ALiEM

MAY 19, 2023

A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. Additional trick: If the x-ray is delayed, you can pre-check with ultrasound [7]. 2012 Feb;33(1):46-54. PulmCrit Wee: Ultrasound-guided blakemore tube placement.

Emergency Department 98

Emergency Department Ultrasounds Wellness EMS 98

PulmCCM

JUNE 26, 2023

Cervical and pancreatic cancer patients often do as well with less invasive surgery, and some patients with rectal cancer or Hodgkin lymphoma can safely get less radiation. An expert panel broadened the definition of acute respiratory distress syndrome (ARDS). They announced this at the American Thoracic Society meeting in May 2023.

Outcomes 98

Outcomes Ultrasounds Hospitals Wellness 98

Don't Forget the Bubbles

NOVEMBER 8, 2023

Tilly is normally fit and well, with no significant past medical history. The Shera Score Children with a low Shera score (less than 3) who are otherwise systemically well may be suitable for discharge home with safety netting advice , whereas patients with high scores (8 or more) warrant immediate surgical referral. Pediatrics, 2012.

Emergency Department 105

Emergency Department Ultrasounds Pediatrics Best Practices 105

EMDocs

JULY 13, 2024

2012 May;27(5):1368-74. Epub 2012 Mar 14. Favorable infertility outcomes following anti-tubercular treatment prescribed on the sole basis of a positive polymerase chain reaction test for endometrial tuberculosis. Hum Reprod. doi: 10.1093/humrep/des076. PMID: 22419745. Morens, David. 2024, [link] Accessed 7 February 2024.

OB/GYN 64

OB/GYN EMS Sepsis Fluid Resuscitation 64

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

Pediatric Emergency Playbook

AUGUST 1, 2017

2012; 43(1):49-51. BMJ 2012; 345:e5521. Hypertrophic pyloric stenosis: tips and tricks for ultrasound diagnosis. 2012; 3:247-250. Intestinal Malrotation – Not Just the Pediatric Surgeon’s Problem. J Am Coll Surg. 2004; 199(4):628-635. Lee HC et al. Intestinal Malrotation and Catastrophic Volvulus in Infancy. J Emerg Med.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

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 J Trauma Acute Care Surg 2012; 73(5): S362-9. Absent bowel sounds Peritoneal signs (i.e.

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

Taming the SRU

OCTOBER 28, 2024

If their injury was from trauma, it would not be unreasonable to initiate trauma consult within the emergency visit, but also if the injury is isolated and the patient is well appearing, they could also follow up closely with the trauma clinic. Spontaneous pneumomediastinum on bedside ultrasound: case report and review of the literature.

COPD 78

COPD Pediatrics Emergency Department Ultrasounds 78

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 Plast Reconstr Surg. 2013;132(4):560e-566e. doi:10.1097/PRS.0b013e3182a0148c

EMS 78

EMS Fractures Soft Tissue Injuries Ultrasounds 78

Taming the SRU

MAY 22, 2023

Use your exam to guide your initial management as well as your imaging decisions and differential diagnosis. Point-of-care ultrasound (POCUS) can evaluate for Achilles tendon rupture with a high sensitivity (96-100%) and specificity (83-100%) [8,9]. 2012 Nov; 470(11):3270-3274. Respect, but do not rely upon, the mechanism.

Fractures 77

Fractures Dislocations Operations Radiology 77

Pediatric Emergency Playbook

JUNE 1, 2017

This child is at risk for expected complications, as well as overdiagnosis and iatrogenia. These children depend on their preload to run blood passively into the pulmonary circuit; afterload reduction is also important to compensate for a poor left ejection fraction, as well as to avoid the development of pulmonary hypertension.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Dr. Smith's ECG Blog

JUNE 2, 2023

She was awake, alert, well perfused, with normal mental status and overall unremarkable physical exam except for a regular tachycardia, possible rales at both bases, some mild RUQ abdominal tenderness. They are best seen in leads V1,V2 — and a bit less well seen in V3,V4. J Electrocardiol, 42 (2009), pp.

EKG/ECG 79

EKG/ECG Wellness Ultrasounds EMS 79

Dr. Smith's ECG Blog

MARCH 15, 2023

But when you see this, you should suspect that the AV node is not well. Her bedside cardiac ultrasound was normal We decided to cardiovert her since the time of onset was very recent. I do not know why she did not have a rapid rate. I signed her out to one of my partners.

EKG/ECG 52

EKG/ECG Dehydration Stroke Wellness 52

Pediatric Emergency Playbook

DECEMBER 1, 2016

If the otherwise healthy child one month and older is: Euvolemic Not hypoxic Well appearing He can likely go home. Ultrasound Not ready for prime time. 2012 Mar;129(3):e605-10. 2012 Sep;28(9):895-7. Epub 2012 Dec 21. Factors that are predictive of a definite infiltrate are: significant hypoxia ( 39°C). Pediatrics.

