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Grand Rounds Recap 6.10.20
This week we reconvened with our pediatric colleagues for a case series of seizures and COVID autoimmune vasculitis. Drs Modi, Harty and Jarrell took us through global health case series and finally guest lecturer Dr. Kenji Inaba from LAC-USC gave us some take-home tips in hemorrhage management.
Global Health Videos
Care of the acutely ill patient in the austere setting is a hallmark of Global Health Medicine. These videos highlight three different examples of how to apply core concepts of Emergency Medicine to a resource limited environment. Dr. Lagasse describes how to make a homemade tourniquet to control life-threatening hemorrhage, Dr. Teuber shows us alternatives to intravascular volume resuscitation, and Dr. Roche outlines how to manage pneumothorax, hemothorax, and hemopneumothorax with and without vacuum assistance
Flights - A Stab in the Dark - Curated Comments and Expert Commentary
Thanks to everybody who contributed to an excellent discussion of the care of the patient on our second “flight.” If you didn’t get a chance to check out the case and the discussion, check it out here. Below is the curated comments from the community and a podcast from Dr. Hinckley and Flight Nurse Practitioner Jason Peng
Q1 - Walk through your initial assessment of this patient. What are the critical aspects of the assessment of this patient?
In response to this question, most everybody wanted to first act on the bleeding wound in the patient’s right antecubital fossa. As explained by Dr. Renne, “I would want to be systematic but efficient, probably using a C-ABCD approach to these kind of critical patients, with the first C being any sort of life-threatening but "C"ontrollable hemorrhage.” Dr. Renne also had a fine point with regards to checking for other potential, as of yet unseen, injuries. This is a patient with multiple stab wounds, it is crucial to conduct a quick, but thorough search for stab wounds to the back, axilla, groin, and/or other locations where significant blood loss could be caused by a stab wound.