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Grand Rounds Recap 7.10.24

Taming the SRU

Femoral nerve block case review - morbidity & mortality - community practice - r2 Clinical pathologic case - visual diagnosis - when time matters - operational aspects of stroke care Femoral nerve Block Case Review WITH dr. stolz Why do we care about regional anesthesia, specifically femoral nerve blocks? for obstructive CAD, OR 1.8

Stroke 97
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How To Manage Tracheo-Innominate Fistula

ACEP Now

18 The finger is inserted through the stoma alongside the endotracheal tube and, while 90 percent success rate has been reported with this method in controlling bleeding, the pressure must be maintained until the patient is transferred to the operating room. 2013:1960-62. Tracheo-innominate artery fistula after stroke.

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The Current Status of Continuous-Seizure Management

ACEP Now

2 A study of routine EEG in the ED in 2013 found that five percent of ED patients with altered mental status had nonconvulsive seizures (of whom 75 percent were in nonconvulsive status epilepticus). Some institutions have the capability to perform real-time EEG monitoring and interpretation by a neurologist in the ED.

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Nephrolithiasis: Ultrasonography versus Computed Tomography

Northwestern EM Blog

Follow up CT should depend on the patient and ultrasound operator. Lastly the POCUS operators were ED physicians with training “recommended by ACEP.” He endorses nausea without vomiting and denies fever. In this study, 40.7% of those in the POCUS group and 27% in the formal ultrasound group underwent subsequent CT. References Fwu, C.

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Diagnostics: Inflammatory Markers

Taming the SRU

Similarly, a 2013 meta-analysis of 6 studies with 1,006 patients published in the American Journal of Emergency Medicine showed neither CRP nor PCT are sufficient to rule-in or rule-out infective endocarditis, with PCT having a pooled sensitivity of 64% and specificity of 73% and CRP having a pooled sensitivity of 75% and specificity of 73% [40].

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Contrast Media Shortage of 2022 – Lessons Learned

EMDocs

3 A study of CT use trends in the ED has shown increasing use of CTs by almost 60% from 2005 to 2013. 3 A study of CT use trends in the ED has shown increasing use of CTs by almost 60% from 2005 to 2013. Under standard operating protocols, residual contrast materials are usually wasted, according to current CDC and JC standards.

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Pediatric Pain

Pediatric Emergency Playbook

Neonatal observational scales have been validated in the intensive care and post-operative settings; ED-specific quantitative scales are lacking. CRIES ( Table 1 ) was validated for post-operative patients; to adapt its use for the ED, the most conservative approach is to substitute “preoperative baseline” with normal range for age.