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SBRIT in the ED - Dr. Griggs

11/17/2016

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1.  SBIRT is an effective strategy to change behavior of patients with substance abuse problems
2. Standard screening tools exist to identify patients that would benefit from Motivational Interviewing.  These include the AUDIT and DAST-10.  
3. Brief Motivational Interviewing requires identifying where the patient is in the stages of change and engaging them with reflective listening to motivate further change. 

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ITP, DIC, & TTP - Dr. Thomas

11/17/2016

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​1. ITP is a diagnosis of exclusion, laboratory findings other than isolated thrombocytopenia and the associated symptoms should suggest an alternative diagnosis.
2. TTP has an extremely high mortality and early initiation of plasma exchange therapy and hematology consult can drastically improve patient outcomes.
3. DIC can be caused by many medical conditions and treatment should be at the underlying cause 
4. In general, platelet transfusion is not the appropriate treatment for ITP, TTP and DIC and is often contraindicated

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CMC Case Conference - Dr. Mollo

11/17/2016

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1.  Cervical check every pregnant patient who presents with potential labor.
2.  Start with transabdominal US for pregnant patients before advancing to transvaginal US. Sometimes "dates" are incorrect!
3.  Be sure to ask pregnant patients about history of reproductive assistance/REI drugs.
4.  Use the airway checklist for intubation preparation. 

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Pediatric Seizure Disorders - Dr. Bryant

11/17/2016

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  • It is important to know pediatric weight based dosing for seizure management
    • Make it simple
      • First line (Benzos)
        • Ativan: 0.1mg/kg
        • Versed/Valium 0.2mg/kg
      • Second/Third line
        • All starting doses 20mg/kg
  • Rule out easy to correct/identify causes for pediatric seizures
    • Remember GLITTER (GLocuse, Infection, Trauma, Tox, Electrolytes, Random)
  • If patient doesn’t meet any of the GLITTER criteria, think outside the box
    • SCD with vaso-occlusive stroke
    • Drug withdrawal 
  • There are several debilitating pediatric seizure syndrome
    • Seizures notoriously difficult to control
      • Ask for help! (consult Peds Neuro, parents usually well educated on child’s condition)
    • Poor prognosis 

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Case Conference - Dr. Goode

11/10/2016

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• Urethral injury should be suspected and excluded in patients with pelvic fractures
• Although efforts have been made to standardize capacity assessments, they are complex and subjective. Take opportunities to introduce the benefits of advance directives early.
• 
All patients with unexplained hematuria need to be informed of this finding and have close follow up.

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Pediatric Burns - Dr. Weihmiller

11/3/2016

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  • Always consider NAT for burn patients
  • Can use palm of a child as 1%  TBSA
  • Metabolic response -> end organ damage and can last several weeks
  • CXR may not show pulmonary damage for 24-28 hours
  • Full thickness burns cannot re-epithelialize
  • No longer using Parkland Formula for fluid calculations
  • Add D5LR maintenance fluids in < 5 years

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  • RESIDENCY
    • About CMC
    • Curriculum
    • Benefits
    • Explore Charlotte
    • Official Site
  • FELLOWSHIP
    • EMS
    • Global EM
    • Pediatric EM
    • Toxicology >
      • Tox Faculty
      • Tox Application
    • (All Others)
  • PEOPLE
    • Program Leadership
    • PGY-3
    • PGY-2
    • PGY-1
    • Alumni
  • STUDENTS/APPLICANTS
    • Medical Students at CMC
    • EM Acting Internship
    • Healthcare Disparities Externship
    • Resident Mentorship
  • #FOAMed
    • EM GuideWire
    • CMC Imaging Mastery
    • Pediatric EM Morsels
    • Blogs, etc. >
      • CMC ECG Masters
      • Core Concepts
      • Cardiology Blog
      • Dr. Patel's Coding Blog
      • Global Health Blog
      • Ortho Blog
      • Pediatric Emergency Medicine
      • Tox Blog
  • Chiefs Corner
    • Top 20
    • Current Chiefs
    • Schedules >
      • Conference/Flashpoint
      • Block Schedule
      • ED Shift Schedule
      • AEC Moonlighting
      • Journal Club/OBP/Audits Schedule
      • Simulation
    • Resources >
      • Fox Reference Library
      • FlashPoint
      • Airway Lecture
      • Student Resources
      • PGY - 1
      • PGY - 2
      • PGY - 3
      • Simulation Reading
      • Resident Wellness
      • Resident Research
      • Resume Builder
    • Individualized Interactive Instruction