The Skeptics' Guide to EM

JANUARY 14, 2018

Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergency department. Urology 2012 Guest Skeptics: Dr. Tony Seupaul is the Chairman of the Department of Emergency Medicine at the University of Arkansas. The issue of renal colic a number of times on the SGEM.

Emergency Department 52

Emergency Department Ultrasounds Hospitals 52

ALiEM

SEPTEMBER 13, 2024

A 32-year-old male with no significant past medical history presented to the emergency department (ED) from an outside hospital for further management of right eye pain and vision loss sustained after he was struck by a metal wire while at work. An emergent ophthalmology consult is needed to plan for operative repair.

Emergency Department 64

Emergency Department Academics Fractures Hospitals 64

PEMBlog

OCTOBER 16, 2023

This case was submitted by… A 12-year-old female was brought to your emergency department by her mother for 1 month of diffuse abdominal and back pain. She also had a pelvic ultrasound with relevant image seen here: Based on those findings, she then got a CT with relevant images seen here: A. 2012 Jan;5(1):67-70.

Ultrasounds 69

Ultrasounds Emergency Department Pediatrics 69

ACEP Now

FEBRUARY 13, 2024

A 77-year-old man presented to the emergency department (ED) with hip pain following a fall. In the January issue of Annals of Emergency Medicine , Merz-Herrara, et al., published a study, “Safety and Pain Reduction in Emergency Practitioner Ultrasound-Guided Nerve Blocks: A One-Year Retrospective Study.”

Ultrasounds 52

Ultrasounds Emergency Department Hospitals Wellness 52

Urgent Care Ultrasounds

OCTOBER 24, 2018

An Anomalous Incidental – and ode to #POCUS #FOAMed Point of Care Ultrasound is based on the ability to answer binary, yes / no questions. Unfortunately ultrasound is not binary, but rather multiple shades of grey. Building a memory bank of normal and abnormal ultrasound findings is vital to help make sense of the unexpected.

Ultrasounds 52

Ultrasounds Urgent Care Emergency Department Hospitals 52

EM Curious

JULY 29, 2015

NO RESPECT FOR THE RIGHT VENTRICLE [PODCAST]: The boys from Ultrasound Podcast sit down with critical care guru, Dr. Haney Mallemat, to discuss the assessment of the right ventricle with ultrasound. Part 1 is here , look out for Part 2 in the coming weeks. Download the screencast here.

Sepsis 52

Sepsis EMS Emergency Department Ultrasounds 52

Pediatric Emergency Playbook

AUGUST 1, 2017

One of our largest responsibilities in the Emergency Department is sorting out benign from surgical or medical causes of abdominal pain. Abdominal Surgical Emergencies in Children: A Relative Timeline General Advice Neonate (birth to one month) Necrotizing Enterocolitis Pneumatosis Intestinalis. J Emerg Med. Lee HC et al.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

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. Emergency Department Management: Emergency ophthalmology consultation. Ophthalmology, in Marx J et al (eds): Rosens Emergency Medicine: Concepts and Practice, ed 9.

Stroke 52

Stroke Emergency Department Ultrasounds Outcomes 52

EB Medicine

MARCH 1, 2019

This month, after a few months of primarily medical topics, we’re talking trauma, specifically Blunt Cardiac Injury: Emergency Department Diagnosis and Management. Nachi: Which is why you’ll have to turn to our good friend the ultrasound, for more useful data. Ann Emerg Med. for pericardial effusion. Jeff: Great point.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

ACEP Now

OCTOBER 30, 2023

Like many other countries around the world, emergency medicine has proven to be one of the fastest-growing specialties, including in the United Arab Emirates (UAE). The official inauguration of ESEM occurred during the 10th Middle East Emergency Medicine Conference in Abu Dhabi on Oct.

Leadership 52

Leadership Emergency Department Ultrasounds CPR 52

EMDocs

MAY 11, 2024

Semin Ultrasound CT MR. 2013 Apr;34(2):131-41. Available from: [link] American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Use of Intravenous tPA for Ischemic Stroke:; Brown MD, Burton JH, Nazarian DJ, Promes SB. Ann Emerg Med. Erratum in: Ann Emerg Med. 2012) 43:2904–9.

Stroke 111

Stroke EMS EKG/ECG Radiology 111

The Skeptics' Guide to EM

DECEMBER 17, 2022

Case: A 71-year-old man is brought to your emergency department (ED) by emergency medical serviced (EMS) having fallen two steps at home. After a bedside ultrasound shows fluid in the right hemithorax, you insert an intercostal drain which immediately fills with one litre of blood. years ( 2 ).

Blood Transfusions 52

Blood Transfusions Fractures EMS Emergency Department 52

Northwestern EM Blog

MAY 16, 2022

What is your initial imaging test of choice, ultrasound (US) or non-contrast CT, and why? Would you be confident in a point-of-care-ultrasound evaluation or a formal ultrasound? Many patients in the ultrasound groups did get additional imaging, but this was not the majority. How do you proceed? In this study, 40.7%

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

Taming the SRU

OCTOBER 7, 2024

epidemiology of venous thromboembolism in pregnancy VTE is not only important to understand because it is the number one cause of mortality for pregnant patients, but also because it is common and will show up in your Emergency Department likely frequently throughout your career. Epub 2012 Oct 12. original drawing by dr zinter.

