LAC+USC DEM

LAC+USC Department of Emergency Medicine Residency. Views are residents' own, not medical advice, not representative of organization. #FOAMed #uscdem #emconf

[Mike Messina @MikeMessina_]

Checking in from #EMRAP_one . Moderating questions and highlighting pearls from @emrap_tweets page as well as here with my @lacuscdem MedEd chiefs for next year. Ready for a great three days! #emergencymedicine #FOAMed

[Manrique Umana McDermott @umanamd]

Hey! Conferences out there:

This is how you start one!

#emrap_one @emrap_tweets

[EM:RAP @emrap_tweets]

We are LIVE here in LA for #EMRAPOne . Tune in here now: https://t.co/X4wqh0Wwvx . @skobner kicking off the live stream! #emergencymedicine #FOAMed

[LAC+USC DEM @lacuscdem]

We're so excited! Welcome to our LAC family!

[LAC+USC DEM @lacuscdem]

On shift pearls to guide your differential from Dr. Kearl and Dr. Rebillot @krebillo

6 hours - duodenal atresia
6 days - volvulus/malrotation, NEC
6 weeks - pyloric stenosis
6 months - intussusception
6 years - appy

[LAC+USC DEM @lacuscdem]

https://t.co/Na6DQwNMTz

Our very own @skobner documenting our work at LAC during this pandemic.

[LAC+USC DEM @lacuscdem]

Wow! Our gracious friends from @KCH_EMed treated us to burritos today. We are so lucky to have an emergency medicine community that spans across the country...and globe! Filling our hearts and stomachs ❤️#POtrial

[LAC+USC DEM @lacuscdem]

When the PGY3s are away, the PGY2s come to play!

[LAC+USC DEM @lacuscdem]

GR Pearls:
1. When to tx AOM (don't watch and wait) - high risk kids, BL < 2yo, fever 39+, pain severe or > 2 days
2. Neonatal herpes is devastating! In febrile neonate, don't forget Acyclovir if herpes hx in mom, CSF pleocytosis, ill-appearing

[LAC+USC DEM @lacuscdem]

GR Hack: in a pinch, use finger-stick on upreg if no access to quick urine/labs

[LAC+USC DEM @lacuscdem]

What a stellar group of people! Welcome to the family! LAC+USC Emergency Medicine Class of 2024. #LACUSCDEM #MatchDay2020

[LAC+USC DEM @lacuscdem]

Welcome to this rockstar class. LAC+USC Emergency Medicine Class of 2023. #lacuscdem #countymade

[LAC+USC DEM @lacuscdem]

41K homeless in Los Angeles, more than most the largest cities in America have combined. “We have to take our care to them.” Bret Feldman PA-C with Street Medicine.

[LAC+USC DEM @lacuscdem]

Lid lacs that need ophthalmology. #lacuscdem #grandrounds

[LAC+USC DEM @lacuscdem]

Treatment of ruptured globe en route to ophtho. #lacuscdem

[LAC+USC DEM @lacuscdem]

Signs of (not so occult) globe rupture. Peaked pupil, hemorrhagic chemosis, Seidel sign on flouresceine exam, scleral smudge, hyphema. #lacuscdem @sphyngoman

[LAC+USC DEM @lacuscdem]

Ruptured globe (occult). Scans don’t save all. Pay attention to the ACUITY! Low IOP? Uh oh (probably better not to check it if suspicion was high in the beginning). #lacuscdem

[LAC+USC DEM @lacuscdem]

Ocular trauma only seen initially by an ophthalmologist in 20% or fewer cases! This is our disease presentation to master. “Have you ever asked an internist about the eye? A trauma surgeon? Answer is always, ‘Just call ophtho!” @sphyngoman #lacuscdem #grandrounds

[LAC+USC DEM @lacuscdem]

Determining capacity in the ED. 1 Is patient capable of UNDERSTANDING the information? 2 Does patient APPRECIATE the illness/symptom and its severity? 3 Is his/her REASONING linear/logical 4 Can patient EXPRESS A CHOICE (verbally or otherwise) - Dr. Michael Perez #GrandRounds

[LAC+USC DEM @lacuscdem]

“Spiked helmet sign” on ekg likely a SICK patient, avoid anchoring bias, consider non cardiac causes -intrathoracic or even intra-abdominal pathology. - Dr. Jagoda #GrandRounds #lacuscdem