Conference 10/1

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Lightning Lecture – Tuberculosis by Hannah Hudson-Knapp

  • ⅓ world population infected
    • Special populations – pediatric, AIDS patients, 
  • Infection types – Primary, latent, reactivation, miliary
  • Evaluate with: Tuberculin skin test (PPD) -> PCR Sputum Assay (gold standard), IGRA, Acid-Fast stain
  • Management
    • RIPE therapy
    • Modifications with pregnancy (RIE therapy)
    • Vit B6 prescribed with isoniazid (to decrease seizure risk)
  • New vaccines currently in clinical trial
  • Disposition

Lightning Lecture – Tetanus by Jonathan Mattingly

  • Mortality rate 45%
  • Clinical features
    • Type: Neonatal, local, generalized, cephalic
    • Grade I-IV presentations
    • Timeline: Incubation, acute, and convalescent phases
    • + Spatula test
    • Wound cultures often negative
  • Management
    • TIG  directly into wound and IM, metronidazole or clindamycin

Teaching Strategies – Feedback Models by Matt Lyons

  • One minute preceptor
    • Get a commitment
    • Probe for supporting evidence
    • Teach a brief principle
    • Reinforce what was done right
    • Correct errors
  • Pendleton model
    • Ask, tell, ask, tell

Question Review – Metabolic, Nutrition, Endocrine by Nicole Harris

R2 Pathway – Sepsis by Makayla Campbell and Olivia Stanforth

  • Sepsis definition – Life threatening organ dysfunction caused by dysregulated host response to infection
  • Surviving sepsis Guidelines (2024)
    • Hour 1 Bundle: Lactic, blood cultures, broad spectrum abx, fluids, vasopressors (if needed)
      • Studies show benefit with LR vs NS
        • Special considerations – managing fluids in heart failure, cirrhotic patients
      • “Broad spectrum” antibiotics initiation = improvement in mortality
        • Special consideration – kidney injury (renally dosing abx)
      • Vasopressors
        • Norepinephrine first line, vasopressin second line/add on if needed
    • Special populations: Neutropenic fever, transplant recipients
  • Refer to updated Sepsis Pathway on Room Niner

Image Review – by Dr Kahra Nix, Dr Jeff Baker, Dr Alex Bequer

  • POCUS during cardiac arrest
    • CAN increase length of pulse checks, CAN decrease in hospital mortality
    • Use POCUS in PEA/asystole, also use after ROSC
      • Record clip 
      • 3 questions: Is there tamponade, RV strain, or cardiac activity? 
      • Do not delay for shocks
    • Can assess peripheral veins for DVT if concerned for PE