Thinking Critical Care

MAY 3, 2024

Had the honour of being invited to give grand rounds by Dr. Paul Mayo and share some thoughts on fluid tolerance and venous congestion. Starts around the 17min mark – sorry I have no editing capabilities! link] cheers Philippe

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Taming the SRU

SEPTEMBER 15, 2023

ultrasound grand rounds: bedside dvt studies - family presence in the ed/icu - r1 clinical knowledge: aicd - r3 small groups: difficult airway management Ultrasound grand rounds: DVT studies WITH Dr. minges Why should we perform bedside DVT studies in the ED?

CPR 79

CPR Burns Airway Management Wellness 79

Taming the SRU

DECEMBER 6, 2023

ems grand rounds: southwest ohio protocol updates WITH dr. weekley Ideally, medications will be administered IV or IO, therefore endotracheal tube drug administration will be de-emphasized. To be a good leader, you have to determine where your deep joy intersects with the world’s deep need. Remember who you are and who you represent.

Leadership 54

Leadership Stroke Airway Management Administration 54

Taming the SRU

AUGUST 7, 2023

Research Grand rounds WITH Drs. Some solutions include patient engagement, tort reform, and improved physician education and feedback and their own imaging practices and clinical decision rules. Freiermuth and Sucharew How do you determine what data your trust?

Stroke 84

Stroke Outcomes EKG/ECG Research 84

Taming the SRU

MARCH 30, 2024

Visiting lecturer: structural leadership - taming the sru - r4 sim and oral boards “Innovation Meets the Bedside: The Evolution of New Models of Emergency Care Delivery” WITH dr. ben bassin “What problem are you trying to solve?”

Hyperthermia / Hypothermia 83

Hyperthermia / Hypothermia Leadership Emergency Department Seizures 83

Taming the SRU

JULY 19, 2023

Covey For planned conversations, be intentional about time and location Use your body language to show you are paying attention Don’t interrupt with your own thoughts and solutions Encourage the speaker to finish their thought Paraphrase back what you’ve heard to make sure you understand correctly Respond to unspoken messages conveyed through tone (..)

Ultrasounds 73

Ultrasounds Leadership Hyperthermia / Hypothermia Poisoning 73

Taming the SRU

MARCH 10, 2024

Qi/KT: Hypoglycemia - R1 CK: Syncope rules - R3 TTS: Traumatic cardiac tamponade - ohio aceP Guest lectUre r2 quality improvement/knowledge translation: Hypoglycemia with drs. beyde and wolski Hypoglycemia: blood glucose of <70 mg/dL.

EKG/ECG 86

EKG/ECG Shock Wellness EMS 86

Taming the SRU

APRIL 23, 2024

Active Shooter Incidents - Mass Casualty Simulation - Climate Change - Hazmat/Decon Active shooter incidents Important to have situational awareness, which is generally defined as knowing what is going on around you Three main tactics for defense in an active shooter situation: Run, hide, and/or fight Run - Evacuation is going to be based on specific (..)

Mass Casualty Incidents 59

Mass Casualty Incidents Emergency Department Hospitals 59

Taming the SRU

SEPTEMBER 1, 2023

Level 2: Often about changing the process and limiting human behavior Goal is to change the workflow to make it easy to do the right thing (and hard to do the wrong thing) Human choices become more limited Such as making the desired action the default, regular reminders, or intentionally inserting redundancy For example: patients receiving asthma education (..)

Sepsis 84

Sepsis Administration Documentation/Coding Fractures 84

Taming the SRU

FEBRUARY 22, 2024

M&M - Arterial Lines - Fat Embolism Syndrome - CPC Morbidity & Mortality WITH Dr. Finney Case 1: MVC AMA, especially in pediatrics, is a high-risk disposition that requires thorough discussion and documentation Approach pediatric blunt abdominal trauma with a thorough physical exam and consider decision making tools when applicable Case 2 & (..)

Pediatrics 73

Pediatrics Documentation/Coding Wellness 73

Taming the SRU

JANUARY 24, 2024

Leadership curriculum: recruiting & building a team r4 Case follow-up - r3 small groups Leadership curriculum: recruiting & building a team WITH Drs.

Fractures 78

Fractures Leadership Resuscitation Dislocations 78

Taming the SRU

DECEMBER 8, 2023

R1 diagnostics & Therapeutics: ear emergencies - r4 case follow-up - r2 CPC R1 diagnostics & Therapeutics: ear emergencies WITH DR. lewis Otologic complaints make up millions of ED visits per year. The feared complications of most external ear complaints are dangerous infections or permanent deformities known as “cauliflower ear."

Hyperthermia / Hypothermia 78

Hyperthermia / Hypothermia Resuscitation Head Injuries Documentation/Coding 78

Taming the SRU

APRIL 13, 2023

stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e. stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Taming the SRU

NOVEMBER 4, 2023

Morbidity & Mortality - Global Health - MAHA - Imaging Decision Rules - BRASH - R4 Capstone Morbidity & Mortality WITH Dr. Yates Foot Infection NSTIs are rare but deadly pathology that need to be considered with any soft tissue infection NSTI is a clinical diagnosis, but there are many imaging and laboratory assessments to help increase clinical (..)

