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Grand Rounds Recap 8.30.23
We start off strong this week with EMS grand rounds, where EMS fellow Dr. Klein walks us through potential uses and barriers for using ultrasound in the prehospital setting. We then moved on to our R1 Diagnostic and Therapeutics lecture, where Dr. Segev expertly led us through a discussion on the use of inflammatory markers in the ED including several small group cases. Next, an exciting CPC matchup between Drs. Schor and Stolz who went head to head to discuss a mysterious case of the hiccups. This was followed by Dr. Diaz who gave her R4 Capstone lecture on what her R4s taught her. Finally, we wrapped up the day with an excellent discussion on airway management during our airway grand rounds.
Diagnostics: Inflammatory Markers
Ever get an ESR or CRP signed out to you and wonder why they were ordered? Want to use them intentionally and in an evidence-based way? Join Dr. Eric Segev as he takes a dive into the data of inflammatory markers and the pathologies in which they have been studied.
Pro's and Con's of Procalcitonin
Procalcitonin was reviewed on Taming the SRU in the context of other biomarkers (ESR, CRP) last year with a grand rounds discussion of its utility in the setting of a febrile 7 week old. As procalcitonin has continued to gain traction in the world of pediatric EM – receiving evaluation as part of proposed protocols for management of febrile infants (1) and for its utility as an aid to diagnosis of Serious Bacterial Infection (2,3) – we turned our attention this year to procalcitonin’s use in adults. Procalcitonin testing has been studied and available for decades (as St. Emlyn’s noted in an update earlier this year), but has not really established itself in widespread use in adults (as EMDocs noted in a sepsis update in 2014). In this blog post, we take the approach of going back to what is known (and is NOT known) about the biochemical basics of this molecule to give context to the sometimes confusing smorgasbord of proposed applications for procalcitonin testing that exists in the literature.