Cook County EM Blog

MAY 1, 2023

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.

Ultrasounds 52

Ultrasounds Emergency Department Hospitals Outcomes 52

Taming the SRU

MAY 27, 2024

Ultrasound in recent years has become a very helpful tool in diagnosing smaller effusions, and is noted to be almost 100% sensitive for effusions > 100 mL (2). While historically reported rates were ~20%, more recent literature with ultrasound guidance suggests much lower rates of ~3% (3, 4).

Emergency Department 87

Emergency Department Ultrasounds Radiology Radiology 87

RebelEM

MARCH 8, 2023

Signs Shafer’s sign (tobacco dust) May see a Weiss ring when the posterior vitreous (PV) detaches from the optic disc margin Visualization with ultrasound. Retinal Detachment ( Hollands 2009 ) Pathophysiology Posterior vitreous shrinks with advancing age (aka synchysis senilis), pulling on the retina. and (–) LR 0.9.

Stroke 52

Stroke Emergency Department Ultrasounds Outcomes 52

ALiEM

SEPTEMBER 29, 2023

2009 Nov;67(5):1046-1050. Author information Andrew Shannon, MD, MPH Ultrasound Director Associate Professor of Emergency Medicine Lakeland Regional Health | The post SAEM Clinical Images Series: Only a Flesh Wound appeared first on ALiEM. References Goodwin RB, Beery PR 2nd, Dorbish RJ, et al. The Journal of Trauma. DOI: 10.1097/ta.0b013e3181b83b63.

Radiology 70

Radiology Radiology Academics Ultrasounds 70

EMDocs

JANUARY 16, 2024

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. Published 2009 Jun 10. The management of accidental hypothermia.

Hyperthermia / Hypothermia 110

Hyperthermia / Hypothermia Resuscitation CPR EMS 110

Taming the SRU

SEPTEMBER 8, 2023

2009 Sep;137(3):856-64, 864.e1. Epub 2009 Jun 12. 2009 Jun;136(7):2159-68. Diagnostic accuracy of Doppler ultrasound, CT and MRI in Budd Chiari Syndrome: Systematic Review and meta-analysis.” Intravenous N-acetylcysteine improves transplant-free survival in early stage non-acetaminophen acute liver failure. 2009.06.006.

Radiology 59

Radiology Radiology Ultrasounds EMS 59

Taming the SRU

JUNE 3, 2024

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.

Shock 91

Shock Seizures Airway Management Stroke 91

EM Curious

JULY 24, 2015

One of our beloved colleagues from the community has recently declared to us his love of ultrasound guided nerve blocks--a skill that is established in the anesthesia world but is quickly gaining traction in our realm. Ultrasound-Guided Three-In-One Nerve Block for Femur Fractures. Sorry we've been out of the loop lately.

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

Pediatric Emergency Playbook

AUGUST 1, 2017

Hypertrophic pyloric stenosis: tips and tricks for ultrasound diagnosis. J Ultrasound. The non-diagnostic ultrasound in appendicitis: is a non-visualized appendix the same as a negative study? Utility of MRI After Inconclusive Ultrasound in Pediatric Patients with Suspected Appendicitis. 2009; 197:211-215.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Taming the SRU

OCTOBER 7, 2024

history of VTE, increased calf circumference, pain and swelling), then the next step is to attain a compressible ultrasound of the affected leg. However, if clinical suspicion is high enough, doppler ultrasound, MR venography, or serial compressive ultrasound imaging can all be considered. original drawing by dr zinter.

Ultrasounds 64

Ultrasounds CDC Research Stroke 64

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

Keep your ultrasound handy. 2009) Trauma in the Obstetrical Patient. Here, then, are some links for Third Trimester Emergencies. Verify your own laws and protocols for your practice before instituting change. Understand the application of the EMTALA law (Emergency Medical Treatment and Active Labor Act [ USA ]) to your situation.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

Dr. Smith's ECG Blog

JULY 7, 2013

If detected early by ultrasound, the patient can be saved. Our own Dave Plummer of HCMC reported on survival of 2 of 6 patients with free wall myocardial rupture diagnosed by bedside ultrasound in the ED.(3) Apr 28, 2009. 3) Oliva et al. (3) J Am Coll Cardiol 53(17):1503-9. Plum mer D, Dick C, Ruiz E, Clinton J, Brunette D.

Ultrasounds 52

Ultrasounds EKG/ECG Emergency Department Shock 52

Dr. Smith's ECG Blog

JULY 18, 2014

If detected early by ultrasound, the patient can be saved. Our own Dave Plummer of HCMC reported on survival of 2 of 6 patients with STEMI who had free wall myocardial rupture diagnosed by presence of hemopericardium on bedside ultrasound in the ED.(3) Apr 28, 2009. 3) Oliva et al. (4) J Am Coll Cardiol 53(17):1503-9.

