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“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

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

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!” Nicholas Testa #lacuscdem #grandrounds

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

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

Treatment of ruptured globe en route to ophtho. #lacuscdem

Lid lacs that need ophthalmology. #lacuscdem #grandrounds

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.

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

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

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

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

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

Wow! Our gracious friends from SUNY Downstate EM 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

latimes.com/california/sto… Our very own Scott Kobner documenting our work at LAC during this pandemic.

On shift pearls to guide your differential from Dr. Kearl and Dr. Rebillot Katie Rebillot 6 hours - duodenal atresia 6 days - volvulus/malrotation, NEC 6 weeks - pyloric stenosis 6 months - intussusception 6 years - appy

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

We are LIVE here in LA for #EMRAPOne . Tune in here now: emrap.org/conference/one . Scott Kobner kicking off the live stream! #emergencymedicine #FOAMed

Hey! Conferences out there: This is how you start one! #emrap_one EM:RAP