Pediatrics 40

Pediatrics Emergency Department Hospitals Wellness 40

ACEP Now

MARCH 15, 2024

An important pitfall is assuming no fracture if a hook-of-hamate fracture is suspected clinically and the standard wrist views as well as the hook-of-hamate or carpal tunnel view are negative. Published June 11, 2012. The sensitivity of the hook-of-hamate view is only 40 percent for fracture.9 German] Rontgenpraxis. 2006;56(2):59-65.

Fractures 52

Fractures Dislocations EMS Emergency Department 52

Downeast Emergency Medicine

APRIL 26, 2021

9] The BRAIN-PROJECT was a multicenter observational study of the prehospital treatment of patients with severe TBI (based on trauma mechanism or clinical findings and a prehospital GCS <9) who were treated by one of the four Dutch physician-staffed Helicopter Emergency Medical Services from 2012-2017. Arch Surg 2012; 147:113-119.[

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

A natural one, and especially suited for increasing capability without regard to physician residency program output of graduates, and in less-well-served rural areas. Advances in Medical Imaging (CT, MRI, and Ultrasound) facilitating rapid, accurate, diagnosis affording new potential to save additional lives. EDNA->ENA. Sakran, J.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

EB Medicine

MARCH 1, 2019

Nachi: This month’s team parsed through roughly 1200 articles as well as guidelines from the eastern association for surgery in trauma also known as EAST. Jeff: Interestingly, the system I work in has prehospital physicians, who do carry US, but I can’t think of a major trauma where ultrasound changed any of the decisions we made.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

We can use intranasal drugs for analgesia, for anxiolysis, for seizures – but not all drugs used for those purposes will perform well – or at all – via the IN route. 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.

Administration 40

Administration Seizures Emergency Department Ultrasounds 40

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. Instead, they strongly advocated for the use of lung ultrasound to diagnose bacterial CAP [45]. Raised inflammatory markers BMJ 2012; 344 :e454 doi:10.1136/bmj.e454 Gabay C, Kushner I. 2012 Jul 23;2(1):32. Oncotarget.

Infectious Diseases 88

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 88

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 ). Tachycardia, tachypnea, and a change in behavior can be indicators not only to the presence of pain, but possibly to its etiology as well.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

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. The most common findings on ECG are ST elevation , most often in the anterior precordial leads, as well as sinus tachycardia and QT interval prolongation. 2012 Aug;164(2):215-21.

EMS 74

EMS Fluid Resuscitation Shock EKG/ECG 74

EMDocs

OCTOBER 23, 2023

She had been feeling well until yesterday when she had a follow-up with her surgeon, at which time she reported that they performed an internal exam and inserted a ‘medication disk’ into her vagina. The patient is noted to be mildly tachycardic as well as febrile. 2012 APR; 52(2): 121-7. Aust N Z J Obstet Gynaecol.

OB/GYN 67

OB/GYN Operations EMS Ultrasounds 67

EB Medicine

JANUARY 2, 2019

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. Nachi: Definitely concerning, but this is all the more reason you need to employ our favorite imaging modality… the ultrasound. For a threatened abortion, the os would be closed with an IUP seen on ultrasound.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

EB Medicine

FEBRUARY 1, 2019

Gabrielle Procopio, a PharmD, have done a fantastic job parsing through the literature, which included over 500 abstracts, 89 full text articles, guidelines from ACEP and the American Academy of Neurology, as well as canadian and european neurology guidelines, to summarize the best evidence based recommendations for you all.

Emergency Department 40

Emergency Department Stroke Outcomes Ultrasounds 40

Dr. Smith's ECG Blog

DECEMBER 5, 2019

J Electrocardiology 45 (2012):433-442. A bedside cardiac ultrasound revealed grossly normal to hyperdynamic systolic function with no obvious areas of wall motion abnormalities. Thus, Brugada is the likely diagnosis _ A very nice explanation of this is given in the document quoted below on current ECG criteria for Brugada pattern.

EKG/ECG 52

EKG/ECG Hyperthermia / Hypothermia Seizures Documentation/Coding 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. Jeff: And the etiology of CHS is not well understood. Similarly, the exact criteria for CHS are poorly defined.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EMDocs

NOVEMBER 13, 2023

2019) argue against a minimum NIHSS score to trigger the use of CTA, instead purporting that clinical suspicion of acute ischemic stroke presenting within 24 hours of the last known well was sufficient evidence to order the study. Semin Ultrasound CT MR 2017, 38 (4), 345-356. Lancet Neurol 2012, 11 (4), 307-314. Tenenbaum, M.

Stroke 86

Stroke Radiology Radiology Emergency Department 86

SheMD

APRIL 23, 2023

Today Dr. Sabrina Gerkowicz, a reproductive endocrinologist (aka fertility doctor) shares with us some very important findings and statistics about #physicianinfertility as well as what a fertility workup looks like, who should have one, and 5 things you MUST know! So when and why should I have a fertility work up?

Ultrasounds 52

Ultrasounds Wellness Operations 52