Hyperthermia / Hypothermia 74

Hyperthermia / Hypothermia Resuscitation Burns Emergency Department 74

Taming the SRU

JANUARY 26, 2024

Morbidity & MOrtality - Mini Lit Blitz - Post-Rosc Care - Qi/KT Morbidity & Mortality WITH Dr. Yates Case 1: Stroke and Stroke Mimics Early diagnosis of stroke improves stroke outcomes, where misdiagnosis is associated with an upwards of 4-time higher likelihood of mortality Missed strokes most often occur with atypical symptoms, in younger (..)

Stroke 59

Stroke EKG/ECG Outcomes Seizures 59

Taming the SRU

JANUARY 12, 2024

r4 case follow up - r1 clinical knowledge: interstitial lung disease - halo - pediatric simulation - pediatric small groups r4 case follow up WITH dr. yates Psychiatric emergency department visits are on the rise in the United States, with roughly 15-19% of all ED visits associated with mental health diagnoses Roughly twenty percent of patients presenting (..)

Fluid Resuscitation 59

Fluid Resuscitation Pediatrics Sepsis Shock 59

Taming the SRU

JULY 8, 2023

Admit/Transfer/Discharge - Breakng bad News - History of EM Admit-Transfer-Discharge WITH Dr. Paulsen There are many factors that influence disposition, including independence of the patient and family/friend support, access to follow up, resources at your hospital, and transfer environment Why Transfer?

EMS 77

EMS Emergency Department Hospitals 77

Taming the SRU

AUGUST 6, 2023

Morbidity and Mortality - Left Ventricular Thrombus - Aneurysmal SAH - Opioid Use Disorder Morbidity and Mortality WITH Dr. Kletsel Pustular psoriasis Psoriasis is characterized by discrete plaques of erythema, scales, and fissures of the extremities It is associated with significant morbidity & treatment consists of topical steroids, along with (..)

Infectious Diseases 74

Infectious Diseases Pediatrics Fractures Wellness 74

Taming the SRU

JUNE 14, 2023

Massive upper Gi bleed - electrical storm - waveform capnography - valproic acid toxicity - severe dka Taming the sru WITH dr. diaz Case: Middle aged patient with esophageal varices, recently banded presents for large volume hematemesis in hypovolemic shock. She required MAC line placement, MTP activation and transfusion.

Shock 76

Shock CPR Wellness 76

Taming the SRU

AUGUST 25, 2023

Harward Resource mobilization and team preparation are essential components of any complex resuscitation Basic tenets of resuscitation are universal: airway, breathing, circulation (the air goes in & out, the blood goes round & round.)

Seizures 66

Seizures Fractures EKG/ECG Resuscitation 66

Taming the SRU

JULY 26, 2023

Social EM - alcohol use disorder - The cases that haunt me - patient evaluations - neuroimaging - oral boards social em WITH drs. jarrel, pulvino and kimmel “One can view the ED (by law, the most accessible door into our healthcare system) as the social barometer of its community.

EMS 68

EMS Wellness Research Hospitals 68

Taming the SRU

NOVEMBER 29, 2023

Morbidity and mortality - cpc: bezoars - r1 diagnostics and therapeutics: troubleshooting tubes - r3 small groups morbidity and mortality WITH dr. stark Fever and immunosuppression In patients with recurrent visits, consider expanding your workup, especially in the setting of vital sign changes or laboratory trends.

Stroke 52

Stroke EKG/ECG Shock Resuscitation 52

Taming the SRU

SEPTEMBER 27, 2023

pediatric airways - Landmark studies in em - ebm in the prehospital setting - cpc - r1 diagnostics: pneumothorax - r4 capstone pediatric airways WITH dr. dean Intubation attempts should follow distinct, slow, and deliberate steps. Safety during intubation must be paid attention, which has led to safety checklists in the pediatric world.

Stroke 52

Stroke EMS Pediatrics Outcomes 52

Taming the SRU

JULY 14, 2023

Hughes Pitfalls: We are not multitasking, we are task switching Instead of shotgun orders, do minimum workup for patients with a specific complaint Goal is disposition in the emergency department, so “hit the box” does not just include seeing patients but also their documentation and disposition On shift hacks: Documentation - start note with sign (..)

Documentation/Coding 58

Documentation/Coding Emergency Department 58

EM Ottawa

MAY 9, 2024

Please refer to Dr. Mark McKinney’s Grand Round Summary from March 2020 (Parts 1 and 2) for a comprehensive literature review on the topic of resuscitating hypothermic patients. In this blog post, I’ll go into a more in-depth review of the staging of hypothermia and how to manage this problem in the field.

