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Is Your Head Spinning? The Sudbury Vertigo Risk Score
There is a wide variation in practice, particularly in obtaining neuro-imaging in patients presenting with vertigo. Many patients are imaged and subjected to a longer length of stay, and on the other side of the coin, some patients with serious pathology fall through the cracks. The authors of this study set out to create a risk score to apply to patients who present to the ED with vertigo which would identify the patients at risk for serious pathology (which they defined as stroke, TIA, vertebral artery dissection, or brain tumor).
Grand Rounds Recap 1.26.22
This week, we started off with an excellent journal club led by Drs. Ijaz and Mullen discussing interventions aimed at improving access to primary care from the Emergency Department and then followed along with Drs. Ferreri and Skrobut as they battled out a case of mysterious altered mental status during the crowd favorite, CPC. Dr. Pulvino reminded us that not all rashes are simple through her case follow up and Dr. Gobble took us on a deep dive of the diagnosis and management of gastroparesis and cyclic vomiting syndrome. Finally, we closed out the day with lessons in nasal endoscopy and cricothyrotomy from the airway guru himself, Dr. Steven Carleton.
Telling Tall Tales: Dogma in Emergency Medicine
In our training and education as Emergency Medicine providers, we often come to accept certain practice patterns as fact. When these established “facts” come along with fantastical clinical claims (don’t give your corneal abrasion patients tetracaine, it’ll melt their corneas; don’t use lido with epi for digital blocks, their finger will fall off; don’t use beta-blockers in patients on cocaine, their BP will skyrocket due to unopposed alpha-effects), we should probably look to question their supporting evidence.