Wednesday Lectures, 1/7/2015

10a Wilderness Cool Cases (Sue Biondich, new Wilderness Fellow)
Spina Bifida & Bony Abnormalities dt casting & bony density changes
…for some reason, >75% develop Latex allergy?!
Malignant Melanoma with Sz?!
Chronic subdural hematoma…
Sp MVC, paralysis & severe injuries…atlantooccipital dissociation (“internal decapitation”) almost universally fatal!
Pulmonary Artery Aneurysm incredibly rare!
Central Cord Syndrome ~ upper extremity paresthesia & most common partial spinal syndrome…
Cavitary TB hemoptysis…PTX association & PTX as pressure treatment!?
Hot Tub Guillan Barre?! Post viral diarrhea? Flu shot?

11a PSQ (Shaw)
HoTN in Trauma increases M&M!
You don’t always follow or agree with consultant’s recs…

12pm Clinical Controversy: CT/LP v CT/CTA in Dx of SAH? (Calleo)
CTA very sensitive for aneurysms…
LP has risks, worth it?
Still slightly better CT/LP vs CT/CTA?
…but CTA tech improving…

1230 TLLT Topic: Single Pill Ingestion, Tox in Peds (Calleo)
ABCDE… Symptomatic mgmt & consider decontamination… Contact PCC!
TCAs, MAOIs, Sulfonylureas, BetaBlk(hypoglycemia, glucagon, hdnarcan?), CCB(hyperglycemia, insulin, hdnarcan?), Opioids, Benzos, Barbs, Antimalarials, Antidysrhythmics, Camphor…
Know ER & XD meds for observation calculations…
Specify exact amount taken & time of onset as well as possible!
contact PCC!

1pm PD Rounds… (Paolo & Hojnowski)
UEM Website!!! <https://uemcurrentawareness.wordpress.com&gt;
SAVE & CHECK Website for PDR Days!!!
*Wound Repair Cutoffs & Management (Hojnowski)
All infections have 2 to 5% infection rate (excluding human & animal bites)
Subjective cosmesis scale not ideal…difficult to take away a hard & fast rule for timing & wound type… Benefit of Abx pox not firmly established even in high risk wounds…
<http://emj.bmj.com/content/31/2/96.full.pdf+html&gt;
*Outpatient/Prehospital NIPPV
Risk reduction for both Mortality outcomes & decreasing need for intubation in multiple pulmonary diseases (mostly CHF & COPD, although asthma & PNA also lumped in)…
EMS should use more CPAP/BiPAP for certain suspected conditions?
Heterogeneity of study outcomes within systematic review may be biased by confounders of differing dyspneic diagnoses & differing standards of baseline care.
“Start with Scopus or google scholar for systematic review” ~Dr. Grant
<http://www.annemergmed.com/article/S0196-0644(13)01587-4/pdf&gt;

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