Hyperthermia / Hypothermia 62

Hyperthermia / Hypothermia Resuscitation Hospitals 62

Taming the SRU

JUNE 7, 2023

CPC: Rheumatic Fever - Carbon Monoxide Poisoning - Pediatrics: Toxicology - Combined EM/IM: Competency CPC: Rheumatic Fever WITH Drs.

Poisoning 66

Poisoning EKG/ECG Pediatrics Burns 66

Taming the SRU

JUNE 26, 2023

morbidity and mortality - wellness: behind the curtain Morbidity and mortality WITH dr. zalesky Meningitis Meningitis is an extremely difficult diagnosis with almost no clinical findings that can aid in the diagnosis outside of suspicion and a LP Seizures can be a presenting sign of infections, often without fevers or leukocytosis Of patients with (..)

Seizures 52

Seizures Best Practices Wellness Outcomes 52

Taming the SRU

MAY 1, 2023

CPC WITH Dr. Davis and Dr. Paulsen - Taming the SRU: ETHYLENE GLycol POISONING WITH Dr. KletseL - R1 CLinical DIAGNOSTICS: Toxic Plants WITH Dr. Arnold - Quick Hit: FASCICULAR Blocks WITH Dr. Baez - Research Lit Blitz WITH Dr. Wosiski-Kuhn and Dr. Zalesky - Oral Boards CPC WITH Dr. Davis and Dr. Paulsen Patient is a teenager with a history of a seizure (..)

Poisoning 52

Poisoning Hyperthermia / Hypothermia Emergency Department Seizures 52

Taming the SRU

FEBRUARY 22, 2023

EMS Grand Rounds with Dr. Connelly - R4 Case Follow up with Dr. Broadstock - R1 Clinical Knowledge: Vitamin Deficiencies WITH Dr. de Castro - Lecture R3 Small Groups Tox,Tasks,Rashes WITH Dr. Fabiano, Dr. Kein, and Dr. Martella4 - Palliative Medicine Consultation WITH Dr. Kiser EMS Grand Rounds WITH Dr. ConnelLy What I learned in my time with Sydney (..)

Hospice 40

Hospice EKG/ECG Wellness Resuscitation 40

Taming the SRU

APRIL 3, 2023

Resuscitative hysterotomy - brash syndrome - R4 Capstone - HIV Screening in the ED R3 Taming the sru: resuscitative hysterotomy w/ Dr. stark Indications: Maternal cardiac arrest > 20 weeks (at or above umbilicus) Ideally, perform within 4 minutes of arrest One study showed that this may be able to be extended to 10 minutes Increases maternal cardiac (..)

Blood Transfusions 40

Blood Transfusions Fluid Resuscitation Resuscitation Stroke 40

Taming the SRU

MARCH 31, 2023

massive bee envenomation - R4 Capstone - Hydrocephalus - cpc: brain tumor - hyperviscosity syndromes - the language of being well & embracing fear in emergency medicine tamingthesru: Massive bee envenomation WITH dr. Yates Anaphylaxis Pathophysiology Type 1 Hypersensitivity Reaction IgE-mediated Mast-cell degranulation of vasoactive materials Reaction (..)

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

The Skeptics' Guide to EM

JANUARY 4, 2021

I had the honour of presenting at the McGill University Emergency Medicine Academic Grand rounds. I had the honour of presenting at the McGill University Emergency Medicine Academic Grand rounds. They titled the talk “Evidence-Based Medicine Master Class”. Date: January 4th, 2021 This is an SGEM Xtra episode.

Academics 40

Academics 40

EM Ottawa

JUNE 8, 2023

Preamble: This Grand Rounds was inspired in part by a conversation I had with Dr. Andrew Petrosoniak during my time at St. Michael’s Hospital where we discussed the growing concern of excessive ED wait times and the limited concerted effort on addressing the waiting experience itself.

Hospitals 97

Hospitals Emergency Department 97

University of Maryland CC Project

MAY 29, 2023

Anica Law, MD, MS, Assistant Professor of Medicine/Pulmonary Center at the Boston University School of Medicine presents Critical Care Grand Rounds with a lecture entitled "After Our Work Here is Done: Survivorship After the ICU." ”

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Taming the SRU

MARCH 17, 2023

mepivacaine (1-3 h) 1% lidocaine +/- epi (2-3h) 0.25% bupivacaine (2-3 h) 0.25-0.5%

Seizures 40

Seizures Fractures Burns Pediatrics 40

Sensible Medicine

MARCH 2, 2024

I encourage the readers of Sensible Medicine who work at universities to email your chair and to request a Grand Rounds on controversial COVID-19 policy. It's clear that this is the role of universities, to have debates on the most substantive issues of our day. And yet, there are very few such debates.

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University of Maryland CC Project

MAY 25, 2023

Stephanie Taylor, MD, Associate Professor of Internal Medicine at Carolinas Medical Center presents at Critical Care Grand Rounds, a lecture entitled, "Clinical Subtypes of Sepsis Survivors Predicts Readmission and Mortality After Hospital Discharge.”

Sepsis 40

Sepsis Hospitals Resuscitation 40