That pesky little RLQ pain is back, but you thought you put a stop to this nonsense! Join Dr. de Castro as he takes us through a case of stump appendicitis and increases awareness of this rare post-appendectomy complication.
Read MoreRecap another week of Grands Rounds with us! Dr. Gabor helps us confidently navigate the medical emergencies in patients with a transplanted organ. Next up, Dr. Kein talks about the difficulty of navigating grief while completing residency training. Dr. Hill introduces use to research topics in the field of medical education. Our faculty who trained at other institutions, Drs. Adan and Lang, highlight different regional practice pattern variations and the evidence behind them. Meanwhile, Dr. Roche helps us learn how to better care for our female patients in the community. Lastly, we wrapped up with a joint lecture with the Cincinnati Children’s PEM program to learn out handling pediatric foreign bodies in the ED.
Read MoreJoin us as we recap another excellent week of Grand Rounds. We start with the final installment of our leadership curriculum, where Drs. Hill and LaFollette guide us through the dreaded task of self-promotion. We join Dr. Stark on a moment of self-reflection and growth following a particularly difficult patient case. We are transported into the SRU as Dr. Wright presents the evidence for how we should approach traumatic cardiac arrests in the resus bay. Dr. Adan shares his airway expertise and provides helpful tips/tricks for overcoming the feared anterior airway. Lastly, our colleagues from pharmacy drop by to discuss some relevant updates- including reasons why you should think twice before ordering a urine culture in the ED.
Read MoreWe started off this Wednesday with the crowd favorite M&M by Dr. Kletsel covering fantastic learning cases. This was followed by an expert discussion of neuromuscular weakness by Dr. Onuzuruike, and a quick hit EKG lecture by Dr. Urbanowicz on EKG artifacts. We wrapped up this day of discussion with our social emergency medicine grand rounds and our quarterly Landmark Studies of EM focusing on critical care.
Read MoreWelcome to Disaster Day! UCEM learned about a broad range of topics today from active shooter incidents, climate change and how it affects our approach to disaster medicine, and mass casualty preparedness.
Read MoreSepsis 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 MoreA hernia is described as, “the abnormal protrusion of abdominal contents through a defect involving the normal confines of the abdominal compartments” (9). It often involves a portion of the intestine protruding through a weak point of the abdominal wall. The location and size of the hernia often determines the symptoms and complications that a patient will present with.
There are several risk factors that make developing a hernia more likely. Older patients and those who have had prior abdominal surgery may have weaker abdominal muscles or connective tissue which would make it easier for a hernia to develop. In addition, if there is increased abdominal pressure, such as patients with obesity, or those who participate frequently in weightlifting, this is another factor that may put someone at a higher risk of developing a hernia. Finally, those with poor wound healing, such as people who smoke often or patients with diabetes, may be at risk for incisional hernias. (6)
Read MoreAn excellent Wednesday here in Cincinnati! We started out the day with our ultrasound grand rounds where ultrasound fellow Dr. Broadstock took us through an interactive lecture on advanced cardiac ultrasound. This was followed by a lecture by faculty member Dr. Irankunda who discussed the importance of names and embracing individuality. Finally, we ended the day with a combined session with our pediatric colleagues where we covered pediatric procedures, foreign body aspiration, and a neonatal potpouri. We can’t wait for next week!
Read MoreWe 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 MoreWe had an exciting Grand Rounds this week! Dr. Ben Bassin, a UCEM alum and our visiting lecturer from the University of Michigan, started off strong discussing innovation in emergency care delivery. He discussed modeling and design of modern emergency departments and our upcoming Flex ICU. Dr. Grisoli then shared an exciting resuscitation of a profoundly hypothermic cardiac arrest. We split off into small groups for simulation and oral boards covering tuberculosis, meningitis and the RV spiral of death.
Read MoreCan the addition of high-dose methylprednisolone to the treatment of out-of-hospital cardiac arrest make a meaningful difference? In this post-hoc analysis of a placebo-controlled randomized control trial comparing high-dose methylprednisolone versus placebo in out-of-hospital cardiac arrest (OHCA), the authors aimed to assess the hemodynamic effects of prehospital high-dose glucocorticoid treatment in resuscitated comatose OHCA patients.
Read MoreSuccessful airway management is one of the cornerstones of every emergency medicine physician’s toolkit, and tracheostomies can often fall under that category of “difficult” or “scary”. In this post, we aim to familiarize learners with the anatomy of the trach airway and basics of trach tubes as well as teach management and troubleshooting of various complications of tracheostomies.
Read MoreAnother great week of Grand Rounds! We started with optimizing our wet reads on MSK xrays then moved into a victorious CPC win in the diagnosis of giant cell artertitis with a patient presenting with CN VI palsy and diplopia. We then discussed the tips and tricks for hernia reduction before hearing a moving story of a harrowing AirCare transport for ECMO cannulation. We moved into R3 small groups covering obstetrics and labor from mother to newborn and finished off with our pediatrics team visiting to discuss emergent cardiac conditions.
Read MoreWith the advent of fast-acting subcutaneous insulin analogs over the past 20 years, multiple studies have demonstrated that subcutaneous insulin protocols for treatment for treatment of mild-to-moderate severity DKA are safe and cost-effective when compared to intravenous insulin infusion protocols in non-ICU settings. In the context of increasing ED and hospital crowding as well as limited ICU availability, this study aimed to evaluate the impact of a subcutaneous insulin (SQuID) protocol in the treatment of DKA on emergency department length-of-stay (EDLOS) and ICU admissions
Read MoreA patient presents with severe knee and leg pain after an MVC and you are worried about a possible knee dislocation, but don’t know how to evaluate them thoroughly… Join us for a special consultant edition of TTSRU - Dr Sean Catlett, a PGY-4 orthopedic surgery resident and Dr Sarah Moulds, a PGY-3 EM resident to discuss a full approach to the knee exam and management of the dislocated knee.
Read MoreSRU (pronounced "shrew") = Shock Resuscitation Unit
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