EKG/ECG 52

EKG/ECG Shock Ultrasounds Wellness 52

ACEP Now

JANUARY 12, 2024

7 Postvoid residual urine volume and levels of prostate-specific antigen are useful for diagnostic purposes, as well as possible CT scan or ultrasound to evaluate for an enlarged and inflamed prostate. 2,10 In the case described, a postvoid residual ultrasound showed that the patient was retaining approximately 700 mL of urine.

Infectious Diseases 52

Infectious Diseases Ultrasounds Wellness Hospitals 52

Taming the SRU

FEBRUARY 19, 2024

12) Axillary While axillary arterial line placement has been uncommon, in the age of facile ultrasound operators it may become a more advantageous and accessible site particularly in patients with high BMIs. They also found that when femoral lines did fail, they did so later in the patient’s clinical course. (12) Cite As: Snyder, B.

Shock 59

Shock Resuscitation Ultrasounds Research 59

PulmCCM

OCTOBER 16, 2023

per 1,000 central-line days between 2001 and 2009. Most central lines in the ICU are placed under ultrasound guidance in the internal jugular vein, representing a perceived middle ground of risk for pneumothorax and infection prevention. also decreased from 3.64 CLABSI rates then increased dramatically during the Covid-19 pandemic.

CDC 52

CDC Hospitals Ultrasounds Documentation/Coding 52

Pediatric Emergency Playbook

JUNE 1, 2017

2009; 8:67-69. Cardiovasculr Ultrasound. 2009; 24:156-8. 2009; 27:942-947. Acute myocarditis mimicking acute myocardial infarction associated with pandemic 2009 (H1N1) influenza virus. Acute myocardial infarction as a cause of death in palliated hypoplastic left heart syndrome. 2004; 90:e17. Canale LS et al.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. In fact, bedside ultrasound might even find severe aortic stenosis.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Advances in Medical Imaging (CT, MRI, and Ultrasound) facilitating rapid, accurate, diagnosis affording new potential to save additional lives. EM makes a strong push into bedside use of ultrasound sonography. Emergency Ultrasound is one of the greatest advances in emergency care. EDNA->ENA. Development of EM Residencies.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

Dr. Smith's ECG Blog

JUNE 2, 2023

My bedside ultrasound was of insufficient quality, but showed somewhat reduced overall EF, distended IVC without respiratory variation, no pericardial effusion, and diffuse bilateral B lines. == What do you think of her ECG? J Electrocardiol, 42 (2009), pp.

EKG/ECG 96

EKG/ECG Wellness Ultrasounds EMS 96

Taming the SRU

MAY 5, 2023

It would be interesting to stratify the doses of vasopressor administration to the few potential adverse events (all of which resolved), or the location of the peripheral line, given the questions raised regarding safety and patency of ultrasound-guided IVs versus non-ultrasound guided-IVs. Jama 318 (13): 1233-1240. Bauer, M.,

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Mind The Bleep

FEBRUARY 29, 2024

You may see ‘FICE / FUSIC’ scans documented – this is an accredited senior making use of ultrasound scanning to answer specific basic questions – for example, significant ventricular dilatation or impairment, assessment of preload or scanning for pleural or pericardial fluid collections. 2009) Oxford Handbook of Critical Care.

Documentation/Coding 52

Documentation/Coding Hospitals Wellness Best Practices 52

ALiEM

OCTOBER 4, 2024

Specific ultrasound findings for an ectopic pregnancy include a gestational sac with a yolk sac outside of the uterus. Are there any other findings on ultrasound that put this pregnancy at higher risk? Confirmation can be done with transabdominal ultrasound but in very early pregnancy may require a transvaginal ultrasound.

Ultrasounds 64

Ultrasounds Academics Emergency Department Hospitals 64

ALiEM

OCTOBER 2, 2023

An outpatient ultrasound was performed showing “multiple scalp echogenic nodular lesions measuring from 0.5 Four days after the ultrasound and before the biopsy could be performed, the patient and his mother presented to the PED due to worsening symptoms. Laboratory Data Non-contributory Case Question: What are the ultrasound findings?

Ultrasounds 75

Ultrasounds Pediatrics Academics Emergency Department 75

EMDocs

JANUARY 20, 2024

Bedside ultrasound shows hypokinesis of the basal portion of the left ventricle with an apparent sigmoid-shaped septum and a dilated inferior vena cava. Ultrasound findings can show bulging of the interventricular septum into the LVOT , which can be interpreted as a sigmoid-shaped septum on bedside evaluation. The oral mucosa is moist.

