TamingtheSRU

In this latest episode of our Research Corner series, Dr. Hill sits down with PGY-3 Adam Gottula, MD and Amanda Peck, PharmD to discuss their recently published case report describing the use of dexmedetomidine for the management of acute intrathecal baclofen withdrawal. The discussion encompasses the mechanisms of action of baclofen, dexmedetomidine, and how dexmedetomidine might be useful in the management of these complex patients.

Over the past 5 years, there has been a dramatic expansion of the treatment strategies used to treat patients with acute ischemic stoke. As some of these treatments involve specific resources only available at certain institutions, appropriate triage of patients in the prehospital environment is becoming ever important. On one hand a patient who would best benefit from endovascular treatment triaged to a center without that capability will undoubtedly suffer a delay in care. On the other hand, over-triaging stroke patients to a comprehensive stroke center could overwhelm the resources of that center, potentially impacting the care of patients at that center. In the podcast below, we talk with Dr. Jason McMullan of the UC EM Division of EMS and Dr. James Li, PGY-3 who both have recent publications focusing on this phase of patient care.

Transporting a VV ECMO and sweating? Hearing beeps in your sleep and fearing the flow alarm? Bolster your VV ECMO knowledge with Dr. Liz Powell and Paige Barger interviewed by Dr. Adam Gottula.

We recap a trio of recent articles looking into various aspects of the care and management of patients with sepsis. Are balanced fluids truly better than plain old normal saline? Are steroids a friend or foe in patients with severe sepsis? Can assessing capillary refill really be better than drawing repeat lactates?

Dr. Mel Otten, tox and wilderness guru and past president of the Wilderness Medical Society, takes us through his new 2019 WMS Guidelines on the prevention and treatment of heat illness.

Flank pain and pain due to ureterolithiasis are common ED presentations. There exist, however, a number of controversies when you dive into the literature addressing the diagnosis and treatment of nephrology/ureterolithiasis. Is IV lidocaine effective at treating pain in these patients? Is there a way to avoid CT scans? What about tamsulosin? Is it only good for big stones/small stones? Is there a benefit at all. For our most recent Journal Club, we tackled several of these controversies.

Should patient who have a V fib or V tac cardiac arrest take a trip to the cardiac Cath lab even if their post-ROSC EKG shows no evidence of ST-elevation? Drs Ham, Habib, and Klaszky breakdown several articles that address this clinical question and then we speak with Dr. Justin Benoit, the site PI for the ongoing ACCESS trial which is also looking into this question

Dr. Adam Gottula interviews Paige Barger and Liz Powell, MD on the basics of LVADs and how to troubleshoot them prehospital and in the ED

Temporal Arteritis by UC Department of Emergency Medicine

A Really Swollen Leg by UC Department of Emergency Medicine