The meeting began with the WACEM chief Dr.Sagar Galwankar's brief introduction to The international speaker Dr. Pushpa Sharma from the Department of Anaesthesiology, Uniformed Services University of the Health Sciences, Bethesda, USA.
COVID-19 AND SEPSIS: Partners in crime to kill innocent mitochondria
Dr. Pushpa Sharma Ph.D
The International speaker started off her talk with a question for the audience that was to get them hooked for the rest of her talk - why does covid target innocent mitochondria? She quoted the Global Sepsis Alliance, 2020 to explore the expanse of covid's relationship with sepsis and multi organ failure that itself was of pandemic proportions. Covid, according to her was smart in selecting mitochondria as their target for attack. By hijacking the powerhouse itself, it triggers a cascade of DNA depletion syndrome that aggravates hypoxemia or leads to a cellular shutdown phase! A transit recovery phase after this shut down was a crucial therapeutic window where anti-covid agents could act to improve survival. She concluded that we should look forward and look around to get over covid! The session had interesting questions at the end by Dr. Irshad Chaudhry and Dr. Sagar which were keenly answered by Dr.Pushpa. Expery comments by Prof. Sarman Singh, Director of AIIMS, Bhopal and Dr. Sagar concluded the session by emphasizing on the need for more collaboration for researches at molecular levels. This was followed by presentations from EM Residency Programs, moderated by Dr. Roshan Mathew, AIIMS, New Delhi.
LOOKING BACK AND FORTH
Dr. Naman Agrawal MD
The faculty presentation was kick started by Dr. Naman Agrawal, Assistant Professor of Emergency Medicine at All India Institute of Medical Sciences, Rishikesh. He briefly outlined the realignment of working patterns, processes, and procedures amidst covid chaos at his centre in Uttarakhand in his inimitable style. Parallel emergency departments for covid and non-covid cases were initiated and run round the clock with the help of other department residents who were quickly trained and oriented by Emergency Medicine department.Unidirectional flow of patients were maintained with the help of innovative ideas to bridge gaps like "zero consultation zones". He navigated through issues like "Plastic Man syndrome" being PPE clad, socially isolated, with broken communication that were identified and steadied by appropriate coordination of team leaders, covid floor managers alongwith social media communications and automated checklists.
THE BITTERSWEET TALE OF COVID19
Dr Himanshi Baid
Dr. Himanshi, MD Resident from AIIMS, Rishikesh presented a case series of Diabetic Ketoacidosis in covid as experienced from her center. She outlined a typical case initially and then presented insights from a case series audit among 13 patients with DKA and 2 patients with diabetic ketosis. She stressed on the importance of assesment of anion gap and balancing fluid resuscitation in DKA vis-a-vis fluid restriction in ARDS.
CARDIOVASCULAR MANIFESTATIONS IN COVID-19 PATIENTS - A CASE SERIES
Dr Hannah Chawang
Dr. Hannah, MD resident from AIIMS, Rishikesh spoke on the cardiovascular manifestations among covid patients at her centre. Take home message was having a third eye open for identification of thrombotic manifestations like pulmonary embolism and deep vein thrombosis necessitating thrombolysis during initial evaluation itself. She also outlined cases of arrhythmias arising out of MI, drug interactions, fluid and electrolyte issues. Rhe take home message was early bedside anticoagulation in covid patients.
PREVALENCE AND DETERMINANTS OF BURNOUT AMONGST HEALTHCARE WORKERS WORKING IN THE EMERGENCY DEPARTMENT IN A TERTIARY CARE HOSPITAL DURING THE COVID19 PANDEMIC
Dr. Takshak Shankar
Dr. Takshak, MD Resident from AIIMS, Rishikesh presented a short research done by his department under guidance of Dr. Poonam. The findings of his cross sectional research were insightful and specific to healthcare workers working in the Emergency Department. He also compared their findings to the ones from recent studies from around the globe.
LESSONS LEARNED: BALANCING ACT AS AN EP DURING COVID PANDEMIC
Dr. Manu Ayyan, MD, FACEE
The other faculty presentation was by Dr. Manu,
Assistant Professor of Emergency Medicine,
JIPMER, Pondicherry. He shared the lessons learnt during covid from experiences at his centre which provides free medical care, food and shelter to patients. His talk enlightened us about the hierarchy of needs in ED and balancing individual needs from the shoes of an administrator, floor manager and clinician. He outlined the infrastructural changes, 'jugads', medical education remodelling, resource acquisition and disaster management skills pivoting ED to the centre of Covid care in their hospital. Covid was an opportunity to foster research among residents, being a team player with a delicate balance of being there for patients, families and friends.
RESUSCITATION COVERALL - A NOVEL DEVICE TO RESUSCITATE COVID19 PATIENTS
Dr KNJ Prakash Raju, MD
Dr. Prakash, Senior Resident from JIPMER, Pondicherry spoke about the frugal innovation "Resuscitation coverall" modelled on saving the patient and saving the resuscitators. Highlight of the presentation was a pilot simulation test for contact and aerosol transmission done the Indian way by innovatively using paint and local detergents!
CLOGGING IN COVID19
Dr. Rose Mary Joseph & Dr. Amaravathi
The final presentation for the day was a case presentation from JIPMER. It was a curious case of mesenteric ischemia arising as a result of simultaneous arterial and venous clot formation in a covid patient and was co-presented by Dr. Rose Mary and Dr.Amaravathi, MD residents from JIPMER, Pondicherry. They emphasized on the need for high clinical index of suspicion, fluids, D-dimer, analgesia, broad spectrum antibiotics and ED-lap for such patients presenting with covid and abdominal pain. Dr. Roshan was instrumental in maintaing the enthusiasm among listeners while maintaining the time limits.
The 5th week of academic extravaganza ended with Dr. Sagar concluding the session with an of inspiration calling upon fellow Emergency Physicians to work hard towards realizing Emergency Medicine as a surgical specialty in India.
Tune in for more next week.
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