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Diagnostics and Therapeutics: The Who, What, Where, When and Why of Lumbar Punctures

Taming the SRU

It is most helpful to do the ultrasound immediately before needle insertion, as movement of the patient may shift cutaneous landmarks from underlying bony structures. This resource offers additional information on ultrasound assisted LP’s. WHY - Why Not? REFERENCES 1. Zambito Marsala, S., Gioulis, M., & Pistacchi, M. Tunkel, A.

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The Higher Tech Kid in the ED

Pediatric Emergency Playbook

Also used for severe MS, stroke, TBI, chronic pain. Ultrasound-guided refilling of an intrathecal baclofen pump—a case report. 2004; 26(4): 163–167. Are VNS safe in everyday life? Intrathecal Pumps Used to infuse basal rate of drug, usually baclofen for spasticity, but pump may contain morphine, bupivicaine, clonidine.

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What does the angiogram show? The Echo? The CT coronary angiogram? How do you explain this?

Dr. Smith's ECG Blog

Stroke-volume:50 ml. The problem is difficult to study because angiographic visualization of arteries is not perfect, and not all angiograms employ intravascular ultrasound (IVUS) to assess for unseen plaque or for plaque whose rupture and ulceration cannot be seen on angiogram. N Engl J Med [Internet] 2013;368(21):2004–13.

EKG/ECG 103
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REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

RebelEM

Randomized, Controlled Trial of Ultrasound-Assisted Catheter-Directed Thrombolysis for Acute Intermediate-Risk Pulmonary Embolism. A prospective, Single-Arm Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism: The SEATTLE II Study. CHEST 2010.

Stroke 133
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Pediatric Pain

Pediatric Emergency Playbook

Use soothing sensory measures: speak softly, offer a pacifier, and stroke the skin softly. mg/kg IV, up to 10 mg ) ( Brousseau 2004 ), often given with diphenhydramine (1 mg/kg PO or IV, up to 50 mg) and IV fluids. 2004 Feb;43(2):256-62. Ultrasound guidance for pediatric peripheral nerve blockade. Ketoralac (0.5

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Diagnostics: Inflammatory Markers

Taming the SRU

Bacterial Meningitis: IDSA guidelines for 2004 report that a normal CRP value has a high negative predictive value for bacterial meningitis, but sensitivities and specificities vary between studies [35]. Instead, they strongly advocated for the use of lung ultrasound to diagnose bacterial CAP [45]. Cleve Clin J Med. doi: 10.3949/ccjm.75.8.557.

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ICU Physiology in 1000 Words: The Geometry of Ejection Fraction

PulmCCM

With the explosion of bedside ultrasound and automated methods to capture LVEF, the ejection fraction will grow in clinical prominence and affect decisions for the acutely-ill. The slope of Ea is measured as the end-systolic pressure [Pes] relative to the stroke volume [SV]. New England Journal of Medicine 2004, 351(11):1097-1105.

Stroke 40