Welcome to the new Tamingthesru

Same great content - new look - improved search

Is a Cuff Enough?
Journal Club, Grand Rounds Jeffery Hill, MD M.Ed Journal Club, Grand Rounds Jeffery Hill, MD M.Ed

Is a Cuff Enough?

Sepsis is a leading cause of mortality for hospitalized patient’s both worldwide and in the United States.  The surviving sepsis guidelines weakly recommend invasive arterial blood pressure monitoring (IABP) over noninvasive blood pressure monitoring (NIBP) with a blood pressure cuff supported by low quality evidence.(1) Data comparing the accuracy between IABP and NIBP measurements are limited. The largest analysis of 736 critically ill patients found a mean difference of 1 mmHg which was not statistically significant, however, there was only one measurement recorded per patient.(2) Arterial lines have several drawbacks compared with non-invasive methods such as: training requirements for caregivers, potential for pain and increased pain medications, limitation of participation in physical therapy, risk of digital ischemia, and risk of iatrogenic infection.(3) In this journal club recap, we analyze an article looking at the relationship between invasive arterial line blood pressure readings and non-invasive cuff measurements.

Read More
Grand Rounds Recap 3.27.24
Grand Rounds Guest User Grand Rounds Guest User

Grand Rounds Recap 3.27.24

We had an excellent Grand Rounds this week! Dr. Yates led our monthly Morbidity & Mortality Conference discussing pathology ranging from Dabigatran overdose to acute limb ischemia. We had an exciting CPC with hypomagnesemia presenting as new onset psychosis with Drs. Joshi & Lang. Finally, Dr. Gallen led a lecture and small group discussion on tracheostomies and their complications.

Read More
Under Pressure - Compartment Syndrome Diagnostics
Diagnostics Jeffery Hill, MD M.Ed Diagnostics Jeffery Hill, MD M.Ed

Under Pressure - Compartment Syndrome Diagnostics

Compartment syndrome is a surgical emergency that can present after a variety of insults, ranging from those we commonly encounter in the ED (fractures, crush injuries) to more rare clinical presentations (snake bites, electrocution). The initial elevation of compartment pressures can be secondary to internal (ex. bleeding, swelling, fluid overload) and/or external (ex. compressive devices, burn eschar) factors. In this post, we detail the history/physical and diagnostic evaluation of possible compartment syndrome.

Read More