ACEP Now

MAY 10, 2024

While waiting for laboratory investigations, including troponin and d-dimer, you wonder if a quick point-of-care ultrasound (POCUS) examination looking for three sonographic findings could help determine the likelihood of this being an AoD. They received a four-hour introductory course taught by emergency ultrasound faculty.

Ultrasounds 52

Ultrasounds Outcomes Academics Documentation/Coding 52

RebelEM

JANUARY 24, 2024

Partial rupture of the proximal Achilles tendon: a differential diagnostic problem in ultrasound imaging. 2010; 92(17): 2767-75. Total Achilles tendon rupture. Sports Med. 1998; 25(2): 79-100. PMID: 9519398 Kayser R et al. Br J Sports Med. 2005; 39(11): 838-42. PMID: 16244194 Margetic P et al. Coll Antropol. 2007; 31:279-284.

Operations 98

Operations Ultrasounds Fractures Outcomes 98

Taming the SRU

JANUARY 1, 2024

Ultrasound Guided Peripheral IV (USGIV) Access anatomy of arm veins when considering USGIV. unported license [link] Ultrasound allows us to visualize deeper, typically larger veins in the forearm and upper arm. Place ultrasound machine on the opposite side of the bed to minimize neck strain. Check for flash in the IV chamber.

Emergency Department 92

Emergency Department Ultrasounds Administration Burns 92

Taming the SRU

FEBRUARY 5, 2024

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?

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97

EMDocs

APRIL 22, 2024

Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. Multiorgan POCUS The diagnostic power of POCUS often resides in combining multiple ultrasound exams. 2010 Apr;38(4 Suppl):S495-501. Am J Prev Med. doi: 10.1016/j.amepre.2009.12.017.

Ultrasounds 98

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 98

Don't Forget the Bubbles

SEPTEMBER 20, 2023

Value of abdominal radiography, colonic transit time, and rectal ultrasound scanning in the diagnosis of idiopathic constipation in children: a systematic review. Clinical guideline [CG99] Published: 26 May 2010 Last updated: 13 July 2017. 2017;191:179-183. doi:10.1016/j.jpeds.2017.08.075 2012;161(1):44–50.e502. 2022;251:127-133.

Pediatrics 133

Pediatrics Emergency Department Radiology Radiology 133

RebelEM

NOVEMBER 30, 2022

History, physical examination and ultrasound are all flawed in making the diagnosis. History, physical examination and ultrasound are all flawed in making the diagnosis. Am J Emerg Med 2010; 28:786-789. The gold standard is surgical exploration. OR = 58.8 (Ben-Israel 10, (-) LR = 0.13 10, (-) LR = 0.13

Ultrasounds 52

Ultrasounds Pediatrics Operations EMS 52

RebelEM

JANUARY 29, 2024

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.

Stroke 136

Stroke Outcomes Hospitals Administration 136

Pediatric Emergency Playbook

AUGUST 1, 2017

2010; 26:769-781. 2010; 149(3):386-391. Hypertrophic pyloric stenosis: tips and tricks for ultrasound diagnosis. J Ultrasound. 2010; 45:1182-1186. 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. Semin Pedaitr Surg.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

RebelEM

JUNE 19, 2023

Patients were actively screened for DVT (all received lower extremity ultrasound on or around day 7). Lancet 2010; 376(9734): 23-32. Broad inclusion (and limited exclusion) criteria increasing external validity. Demographics were well balanced in the two groups. PMID: 20554319 Post Peer Reviewed By: Salim R.

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

Urgent Care Ultrasounds

APRIL 1, 2018

However, the point of care ultrasound images also reveal a dilated cardiomyopathy with severely reduced LV systolic function. 2010; 31(6):703-11. Urine dipstick – protein Disposition Nephrotic syndrome was suspected based on the history of lethargy, oedema, hypertension, proteinuria and a family history of glomerulonephritis.

