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Ultrasound of the Month: No Definitive Yolk Sac, No Definitive IUP!

Taming the SRU

A bedside ultrasound is completed to assess the location of the pregnancy. A radiology performed ultrasound is ordered and has similar findings– Impression: no definitive IUP with a small amount of free fluid within physiologic limits. Laboratory evaluation reveals a hemoglobin and hematocrit of 12.6/37.1

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Ortho Pearls: Septic Bursitis

Cook County EM Blog

A point-of-care ultrasound was performed, which identified thickening of the skin overlying the elbow with a cobblestone appearance, and an underlying fluid collection consistent with an olecranon bursitis. Ultrasound is often a more useful imaging modality and is readily available at the bedside. 2009 Jun 25. and ESR 26.

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REBEL Core Cast 97.0 – Acute Vision Loss II

RebelEM

Rapid diagnosis and emergency referral improves outcomes of ophthalmologic interventions. Retinal Detachment ( Hollands 2009 ) Pathophysiology Posterior vitreous shrinks with advancing age (aka synchysis senilis), pulling on the retina. Symptom characteristics ( Hollands 2009 ) Any flashers/floaters: (+) LR 1.2 and (–) LR 0.9.

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Qi:KT - Acute Liver Failure

Taming the SRU

2009 Sep;137(3):856-64, 864.e1. Epub 2009 Jun 12. 2009 Jun;136(7):2159-68. Prognosis of acute severe autoimmune hepatitis (as-AIH): The role of corticosteroids in modifying outcome.” Diagnostic accuracy of Doppler ultrasound, CT and MRI in Budd Chiari Syndrome: Systematic Review and meta-analysis.” 2009.06.006.

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Don’t Forget About the IO in the Critically Ill Patient

RebelEM

The current standard of practice has moved away from landmark-based central line placement given the efficacy and safety of ultrasound-based techniques. Int J Emerg Med 2009 PMID: 20157465 4. This study also showed the median time for IO placement was only 1.2 minutes compared to a mean placement time of 10.7 minutes CVC group.

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Hypothermic Cardiac Arrest: Pearls and Pitfalls

EMDocs

Patients can have excellent outcomes despite prolonged resuscitation. VF/asystole), a pulse cannot be identified via Doppler ultrasound for a full minute, or if lack of organized cardiac activity is confirmed on bedside echocardiogram. This is a good time to utilize an arterial line or use the ultrasound to find a central pulse.

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Grand Rounds Recap 5.22.24

Taming the SRU

CESAR Trial Published in 2009 Found that even those who didn’t get ECMO, but were transported to a tertiary care center had better outcomes No matter where you go, critical care transport will be part of your life as a sending physician, receiving physician, or both. This shows that we are sometimes limited by the data that we have.

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