RebelEM

SEPTEMBER 11, 2023

Background: Point of care ultrasound (POCUS) has a demonstrated sensitivity of 89.8% Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Similarly, surgeons might hesitate to operate on older patients with multiple comorbidities due to higher associated risks.

Ultrasounds 68

Ultrasounds Radiology Radiology Emergency Department 68

ALiEM

SEPTEMBER 13, 2024

Tonometry and ocular ultrasound (US) are generally not recommended as you could squeeze more liquid out of the eye or increase the intraocular pressure even more, pushing the iris further out. An emergent ophthalmology consult is needed to plan for operative repair. Epub 2011 Dec 2. Endophthalmitis following open-globe injuries.

Emergency Department 64

Emergency Department Academics Fractures Hospitals 64

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). This often is seen in trauma, cancer, post-operatively, and end-stage metabolic conditions with excessive colloid or protein leak.

Emergency Department 87

Emergency Department Ultrasounds Radiology Radiology 87

Don't Forget the Bubbles

JANUARY 17, 2024

Forrester reported data from the Texas Poison Centers surrounding 110 cases of superabsorbent polymer bead ingestions between 2011 and 2016. Abdominal ultrasound, used in 34 cases, was able to visualize a rounded intraluminal image corresponding to a bead in 28 patients. They passed away a few days after a second operation.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

PHEM Cast

DECEMBER 1, 2017

Journal of Special Operations Medicine : a Peer Reviewed Journal for SOF Medical Professionals , 13 (4), 53–58. Ultrasound determination of chest wall thickness: implications for needle thoracostomy. Ultrasound in Emergency Medicine. The Journal of Emergency Medicine , 13 (2), 155–163. Beckett, A., Pannell, D., Acharya, S.,

Academics 52

Academics Radiology Radiology Resuscitation 52

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. Goldfrank’s Toxicologic Emergencies, 9e New York, NY: McGraw-Hill; 2011. The gold standard is surgical exploration. 10, (-) LR = 0.13 10, (-) LR = 0.13

Ultrasounds 52

Ultrasounds Pediatrics Operations EMS 52

Northwestern EM Blog

DECEMBER 20, 2021

Management includes imaging studies, typical ultrasound to assess for a joint effusion, then a diagnostic arthrocentesis & antibiotics. Management is orthopedic consultation for operative stabilization [12]. doi:10.1136/archdischild-2011-301245. References Smith E, Anderson M, Foster H. 2012;97(5):185-193.

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

Taming the SRU

AUGUST 30, 2023

A 2011 meta-analysis in the journal of Academic Emergency Medicine found ESR, CRP, and PCT were not acutely useful in the diagnosis of septic arthritis due to wildly varying sensitivities and specificities between studies. Instead, they strongly advocated for the use of lung ultrasound to diagnose bacterial CAP [45]. Acad Emerg Med.

Infectious Diseases 89

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

Pediatric Emergency Playbook

MARCH 1, 2016

Often children even with high-grade splenic and liver lacerations can be managed non-operatively. Unfortunately, a negative FAST cannot help with detecting or grading the laceration for non-operative management. CT Abdomen and Pelvis, IV contrast: helpful in grading splenic and liver lacerations with goal to manage non-operatively.

Resuscitation 40

Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

Pediatric Emergency Playbook

JUNE 1, 2017

Fontan Operation and the Single Ventricle. Cardiovasculr Ultrasound. 2011; 2(1):70-72. 2011 Jan-Jun; 4(1): 81–83. 2011; 32:492-497. 2011; 552-555. 2011; 128(6):1-6 Munk K et al. References Congenital AboulHosn JA et al. Congenit Heart Dis. 2007; 2:2-11. Aliku TO et al. Circulation. 2014; 12:15.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

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

Don't Forget the Bubbles

FEBRUARY 7, 2024

One systematic review of 1283 patients showed that if you got to the operating room within 6 hours, you had a 97% chance of saving the testicle. Urgent senior review, decision making and operation 31.3% What is the role of ultrasound? This dropped to 79.3% of patients were first seen by a junior specialist trainee.

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111

EMDocs

JUNE 21, 2023

Common operator errors Failing to enter joint capsule before injecting STS. Can Ultrasound Identify Traumatic Knee Arthrotomy in a Cadaveric Model? 2011 Nov;71(5):E110-3. When in the joint, you’ll obtain synovial fluid. Inject lidocaine first, then slowly start injecting STS looking at the wound for saline coming out.

Soft Tissue Injuries 95

Soft Tissue Injuries Fractures Dislocations Radiology 95

Pediatric Emergency Playbook

JANUARY 1, 2017

Neonatal observational scales have been validated in the intensive care and post-operative settings; ED-specific quantitative scales are lacking. CRIES ( Table 1 ) was validated for post-operative patients; to adapt its use for the ED, the most conservative approach is to substitute “preoperative baseline” with normal range for age.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EB Medicine

JANUARY 2, 2019

Jeff: Perhaps most importantly, no history or physical alone can rule in or out an ectopic pregnancy, for that you’ll need testing and imaging or operative findings. So to get us all on the same page, the discriminatory zone is the b-HCG at which an IUP is expected to be seen on ultrasound. Jeff: Up first is the urine pregnancy test.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

EMDocs

SEPTEMBER 9, 2023

The value of ultrasound for detecting hand fractures: A meta-analysis. Results of primary extensor tendon repair in relation to the zone of injury and pre-operative outcome estimation. New York, NY: McGraw-Hill Medical; 2011:207-211. Emergency Medicine News 33(12):p 8,9, December 2011. | Plast Reconstr Surg.

EMS 103

EMS Fractures Soft Tissue Injuries Ultrasounds 103

Mind The Bleep

DECEMBER 6, 2024

Initial Management (whilst Urology team are on their way) Bloods FBC, U/Es, CRP, Coagulation screen, Blood glucose levels, Blood cultures IV Antibiotics as per Trust guidelines (may be under section for Necrotising fasciitis) Urethral catheter- this will help with monitoring urine output and help identify the urethra during the operation.

Documentation/Coding 52

Documentation/Coding Operations Ultrasounds Hospitals 52