Ultrasounds 64

Ultrasounds CDC Research Stroke 64

Taming the SRU

AUGUST 30, 2023

While PCT may be more specific for bacterial infections, it is flawed by still being rather non-specific and is not validated as a stand-alone diagnostic criteria for infection in the setting of the emergency department. Instead, they strongly advocated for the use of lung ultrasound to diagnose bacterial CAP [45]. ng/mL, 0.25-0.5

Infectious Diseases 89

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

Pediatric Emergency Playbook

DECEMBER 1, 2016

Ultrasound Not ready for prime time. Discharged on supplemental oxygen from an emergency department in patients with bronchiolitis. 2012 Mar;129(3):e605-10. Management of bronchiolitis in the emergency department: impact of evidence-based guidelines? Pediatr Emerg Care. 2012 Sep;28(9):895-7.

Pediatrics 40

Pediatrics Emergency Department Hospitals Wellness 40

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

The downside is that it can last 30 minutes or more, but it may be a good choice for an abdominal ultrasound or CT head in unruly toddlers. 2012 Jul-Aug;8(4):237-41. Intranasal sufentanil provides adequate analgesia for emergency department patients with extremity injuries. Before You Go: The “Semmelweiss reflex”.

Administration 40

Administration Seizures Emergency Department Ultrasounds 40

Pediatric Emergency Playbook

JUNE 1, 2016

Cardiogenic Shock: Act Use point-of-care cardiac ultrasound : Good Squeeze? It’s seen easily enough on point of care ultrasound. Tamponade: if any sign of shock, pericardiocentesis, preferentially ultrasound-guided. Pulmonary embolism in the pediatric emergency department. You will see cool, mottled extremities.

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

ACEP Now

MARCH 15, 2024

A 20-year-old man presents to the emergency department (ED) directly from the scene of a fall from a bicycle, where he lost balance and landed on his outstretched hand. Anatomy for emergency medicine 018: EM Ireland website. Published June 11, 2012. He complains of pain both in the palm of his hand and in the wrist.

Fractures 52

Fractures Dislocations EMS Emergency Department 52

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

EB Medicine

FEBRUARY 1, 2019

This month, we’re tackling an incredibly important topic - evaluation and management of life threatening headaches in the Emergency Department. Nachi: Unfortunately, the 2008 ACEP guideline and 2012 AHA guidelines still recommend a lumbar puncture in those being worked up for SAH. Tylenol should be offered for pain management.

Emergency Department 40

Emergency Department Stroke Outcomes Ultrasounds 40

Pediatric Emergency Playbook

JANUARY 1, 2017

For example, a very anxious caregiver can easily transmit his or her anxiety to the child, which may either inhibit or amplify presentation of symptoms ( Bearden 2012 ). Intranasal ketamine for analgesia in the emergency department: a prospective observational series. Acad Emerg Med. Pediatr Emerg Care. Liebelt EL.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EMDocs

NOVEMBER 13, 2023

The use of CTA (computed tomography angiography) in the emergency department (ED) has increased dramatically in the past 20 years. Pearls and Pitfalls CT Angiography has become a more readily available tool for diagnosis in the emergency department though requires an understanding of its specific uses and indications.

Stroke 105

Stroke Radiology Radiology Emergency Department 105

Taming the SRU

MAY 22, 2023

Point-of-care ultrasound (POCUS) can evaluate for Achilles tendon rupture with a high sensitivity (96-100%) and specificity (83-100%) [8,9]. role of consulting services, emergent closed reduction, need for vascular imaging). Most frequent reasons for emergency department visits, 2018. 2012 Nov; 470(11):3270-3274.

Fractures 77

Fractures Dislocations Operations Radiology 77

EMDocs

SEPTEMBER 9, 2023

Answer : Extensor tendon laceration Epidemiology: Hand extensor injuries make up >25% of orthopedic soft tissue injuries 2, 3 Common in young men in manual labor Dominant hand more likely to be injured 4 2012 study on 86 patients reported 83% men with a mean age of 34.2 Ann Emerg Med. J Emerg Med. 2013;132(4):560e-566e.

EMS 104

EMS Fractures Soft Tissue Injuries Ultrasounds 104

EMDocs

JANUARY 20, 2025

Over the last few years, however, ultrasound has been increasingly playing an important role in the conversation with multiple studies looking at using ultrasound to predict fluid responsiveness in septic patients – for example, using the velocity time integral with passive leg raise. According to a meta-analysis by Chen et al.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

Don't Forget the Bubbles

FEBRUARY 17, 2025

1] Fred is a 3-year-old boy who presents to the emergency department. Before considering a further fluid bolus, you do a point-of-care ultrasound (POCUS). Taken together, the adult critical care community has shifted towards assessing for venous congestion at the organ level with Doppler ultrasound. References 1.

Pediatrics 78

Pediatrics Ultrasounds Shock Resuscitation 78

Taming the SRU

OCTOBER 28, 2024

When should I get a consultant involved in the emergency department? Spontaneous pneumomediastinum on bedside ultrasound: case report and review of the literature. West J Emerg Med. Pneumomediastinum Diagnosed on Ultrasound in the Emergency Department: A Case Report. Eur J Trauma Emerg Surg.

COPD 79

COPD Pediatrics Emergency Department Ultrasounds 79