Category: Journal Club

Hard to believe another block is finished! Soon we will find ourselves in a FLIP conference desert with a long stretch of regional conferences until Halloween. However, that doesn’t mean that we will slack on continual content. See the highlights below

JC: Dr. Chris Moore

We had another solid JC this month. We investigated junior resident’s success using video-guided laryngoscopy vs DL. Below is the article/summaries, as well as the clinical vignette/correlation. Remember the articles/summary is the raw by the books examination of the literature while the clinical vignette/correlation applies all the researchy stuff into clinical practice!

Articles/Summary
Clinical Vignette/Correlation

AMS: Algorithm Building

We unveiled another new FLIP station this block: algorithm building. The point was to take a common ED chief complaint, and break down the steps we take to work it up. This was a HUGE topic, and 40 minutes didn’t do it justice. The full content of the station is posted below, including a recommended algorithm, all 4 cases, and detailed case reviews. Check out the notes for each powerpoint slide, there is quite a lot of educational goodness packed behind all those memes/GIFs.

Recommended AMS Algorithm
Case Scenarios
Case Review

Admini: Ebola Review

Ebola is quite the problem. Management is VERY particular. Dr. D gave us a very detailed rundown from a real situation we had at DRH. Stay informed, 70-90% mortality is no joke.

Admini Ebola Lecture

Melanie’s PharmD tPA Breakdown

Our ED pharmacist’s killed it again, this block breaking down the essentials of tPA

pharm lecture tPA

Journal Club: High Flow Nasal Cannula

Hey Everyone! As the new interns settle in, we don’t want new education falling behind. Some of you may have celebrated at Dubey’s pool party, but little did you know there was a club within the party…a JOURNAL CLUB. If you missed out on it, Dr. Maqbool discussed the benefits of high flow nasal cannula (something we see everyday at CHM but RARELY at DRH). See below for the recap!

Clinical Vignette: A 55 year old male with a history of Type II diabetes and hypertension presents to the emergency department with a chief complaint of “I’m having trouble breathing.” Patient states that for the past two days, he has felt increasingly short of breath. He denies any fever, cough, rhinorrhea, or chest pain. He is tachypneic and lungs are clear to auscultation. Initial vitals are blood pressure 180/76, HR 94, RR 24, SpO2 is 91% on room air. You are concerned about the patient’s respiratory distress but don’t think the patient warrants intubation because he is alert, has no accessory muscle use, and is able to speak to you in full sentences. However, you want to address the patient’s tachypnea and hypoxia. You wonder which intervention will help prevent your patient from being intubated in the ED today and also provide the greatest long term benefit for his respiratory status. What will you use for oxygen therapy? Standard O2 nasal cannula or high flow nasal cannula? What would you use if the patient had COPD? What if the patient had fevers or signs of pneumonia? What if the patient presented with signs of pulmonary edema or heart failure?

Click here for the response to the vignette!
Click here for all the articles!

Journal Club: RSI in TBI

If you missed Dr. Neha Mehta-Sykes’s JC on this topic, make sure to read the review posted below. Our choice of paralytics in these patients often causes a stur amongst our NICU colleagues, so educate yourself!

Clinical Vignette: 70 yo M with PMH of HTN, non-compliant with HCTZ and amlodipine, presenting with new-onset seizure x2 witnessed by family, followed by altered mentation. EMS was called by family. Presenting vital signs are: BP 225/135, HR 120, RR 12, pulse ox 95% on non-rebreather mask, temp 37.3. GCS 5, responsive to pain in all extremities except for right upper, with right eye gaze deviation. The decision is made to intubate the patient for airway protection. You suspect an intracranial hemorrhage as the cause of his seizures. Which medications would you like to use to intubate the patient?

Click here for the review and musings on the topic!
Click here for all the articles!

Think Pair & Share: Abscess/Cellulitis

We had our first ever Think Pair & Share FLIP this week! Big shout out to Drs. Messman, Kava, and Burkholder for paving the way for this. We hope to integrate more true FLIPs such as this into our conferences. These are discussion based small groups, so I’m sure every group had a slightly different experience. See the full literature review below if you wanted to revisit any of the topics.

Click here for the deepest of dives