Urgent Care 52

Urgent Care Ultrasounds Hospitals 52

Pediatric Emergency Playbook

OCTOBER 1, 2017

2010; 30:76–81. Ultrasound-guided refilling of an intrathecal baclofen pump—a case report. 2010; 6: 46-53. Complications of Intrathecal Baclofen Pump Therapy in Pediatric Patients. J Pediatr Orthop. Ghosh D, Mainali G, Khera J, Luciano M. Pediatr Neurosurg. 2013; 49:138–144. Yang TF, Wang JC, Chiu JW et al. N Engl J Med.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

Pediatric Emergency Playbook

JANUARY 1, 2018

Structurally abnormal ovary (including cysts) that causes the ovary to flop over and twist on its vascular axis Hypermobile ovary with vigorous movement twists on its vascular pedicle and cuts off blood supply The Dual Blood Supply to the Ovaries: Why Doppler Flow can Fool You What ultrasound findings suggest ovarian torsion? Epub 2010 Feb 1.

Pediatrics 52

Pediatrics Ultrasounds Radiology Radiology 52

Dr. Smith's ECG Blog

SEPTEMBER 20, 2011

We did a bedside cardiac ultrasound. The ECG and ultrasound could not have been differentiated from acute plaque rupture with occlusion of the RCA. So this ECG gets 8 points PLUS has excessive discordance in V1 PLUS has the finding in many leads, not just one. 3 points gets you an MI by Sgarbossa. The Q-wave in lead III persists.

EKG/ECG 52

EKG/ECG Ultrasounds Resuscitation Wellness 52

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

Broome Docs

APRIL 6, 2023

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. PMID: 36688507 You can read Justin’s Full write up here. Lukosiute-Urboniene A, Nekrosius D, Dekeryte I, Kilda A, Malcius D. Emerg Med J.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

Taming the SRU

OCTOBER 1, 2023

Possibly more useful in trauma patients during e-FAST to determine presence or absence of PTX and less helpful in spontaneous PTX where management is partially based on size, which is difficult to quantify on ultrasound and may be falsely positive in the setting of emphysematous blebs. J Emerg Med. 2021;61(5):517-528. doi:10.1016/j.jemermed.2021.07.006

Fractures 96

Fractures COPD Hospitals Emergency Department 96

RebelEM

JANUARY 25, 2023

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. Am Surg 2010; 76:687-691. Louis, Mosby, Inc., 0.27 – 0.83

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

PHEM Cast

DECEMBER 1, 2017

Ultrasound determination of chest wall thickness: implications for needle thoracostomy. Ultrasound in Emergency Medicine. Devices used for decompression: Dressings available for covering an open pneumothorax +/- thoracostomy in a spontaneously breathing patient: References Ball, C. Wyrzykowski, A. Kirkpatrick, A. Nicholas, J.

Academics 52

Academics Radiology Radiology Resuscitation 52

Don't Forget the Bubbles

MAY 28, 2024

Were there any abnormalities on ultrasounds? So here, we must think about the risk factors for PPHN. Does the baby look septic? Are they covered in meconium? Were there any concerns during the pregnancy? Identifying the cause (if at all possible) definitely helps treatment. How do you manage PPHN? Early identification is key!

Sepsis 52

Sepsis Ultrasounds Pediatrics Research 52

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

Keep your ultrasound handy. 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. de Boisblanc, B., & Suresh, M. Bisanzo, M.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 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? The diagnosis is not easy (see below). J Electrocardiol, 42 (2009), pp.

EKG/ECG 96

EKG/ECG Wellness Ultrasounds EMS 96

ACEP Now

SEPTEMBER 3, 2024

Private equity investment in health care has increased more than 20-fold since 2000, with 70 percent of this activity since 2010. Her primary interests are in ultrasound, machine learning, and health justice. The views expressed in this article do not represent an official position of the American College of Emergency Physicians.”

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113

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

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

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Was there any prenatal care or ultrasound done? Part 15: Neonatal Resuscitation: 2010 American Heart Association Guidelines. Do a total body check. Heart disease or Hypovolemia - is there a history of congenital heart disease? Look for clitoromegaly in girls, or hyperpigmented scrotum in boys. ACEP/McGraw-Hill, 2013. McGowan et al.

