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. 2013 Apr;98(4):545-8. Haematologica. 2012.072009.

Ultrasounds 63

Ultrasounds CDC Research Stroke 63

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. WHY - Why Not? REFERENCES 1.

Infectious Diseases 96

Infectious Diseases Seizures Ultrasounds Sepsis 96

EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. Consider performing a RUSH exam (that is rapid ultrasound for shock and hypotension) to identify the cause. Jeff: Next up is ultrasound.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

ALiEM

MARCH 7, 2024

Given her pain with a history of intermittent hematuria and dysuria, you perform a renal and bladder point of care ultrasound (POCUS) examination. Pre-warmed ultrasound gel is helpful when available. Then test your skills on the ALiEMU course page to receive your PEM POCUS badge worth 2 hours of ALiEMU course credit.

Ultrasounds 70

Ultrasounds Pediatrics Emergency Department Radiology 70

EMDocs

AUGUST 12, 2023

He presented to the emergency department because he is having numbness distal to the site of injury, as well as constant bleeding and some difficulty with flexing his finger. The value of ultrasound for detecting hand fractures: A meta-analysis. April 9, 2013. Examination reveals the following: What is the diagnosis?

EMS 70

EMS Fractures Operations Ultrasounds 70

EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). 2013 Jan 24;368(4):394]. Ann Emerg Med. N Engl J Med.

Hyperthermia / Hypothermia 85

Hyperthermia / Hypothermia Resuscitation CPR EMS 85

Taming the SRU

SEPTEMBER 15, 2023

ultrasound grand rounds: bedside dvt studies - family presence in the ed/icu - r1 clinical knowledge: aicd - r3 small groups: difficult airway management Ultrasound grand rounds: DVT studies WITH Dr. minges Why should we perform bedside DVT studies in the ED?

CPR 89

CPR Burns Airway Management Wellness 89

PEMBlog

OCTOBER 2, 2024

2013-0421 Tighe M, Afzal NA, Bevan A, et al. Now, in the pediatric emergency department, the diagnosis of reflux is primarily clinical. Maybe parents will have to thicken the feeds, but I do not recommend this in the emergency department. J Pediatr Gastroenterol Nutr. 2018;66(3):516-554. doi: 10.1097/MPG.0000000000001889

Pediatrics 52

Pediatrics Emergency Department Ultrasounds 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. jps Sources Roberts and Hedges Clinical Procedures in Emergency Medicine. Academic Emergency Medicine, 20(6), 584–591.

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

EB Medicine

AUGUST 6, 2019

But next we should talk about ultrasound. Natalie Kreitzer from the University of Cincinnati, and Dr. Isaac Tawil from the University of New Mexico. Jeff: Interestingly, though only a small retrospective study of 156 patients, one study found markedly reduced mortality, 4.9% Jeff: And we’ll get to that in a few minutes.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

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 90

Emergency Department Ultrasounds Administration Burns 90

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

Here, then, are some links for Third Trimester Emergencies. Keep your ultrasound handy. Understand the application of the EMTALA law (Emergency Medical Treatment and Active Labor Act [ USA ]) to your situation. Preeclampsia/ Eclampsia - Emergency Department Resources. {3 abstracts} Luckett-Gatopoulos, S.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

Emergency Medicine Journal

JULY 22, 2024

Background and objectives The ability to rule appendicitis in or out using ultrasound is limited by studies where the appendix is not visualised. For those patients who had formal ultrasound, direct and indirect findings of ultrasound were abstracted from the ultrasound report. 95% CI 1.7 95% CI 3.8 95% CI 1.4

Ultrasounds 52

Ultrasounds Radiology Radiology Emergency Department 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. 2013.01.004.

Stroke 89

Stroke EMS EKG/ECG Radiology 89

Taming the SRU

JULY 22, 2024

INDICATIONS Arthrocentesis is a common procedure performed in the Emergency Department, in which a needle is inserted into a joint to withdraw fluid from the joint capsule. Studies have shown that effusions of as little as 2 to 4 mL can be identified using ultrasound [6]. ANESTHETIZE THE AREA step 7. Step 1: Prepare STEP 2.

Ultrasounds 95

Ultrasounds Emergency Department EMS 95

PEMBlog

JANUARY 17, 2024

Camargo, Clinical Trial: Comparative Effectiveness of Cephalexin Plus Trimethoprim-Sulfamethoxazole Versus Cephalexin Alone for Treatment of Uncomplicated Cellulitis: A Randomized Controlled Trial, Clinical Infectious Diseases, Volume 56, Issue 12, 15 June 2013, Pages 1754–1762, [link] Liu C, Bayer A, Cosgrove SE, et al.

