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Grand Rounds Recap 9.5.18
This weeks grand rounds started off with a discussion on the utility of the bougie in airway management by Dr. Carleton. This was followed by Dr. Kiser and Dr. Gensic who led us through a case-based discussion on complex laceration repairs encountered in the community ED setting. Dr. Neth then presented the evidence behind the use of epinephrine and mechanical CPR in out of hospital cardiac arrest. Next up was Dr. Soria who presented a case of Wernicke’s Encephalopathy with some learning pearls about this often under-diagnosed condition. Dr. Goel then masterfully answered the CPC challenge placed by Dr. Li to diagnose a rare case of ocular syphilis. Dr. Berger then finished the day with an overview of necrotizing fasciitis and the LRINEC score.
QI/KT: Cardiac Arrest
The first of a new series of posts with associated podcasts looking at the literature behind what we do every day in the ED with takeaways of tangible algorithms to guide every day practice. This month Drs Gauger and Harty lead us in a discussion of cardiac arrest, the drugs we use, the ultrasound we dabble with and the future interventions that could become standard of care.
Cotton Fever
When a patient with a history of recent IVDU presents with a complaint of fever, the mind of the provider should immediately focus on the numerous possible infectious complications that can arise. Infectious endocarditis can lead to septic emboli spread to any organ system. Pneumonia can result from aspiration or septic embolization. Cellulitis/abscess can obviously result from local injection. But what about when a source of fever is not readily identifiable? When cultures are negative and the patient’s symptoms have resolved, what could have been the cause of their febrile illness?