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Grand Rounds October 12, 2023

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Allergic Reactions and Angioedema – Rachel Patterson, MD

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9:30-10:15) Sickle Cell, What You Need to Know – Jason Becker, MD

10:15-11) Jeopardy – Patrick Cheatle, MD

11-11:30) EM Case Presentation – Matt Bollard, DO

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  • Pathophysiology:
    • Liver senses insulin not glucose
    • No insulin🡪 gluconeogenesis and eventually ketosis
    • Causes acid-base disturbances
    • Osmotic diuresis= dehydration
    • Electrolyte disturbances
  • What do you need to do?
    • Correct for fluid deficits
    • Replace electrolytes- MAINLY K
    • Close aniongap to stop further ketone production
    • Treat underlying precipitant
  • Peds fluids
    • Initial bolus = 20cc/kg
    • Maintenance- 4 2 1 rule
      • 4cckg/hr first 10kg
      • 2cc/kg/hr next 10kg
      • 1cc/kg/hr every kg after
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12-1) Optional Board Review

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Jefferson fracture- C1 burst fracture

Mechanism: axial load

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Hangmans fracture- c2 fracture of pars interarticularis

Hyperextension injury

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Subdural

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Epidural

“lucid interval”

  • Most common abd organ injured in ped trauma?
    • Penatrating- liver
    • Blunt- spleen
  • Cause of coma after head injury?- Diffuse axonal injury
  • Parkland formula for burns
    • 24hr replacement of volume= 4ml/kg/totalBSA burned
    • Half over first 8 hours; next over 16 hours
  • Human bite bacteria- eikenella corrodens
  • Cat bite- pasturella multocida
  • Dog bite- capnocytophaga canimorus
  • Hemophilia A- lack of factor 8; normal pt and prolonged ptt
  • Most common bleeding disorder- vwf; normal platelets but they don’t function well; prolonged bleeding time
  • Hemolytic anemia, neurologic changes, fever, aki,thrombocytopenia- TTP
  • Central cord- upper extremity weakness and paresthesias> lower extremity- think hyperextension injury
  • Anterior cord- loss of moter/pain/temp distal to leasion
  • Brown Sequard syndomre- ipsilateral paralysis with loss of position vibration and touch; contralateral loss of pin prick and temp sensation

October 19, 2023. Lecture Room 2 

8-9) Charting Review and Updates – Marc Lewbart, DO

9-9:30) 302 & 201, What Emergency Physicians Need to Know– Eric Eustice, DO

9:30-10) Pediatric Mental Health Concerns – Guhan Rammohan, MD

10-11) Cases – Multiple Faculty

11-12) Morbidity & Mortality Conference. David Pronchik, MD

12-12:30) EM Case Presentation – John Bianco, MD

12:30-1) TRIAGE

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