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Grand Rounds Recap 1.10.24
We started off the day strong with a R4 Case Follow Up lecture presented by Dr. Yates who led an excellent discussion on psychosis, including maintaining a broad differential for secondary psychosis and appropriate management. We then transitioned to an R1 Clinical Knowledge lecture where Dr. Segev guided us through interstitial lung disease and fibrosis ranging from epidemiology to diagnosis and treatment. This then followed by a hand-on high acuity low opportunity procedure review including esophageal balloon tamponade, transvenous pacemaker placement, and chest wall escharotomy. The hands-on sessions continued into the afternoon where our CCHMC colleagues led a simulation on neonatal shock. Overall, a great day at UCEM Grand Rounds!
Grand Rounds Recap 1.3.24
We are back and ready for our first grand rounds of the year! We had a great variety in lectures today. Dr. Wosiski-Kuhn shared her capstone on violence against healthcare workers. Dr. Martella followed up a case of a patient with a spontaneous coronary artery dissection and their puzzling ED clinical presentation. Dr. Guillaume helped us troobleshoot and optimize our options for vascular access including EJ cannulation, ultrasound-guided IVs and all things PICC line. Dr. Haffner took us through a pathophysiology and treatment review of a patient with a very large calcium channel blocker overdose. The R2 team of Drs. Della Porta and Hajdu presented their protocol on alcohol withdrawal in the ED. We learned about the use of panorex as a new study for certain dental patients in conjunction with oral surgery from Dr. Urbanowicz. Finally, Dr. Baez dropped some protips to be confident and competent at a busy community ED site.
Diagnostics and Therapeutics: Vascular Access in the Emergency Department
Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. However, in at least 10% of patients, blind insertion of a peripheral IV may be unsuccessful for a variety of reasons. In this post, we will review multiple alternative access options, as well as briefly discuss concerns related to PICC lines.