations in the emergency department.
Annals of B-Pod: Neurosyphilis
One of the fundamental axioms of medicine, passed down from generation of physicians to generation of physicians, “it could be syphilis” Perhaps no spirochete has garnered such infamy nor acrimony as Treponema pallidum. In this impeccably researched piece, Dr. Hall delves into a presentation of neurosyphilis, a devastating manifestation of the infection stemming from transmission of the bacterium into the central nervous system. Dr. Hall details the presenting symptoms, diagnostic approach, and emergent management of syphilis before delving into the various other forms this “great imitator” might take.
Grand Rounds Recap 8.8.18
This week started with a discussion on how we can improve our documentation to maximize our level V billing. This was followed by a summary of practice changing literature over the last year, a discussion on how we deal with failure in the clinical setting, and a guide to the approach of the agitated pediatric patient. Finally, we broke into small groups to learn about ENT emergencies.