EMS 102

EMS Fluid Resuscitation Shock EKG/ECG 102

Dr. Smith's ECG Blog

APRIL 8, 2015

Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Yield of Diagnostic Tests in Evaluating Syncopal Episodes in Older Patients Arch Intern Med 2009 Jul 27; 169:1299-1305.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

ACEP Now

APRIL 5, 2024

In 2009, the Excited Delirium Task Force convened by an ACEP Council resolution authored a white paper that endorsed the existence of excited delirium syndrome and made recommendations for identifying and managing it clinically. Her primary interests are in ultrasound, machine learning, and health justice. Do I think it was successful?

Forensics 49

Forensics Psychiatric Burns Hospitals 49

EMDocs

OCTOBER 7, 2023

Published June 2009. The incidence of a similar condition, traumatic rhabdomyolysis, is estimated to be around 0.074%. Veenstra J, Smit WM, Krediet RT, Arisz L. Relationship between elevated creatine phosphokinase and the clinical spectrum of rhabdomyolysis. Nephrol Dial Transplant. 1994;9(6):637-641. Accessed February 3, 2023. Critical Care.

EMS 98

EMS Fluid Resuscitation Fractures Resuscitation 98

Downeast Emergency Medicine

MARCH 13, 2022

rebound tenderness), getting an EKG if you have a high suspicion for cardiac involvement, or using ultrasound to assess for free fluid. Abdominal ultrasound: Complete a bedside abdominal aortic ultrasound if the patient has risk factors, or a FAST exam if a ruptured ectopic pregnancy is suspected. Silverio, Luz. Abdominal Pain.”

Ultrasounds 52

Ultrasounds EKG/ECG Radiology Radiology 52

EMDocs

OCTOBER 23, 2023

Diagnosis can be confirmed with ultrasound (for deep vein thrombosis) or CT angiography (CTA) chest (for pulmonary embolism) and patients treated with anticoagulants. 2009 Apr;49(2):198-201. Half of all embolisms occur within the first 24 hours and 75% will present by postoperative day 3. Aust N Z J Obstet Gynaecol. Up to Date.

OB/GYN 95

OB/GYN Operations EMS Ultrasounds 95

EMDocs

DECEMBER 18, 2023

Furthermore, since the 2021 guidelines, multiple RCTs have shown that utilizing IVC respiratory variation, assessed by bedside ultrasound, as a guide to fluid resuscitation can result in less fluid administered. Incidence and trends of sepsis in US hospitals using clinical vs claims data, 2009–2014. Current estimates and limitations.

Sepsis 93

Sepsis Fluid Resuscitation Resuscitation Shock 93

Pediatric Emergency Playbook

JANUARY 1, 2017

Further, children participate in and absorb their family’s culture and specific personality from a very young age ( Finley 2009 ). Some children are ultra-rapid-metabolizers of codeine to morphine, causing a rapid “bolus” of the available drug, with respiratory depression and death in some cases ( Ciszkowski 2009 , Racoosin 2013 ).

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

ALiEM

FEBRUARY 12, 2024

At the time her beta-hCG was 7225 mlU/mL with no intrauterine pregnancy demonstrated on transvaginal ultrasound. Three days later, the patient had declining b-hCG and transvaginal ultrasound again with no intrauterine pregnancy. Case Question: How would you describe the uterine cavity from the ultrasound images? 16, 2009, pp.

Ultrasounds 64

Ultrasounds Emergency Department Academics Operations 64

EMDocs

NOVEMBER 13, 2023

Semin Ultrasound CT MR 2017, 38 (4), 345-356. Emerg Radiol 2009, 16 (3), 195-201. DOI: 10.1161/strokeaha.118.023173 118.023173 From NLM. (4) 4) Madhuripan, N.; Tenenbaum, M. Computed Tomography Angiography in Head and Neck Emergencies. DOI: 10.1053/j.sult.2017.02.003 2017.02.003 From NLM. (5) 5) New Choice Health, I. Schaefer, P.

Stroke 105

Stroke Radiology Radiology Emergency Department 105

Taming the SRU

JANUARY 22, 2025

Epub 2009 Nov 5. Identification of asthma phenotypes using cluster analysis in the Severe Asthma Research Program. Am J Respir Crit Care Med. 2010 Feb 15;181(4):315-23. doi: 10.1164/rccm.200906-0896OC. 200906-0896OC. PMID: 19892860; PMCID: PMC2822971. Ruvuna L, Sood A. Epidemiology of Chronic Obstructive Pulmonary Disease. Clin Chest Med.

COPD 80

COPD CDC Research Emergency Department 80