Tamingthesru

We spent some time as a residency this past month running through a series of asynchronous small group cases. This is the recap of the third case. We cover the approach to a patient presenting with a headache and look at the diagnostic approach to temporal arteritis

We spent some time as a residency this past month running through a series of asynchronous small group cases. This is the recap of the second case. We cover the diagnostic approach to the patient with unilateral leg swelling and what happens when DVTs are really really bad

We spent some time as a residency this past month running through a series of asynchronous small group cases. This is the recap of the first case. We cover the initial case set up and the high yield learning points: hitting on an unusual cause of sepsis and what to do with a fib with rvr in the setting of sepsis

This months journal club focused on evidence supporting (or not supporting) three different entrenched practices in the ED. The authors discuss the use of lidocaine with epinephrine for digital blocks, use of beta blockers in cocaine associated chest pain, and discharging patients with corneal abrasions with tetracaine.

We take a dive into the literature looking at the treatment, evaluation, and disposition of patients with community acquired pneumonia. Is any one scoring system better than another? Can we predict which patients will have drug resistant pathogens? Can BNP replace PSI for predicting patient mortality?

We discuss several articles looking at the care of patients with heart related complaints. Does Magnesium have an adjunctive role for rate control in A fib with RVR? Can we not just treat most all A fib with RVR patients in an outpatient pathway? Does the HEART score perform as well 1 year out as it does at 30 days in terms of limiting health care utilization

We dive into the key defining characteristics to recognize cardiogenic shock with limited information available. We then review what key initial steps may help stabilize these often critical patients.

We discuss several articles pertaining to the use of antibiotics in the ED. Should we be ordering Vancomycin for patients likely to be discharged? Is the combo of Vancomycin and Pipercillin-Tazobactam nephrotoxic? Is it helpful to add Bactrim to Cephalexin for patients with cellulitis but no abscess?

Dr. LaFollette discussed the evidence based approach to cardiac arrest care with Dr. Joshua Gauger and Dr. Shaun Harty as the summarize and recap their quality improvement and knowledge translation project.

In this rundown of our most recent Journal Club, Drs Soria, Murphy, and Whitford cover 3 articles looking into how best to manage a patient's airway in cardiac arrest. Should we just bag all these patients or should we move to intubating quickly? How good are EGDs? Are they better than intubation? The discussion also turns to the results of an abstract presented at the most recent SAEM Academic Assembly which outlines the first randomized control trial looking into airway management in out of hospital cardiac arrest.

Drs Andrew Latimer and Adam Gottula cover the use of ultrasound in the helicopter EMS. They talk about the barriers to using the device in the field and the advantages to patient care.

The choice of resuscitative fluid for bleeding trauma patients is clear: blood is your go to. But what kind of blood product is best. Recently literature has suggested that the transfusion of blood components in a 1:1:1 ratio portended better outcomes. Most recently, based on some emerging military literature, it has been suggested that the transfusion of whole blood may result in improved outcomes and reduce overall transfusions. In this podcast, we will take a look at three articles that look into the feasibility of and benefits from the transfusion of whole blood.

Differing guidelines between European and US healthcare societies can make the administration of Rhogam in the ED a bit confusing. Dr. Gottula sits down with Afshin Taleghani, PharmD to demystify the indications for administration.

On this podcast we cover 3 articles that seek to address frequent challenges we encounter with patients who have blunt trauma and negative cervical spine imaging. Must we wait until all patients are clinically sober to clinically clear them? How aggressively should we pursue the ligamentous injuries and if we do what should our diagnostic strategy be?

On this podcast we cover a broad swath of flu related topics. From the devastating pandemic H1N1 influenza of 1918 to the diagnosis and treatment of influenza in 2018.

On this podcast we cover 2 topics that have emerged in the airway literature that may be impacting our airway management practices going forward - flush rate oxygen for pre oxygenation and intubation with head of bed elevation

Dr. IC Cordes himself, Dr. Steven Carleton is on to discuss the management of tracheostomy complications in the Emergency Department. During the discussion, we cover the management of the bleeding stoma site, the displaced tracheostomy tube, the stenosed tracheostomy site.

We take a look at the literature surrounding the use of CCTA in patients with chest pain. Should we be using this diagnostic test on low risk chest pain? intermediate risk chest pain? at all?

We take a look at the emerging literature surrounding the treatment of submassive, also known as intermediate risk, pulmonary emboli. What can we do about these clots causing significant hemodynamic changes? Are the emerging treatments ready for prime time?

We delve into the evidence surrounding the phenomenon of contrast induced nephropathy. Is it real or a figment of our imagination? Should we just flood these patients with saline to avoid the possibility of CIN? Drs Ludmer, Polsinelli, and Miller lead us in a discussion of 3 articles on the topic.