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Not a Stab in the Dark - Mastering the Ultrasound Guided Peripheral IV

Downeast Emergency Medicine

Key concepts for Ultrasound Guided IV placement LENGTH Always use long IV (1.88 Use a tourniquet when you LOOK for the vein as well as when you place the IV otherwise the pressure from the probe will compress the veins and you won’t find anything. 2012 Sep;30(7):1134-40 References Fields JM et al. 2012 Sep;30(7):1134-40.

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Subclinical hypothyroidism

Don't Forget the Bubbles

His thyroid ultrasound is normal, and thyroid antibodies are negative. Six months later, his weight and height remain normal, he still does not have a goitre and his thyroid ultrasound is unchanged. She has a normal thyroid ultrasound and negative anti-microsomal and anti-thyroglobulin antibodies. She also has a goitre.

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SAEM Clinical Images Series: Retrobulbar Spot Sign

ALiEM

It requires immediate consultation with ophthalmology as well as neurology as it is considered a stroke equivalent. 2012 Dec;33(7):E263-E267. Epub 2012 Sep 21. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine vol. Ultraschall Med. doi: 10.1055/s-0032-1312925.

Stroke 64
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How to Manage Elderly Patient Pain without Opioids

ACEP Now

See below: Fascia iliaca Serratus anterior Erector spinae The risks of opioid medications, especially in the elderly, has been well described. published a study, “Safety and Pain Reduction in Emergency Practitioner Ultrasound-Guided Nerve Blocks: A One-Year Retrospective Study.” The pain scores decreased from 7.4 mean) to 2.8

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SAEM Clinical Images Series: What’s Coming Out of Your Eye?

ALiEM

On arrival to our emergency department, the patient expressed continued eye pain with bloody discharge as well as blurry vision from his right eye. 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.

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Don’t Forget the Orbeez!

Don't Forget the Bubbles

Abdominal ultrasound, used in 34 cases, was able to visualize a rounded intraluminal image corresponding to a bead in 28 patients. Point-of-care ultrasound may show well-demarcated, round, and hypoechoic material in the stomach and first part of the duodenum, though it can underestimate the number of beads present. Krisch et al.

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Don’t Forget About the IO in the Critically Ill Patient

RebelEM

CVC vs PIV The critically ill patient is often associated with pathology that makes IV access difficult such as shock state, hypovolemia, obesity, IV drug abuse, end-stage renal disease, cardiac arrest, as well as other conditions. 2012 PMID: 21893125. This study also showed the median time for IO placement was only 1.2 Resuscitation.