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

Taming the SRU

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). 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. WHO - Who Needs an LP in the ED?

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REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

RebelEM

CHEST 2010. 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.

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The Pediatric Surgical Abdomen

Pediatric Emergency Playbook

2010; 26:769-781. 2010; 149(3):386-391. Hypertrophic pyloric stenosis: tips and tricks for ultrasound diagnosis. J Ultrasound. J Emerg Med. 2012; 43(1):49-51. Martin V, Shaw-Smith C. Review of genetic factors in intestinal malrotation. Pediatr Surg Int. Nehra D, Goldstein AM. Pyloric Stenosis Aspelund G, Langer JC.

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REBEL Core Cast 94.0 – SBO

RebelEM

2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5 2010, (Ch) 92: p 1216-1227. Absent bowel sounds Peritoneal signs (i.e. Louis, Mosby, Inc.,

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First10EM Journal Club: April 2023

Broome Docs

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. Clinical risk factors for testicular torsion and a warning against falsely reassuring ultrasound scans: a 10-year single-centre experience. 2010 Oct 5;182(14):1527-32. Epub 2010 Aug 23. N Engl J Med. 2023 Jan 21. doi: 10.1056/NEJMoa2212663.

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Diagnostics: Inflammatory Markers

Taming the SRU

Notably, lung ultrasound for the diagnosis of bacterial CAP demonstrated exceptional stand-alone diagnostic accuracy in 33 studies including 4,901 adults and children in the emergency department, with a pooled sensitivity of 92% and specificity of 90%. Critical Care Medicine 38():p S26-S34, February 2010. | N Engl J Med. Procalcitonin.

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Persistent Pulmonary Hypertension of the Newborn

Don't Forget the Bubbles

Hence, PPHN can be idiopathic or secondary to a variety of conditions such as meconium aspiration syndrome , respiratory distress syndrome, sepsis, asphyxia and congenital diaphragmatic hernia. Were there any abnormalities on ultrasounds? Imagine being a few hours old and dealing with this). Does the baby look septic?

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