Seizures 40

Seizures Sepsis Pediatrics Shock 40

Northwestern EM Blog

FEBRUARY 14, 2022

In a patient already on vaso that has stopped responding to escalating doses of norepinephrine, I reach for my ultrasound probe and reassure myself that there isn’t significant sepsis-related myocardial dysfunction because those patients may benefit from a trial of an inotrope like epinephrine. NEJM 2008; 358(9): 877 – 87.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

Taming the SRU

AUGUST 30, 2023

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.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

Pediatric Emergency Playbook

MARCH 1, 2016

In other words, feel free to use ultrasound – especially for things that we in the ED will react to and intervene on – but CT may help to manage the traumatized child non-operatively. 2010 Nov;19(4):286-91. If they are supported adequately, they are observed in the ICU and can avoid surgery in many cases. Semin Pediatr Surg.

Resuscitation 40

Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

Pediatric Emergency Playbook

JUNE 1, 2017

Cardiovasculr Ultrasound. 2010; 12(3): 3–8. 2010 Oct 1;33(10):821-42. Tomkewicz-Pajak L et al. Arterial stiffness in adult patients after Fontan procedure. 2014; 12:15. Varghese MJ et al. The caveats in the diagnosis of anomalous origin of left coronary artery from pulmonary artery (ALCAPA). Images Paediatr Cardiol.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Downeast Emergency Medicine

APRIL 26, 2021

If the trauma center performed screening ultrasounds to evaluate for asymptomatic DVTs, they were not included in this study. Lancet 2010; 376:23-32.[ A total of 1333 patients across 17 trauma centers were enrolled. 67% received TXA. There was no difference in the associated risk of VTE or MI/CVA after multivariable risk adjustment.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

Dr. Smith's ECG Blog

JULY 12, 2020

So I immediately left the room to get an ultrasound machine. While calling for some help and arranging to have her transported to our critical care zone, I got this quick ultrasound which confirmed my suspicion: This quick view was all I was able to obtain in the circumstances.

EKG/ECG 40

EKG/ECG Hospitals Ultrasounds Wellness 40

EB Medicine

JULY 8, 2019

Additionally, back in 2010, it was estimated that 6.6% Consider performing a RUSH exam (that is rapid ultrasound for shock and hypotension) to identify the cause. Nachi: If possible, obtain a view of the IVC also while doing your ultrasound to assess for volume status. Jeff: Next up is ultrasound. million adults!!

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

EB Medicine

SEPTEMBER 1, 2018

Nachi: In terms of imaging, a chest x-ray should be obtained in those with respiratory symptoms and ultrasound may even have an expanding role here for tracking edema, looking for fluid collections, and assessing deep muscle compartments and vascular flow. Position statement) 10. Wood A, Schauben J, Thundiyil J, et al. Clin Toxicol (Phila).

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

EB Medicine

AUGUST 1, 2018

It was peer-reviewed by Joseph Habboushe, assistant professor at NYU and Nadia Maria Shaukat, director of the emergency and critical care ultrasound at Coney Island Hospital in Brooklyn, New York. From 2010 to 2011, the number of ED visits by children aged 12 to 17 years old due to synthetic cannabinoid use also has doubled.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EB Medicine

AUGUST 6, 2019

Nachi: However, in 2010, the FDA approved the first DOAC, a real game-changer. But next we should talk about ultrasound. Jeff: Unfortunately, these agents have a narrow therapeutic window and many drug-drug interactions, and they require frequent monitoring - making them less desirable to many.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

Don't Forget the Bubbles

FEBRUARY 7, 2024

What is the role of ultrasound? Whilst we all love to wield the ultrasound probe, its use in diagnosing torsion remains controversial. This means that Doppler ultrasound can give both false negatives (they had a torsion, but it is not seen in the US) and false positive results (identified as having a torsion when they do not have it).

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111