September 6th Conference Pearls

Brought to by: Maninder Singh and Brian Gilberti

How to Give Effective Feedback (Dr. Amato):

• There’s a time and place
• Take <5 minutes after your shift to sit down in private and have a discussion
• Self Assessment:
  • How do you think you did?
• Facts: Avoid using judgmental phrases and stick only to facts
  • Example: Instead of saying “You were rude to your colleague,” you can try “I noticed your tone was unprofessional when speaking with your colleague”
• Encourage
• Direction
  • What can the person do to improve?

How to read a CT P/E study (Dr. Bhatt):

• Hyperattenuation: Air (black) < Fat < Water < Bone (white)
• Trace all vessels back to the point of origin
• Look at the main pulmonary artery –> right/left pulmonary artery –> lobes
• YouTube Video on How to Read A CT P/E

Tear Gas and Pepper Spray (Dr. Schramm):

• Scene safety- make sure you don’t become a patient also
• Contamination- make sure you don’t get contaminated and then contaminate your other patients (PPE- Gloves, gown, facemask)
• ABCs- Concern for respiratory distress (especially in those w/ pre-existing pulmonary conditions and the young/old)
• Concern for corneal abrasions and ulcers- Remove contacts ASAP.
• Eyeflushes w/ saline+morgan lens; Consider Woods lamp/fluorescein.

Toxidrome EKGs (Dr. Fontana):

• Watch Video

Bradycardia (Dr. Bassi):

• Watch Video
• Identity stable vs unstable Bradycardia
• Identify the AV nodal blocks and know the management of 2nd degree type 2 and 3rd degree ( TCP or TVP)
• Treat underlying causes of bradycardia (e.g. electrolyte imbalance, drug overdose, or ischemia)

Pandas and how to take them down effectively (Dr. Gilberti):

• Watch Video
• Haldol
  • Time to Sedation (IM): 17 minutes
  • Duration of Action (IM): 24 hours
• Ativan
  • Onset of Action (IV): 2.5 minutes
  • Onset of Action (IM): 25 minutes
  • Duration of Action: 9 hours
• Versed
  • Onset of Action (IV): 4 minutes
  • Onset of Action (IM): ~15 minutes
  • Duration of Action (IV): <2 hours
  • Duration of Action (IM): 2 hours
• Ketamine
  • Onset of Action (IV): 30 seconds
  • Onset of Action (IM): 5 minutes
  • Duration of Action (IV): 7.5 minutes
  • Duration of Action (IM): 18 minutes

The Dangers of Smoke (Dr. Haque):

• Watch Video
• For presumed smoke inhalation and any concern for the airway- intubate immediately
• Treatment for CO poisoning: oxygen (via NRB or ETT)
• Cyanide poisoning is fatal and easily treatable. Have a low threshold for treating cyanide poisoning in altered CO poisoning patients (especially if acidotic)
• Hydroxycobalamin administration alters certain lab values for 2-3 days