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

Pediatric Emergency Playbook

JANUARY 1, 2017

The FPS-R uses more neutral and realistic faces and, unlike the Wong Baker scale, does not use smiling or crying faces to anchor the extremes of pain ( Tsze 2013 ). Ibuprofen may be more effective than acetaminophen (paracetamol) for odontogenic pain ( Bailey 2013 ). Author’s advice: take codeine off your formulary.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 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. 2013 Oct;132(4):663-7. Pediatrics.

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

Written by Destiny Folk MD, with edits by Meyers, peer reviewed by Smith and Grauer A woman in her late 20s with a past medical history of cervical cancer status post chemotherapy and radiation therapy presented to the emergency department for shortness of breath, chest tightness, and two episodes of syncope. 2013 Sep;26(9):965-1012.e15.

EKG/ECG 52

EKG/ECG Ultrasounds Documentation/Coding COPD 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

A emergent cardiology consult can be helpful for equivocal cases. New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department. Widespread ST-depression with reciprocal aVR ST-elevation can be cause by: Heart rate related: tachyarrhythmia (e.g.,

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52

RebelEM

JANUARY 25, 2024

Background: Point-of-care ultrasound (PoCUS) is a valuable clinical tool in the assessment of acute dyspnea. In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. Emerg Med J. 2023;40(10):700-707.

Ultrasounds 127

Ultrasounds Outcomes COPD Hospitals 127

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 87

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 87

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

EMDocs

AUGUST 8, 2023

Keys: Order the ultrasound in a patient with testicular pain, especially with any TWIST score >0. Minimal if any harm to patients by obtaining ultrasound. If you are going to use the TWIST score, make sure your department and your urologists are comfortable with it. Horizontally lying testicle. POCUS is not as accurate.

Ultrasounds 68

Ultrasounds Outcomes Documentation/Coding Emergency Department 68

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. 2013; 95(6): 474-477.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

ACEP Now

APRIL 4, 2024

3 The majority of those who arrive to the emergency department (ED) live for 2 hours or more, leaving a small window for surgical intervention. The diagnosis is confirmed with bedside ultrasound (US) or CT. Boca Raton, FL:CRC Press; 2013. About 35 percent of individuals with rAAA will die at home.

Operations 40

Operations Ultrasounds Emergency Department 40

ACEP Now

JUNE 14, 2024

And, finally, patients with a history of COPD frequently present to the emergency department with dyspnea. Although dyspnea in this setting likely represents an AECOPD, other emergent differentials must be considered. Ultrasound evaluates for global heart function, right heart strain, pulmonary edema, and lung sliding.

COPD 52

COPD Hospitals Emergency Department Outcomes 52

Mind The Bleep

JUNE 17, 2023

per 100,000 (Samad L, 2013) As these patients may be too young to vocalise, they tend to present very irritable, drawing their legs up to their tummy, and inconsolable and the pain is intermittent. Ultrasound (USS) should be urgently requested for suspected appendicitis, or ovarian torsion. Open Access Emergency Medicine , 283-291.

Shock 93

Shock Wellness Emergency Department Ultrasounds 93

Pediatric Emergency Playbook

DECEMBER 1, 2016

Ultrasound Not ready for prime time. Discharged on supplemental oxygen from an emergency department in patients with bronchiolitis. Management of bronchiolitis in the emergency department: impact of evidence-based guidelines? 2013 Mar;131 Suppl 1:S103-9. 2013 Apr;1(2):113-20. Pediatrics. Pediatrics.

Pediatrics 40

Pediatrics Emergency Department Hospitals Wellness 40

Mind The Bleep

JUNE 17, 2023

per 100,000 (Samad L, 2013) As these patients may be too young to vocalise, they tend to present very irritable, drawing their legs up to their tummy, and inconsolable and the pain is intermittent. Ultrasound (USS) should be urgently requested for suspected appendicitis, or ovarian torsion. Open Access Emergency Medicine , 283-291.

Shock 52

Shock Wellness Emergency Department Ultrasounds 52

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 87

Stroke Radiology Radiology Emergency Department 87

Don't Forget the Bubbles

FEBRUARY 7, 2024

My first real encounter with the healthcare system took place when I was about seven years old and had to go into hospital for an orchidopexy, so I can empathize with all the young people who come through our emergency department with acute testicular pain. What is the role of ultrasound? Normal testicle buddy view with colour.

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111

Don't Forget the Bubbles

SEPTEMBER 23, 2024

You are working in the paediatric emergency department of a busy District General Hospital. These centres have a close relationship with their patients, but this does not mean they may not turn up at your emergency department! An ultrasound scan of the graft is usually sufficient to rule out these complications.

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52