Includes References and Index

The initial inspiration for LEARNing Rounds originated in a teaching exercise
performed at the bedside with residents and medical students rotating in the
emergency department at The Ohio State University Wexner Medical Center
Emergency Department. We would find an interesting case and gather around the
bedside to discuss the clinical aspects of the case. We would start out with some
background about the disease in question and proceed to a discussion of the
physiology/pathophysiology involved and then on to making the diagnosis and
treating the patient. These were originally called teaching rounds. I would have the
resident who was involved in the case write a brief description and some important
learning points. I would then edit these, add to them, and send them out to our
faculty and residents. Many of our internal medicine rotating residents found these
cases to be interesting and a good source of information so we began to distribute
them to our IM colleagues. As time went on, the level of complexity used in the
writing of one of these documents increased. I thought the name “LEARNing
Rounds” would be more fitting as it puts emphasis on the learners’ role in
understanding, alongside the initiative and innovation of the teacher. LEARNing
Rounds was also an acronym for learn, evaluate, adopt, right now. After having
spent so much time putting these cases together, I thought it would be a fun and
educational endeavor to bring them together in one publication.
The focus of learning rounds is to highlight cases that were not so rare as to reach
the status of “Zebra” but at the same time were not bread-and-butter emergency
medicine presentations. The goal was to create the right mix of diagnoses that were
very clinically important but not regularly seen by emergency physicians. In a
Grand Rounds lecture I have given a number of times, I referred to these as “syndromes you can’t afford to miss.”
In this book, I and my coeditor attempt to create a case-based approach to learning about these selected topics that would be fun and creative and help to cement
fundamental concepts in the minds of the readers. We focused on providing enough
information on each diagnosis to be practical without creating an exhaustive treatise
on the subject. We began by soliciting the attendings and residents in our department and in other programs to find interesting and not-so-common cases that would
be best suited to our format. The plan was to pair a resident with an attending to
create a chapter using our format. We even have a few medical student-attending
and attending-attending chapters. The response was excellent with more case proposed than we could put together in a single book! As very involved editors (and
co-authors of many cases), we provided our writers with images and drawings and
any help possible to make their cases fun and memorable.
To put this book together, I chose my coeditor wisely! Dr. Christopher San
Miguel was well known to me, having completed his EM residency at OSU, where
he was a chief resident and resident lecturer of the year. He also completed an
education fellowship in our EM program. His dedication to both the practice of
emergency medicine and his passion for education made him the perfect choice. We
also engaged one of our former emergency medicine pharmacy fellows extraordinaire,
Elena Ko, to assist with editing chapters that were heavy in pharmacology. She
brought a very specialized knowledge to the book and helped us immensely to
assure the reader of accurate and up-to-date drug information.
We would like to extend a huge thanks to the many very knowledgeable and
motivated contributors to this book for their interesting cases, personal experiences,
and passion for education. We could never have gotten this done without their
contributions!
We sincerely hope you enjoy and learn from this book as much as we did in
developing and editing the content.