Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. In fact, bedside ultrasound might even find severe aortic stenosis.

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PulmCCM

JULY 10, 2023

In the MERCY trial, 607 critically ill patients with sepsis (most with septic shock) at 26 hospitals in Croatia, Italy, Kazakhstan, and Russia were randomized to receive meropenem by either continuous (3 g / 24 hours) or intermittent administration (1 g every 8 hours). However, the practice has not been supported by randomized trials.

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Dr. Smith's ECG Blog

NOVEMBER 4, 2022

An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Literature 1. ST elevation (STE) in lead augmented vector right (aVR), coexistent with multilead ST depression, was endorsed as a sign of acute occlusion of the left main or proximal left anterior descending coronary artery in the 2013 STEMI guidelines.

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Pediatric Emergency Playbook

SEPTEMBER 1, 2015

The combination of abnormalities determines the category of pathophysiology: respiratory distress, respiratory failure, CNS or metabolic problem, shock, or cardiopulmonary failure. Was there any prenatal care or ultrasound done? ACEP/McGraw-Hill, 2013. Look for clitoromegaly in girls, or hyperpigmented scrotum in boys.

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Pediatric Emergency Playbook

JUNE 1, 2017

The infant in shock after a ‘cold’: myocarditis Beware of the poor feeding, tachycardic, ill appearing infant who “has a cold” because everyone else around him has a ‘cold’. 2013; 34(3):489-491. Cardiovasculr Ultrasound. 2013; 34(4). 2013; 8(2):61-63. 2013; 6(5):752-761. 2014; 5(4)L631-634. Pediatr Cardiol.

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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.

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PEMBlog

OCTOBER 2, 2024

2013-0421 Tighe M, Afzal NA, Bevan A, et al. or somebody who appears pale, dehydrated, in severe pain, or worse, even in shock. Now, ultrasound is useful if you suspect gallbladder disease, but the patient needs to be NPO for six to eight hours before the procedure. J Pediatr Gastroenterol Nutr. 2018;66(3):516-554. Pediatrics.

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Dr. Smith's ECG Blog

NOVEMBER 28, 2022

A bedside cardiac ultrasound was performed with a parasternal long axis view demonstrated below: There is a large pericardial effusion with collapse of the right ventricle during systole. Given her tachycardia and episodes of syncope, the patient was judged to be in compensated obstructive shock with very high risk of imminent decompensation.

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Rural Doctors Net

AUGUST 30, 2013

Intubation for humanitarian reasons is also reasonable – he’ll be in pain and this is not the time to be faffing around with the ultrasound or nerve stimulator doing blocks! Ultrasound can be useful – I am a fan of the SUSS-IT examination (seconary ultrasonographic survey in trauma). How to intubate?

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EMDocs

DECEMBER 1, 2024

Flea-Borne Typhus: Epidemiology Summary 2013-2019. Ischemic Hepatitis and Septic Shock Secondary to Murine Typhus Infection in Pregnancy. The RUSH exam: Rapid Ultrasound in SHock in the evaluation of the critically lll. Rosh Review Website Link References: Texas Department of State Health Services. Flea-Borne Typhus.

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EMDocs

NOVEMBER 13, 2024

Ultrasound can assist: confirm ascites, evaluate for best site, abdominal wall thickness, blood vessels along needle track. Management: Patients can rapidly progress to septic shock and multiorgan failure. A 2013 meta-analysis found IV albumin was associated with 22.3% 2013 May;44(5):903-9. IV albumin is essential.

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EMDocs

JANUARY 16, 2024

VF/asystole), a pulse cannot be identified via Doppler ultrasound for a full minute, or if lack of organized cardiac activity is confirmed on bedside echocardiogram. This is a good time to utilize an arterial line or use the ultrasound to find a central pulse. 2013 Jan 24;368(4):394]. Resuscitation. N Engl J Med. Hypothermia.

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Pediatric Emergency Playbook

AUGUST 1, 2017

Hypertrophic pyloric stenosis: tips and tricks for ultrasound diagnosis. 2013; 95(6): 474-477. 2013; 48:1789-1793. J Ultrasound. Pyloric Stenosis Aspelund G, Langer JC. Current management of hypertrophic pyloric stenosis. Semin Pedaitr Surg. 2007; 16:27-33. Dias SC et al. Insights Imaging. 2012; 3:247-250. J Pediatr Surg.

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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.

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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?

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Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Perhaps, not insignificantly, they were accustomed to receiving systematized government-supplied medical and trauma care, with "shock rooms" receiving an influx of victims, as contrasted to those later who opposed "socialized medicine." EM makes a strong push into bedside use of ultrasound sonography. 10/20/2013.

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Pediatric Emergency Playbook

MARCH 1, 2016

On arrival, he was in compensated shock, with tachycardia. In other words, feel free to use ultrasound – especially for things that we in the ED will react to and intervene on – but CT may help to manage the traumatized child non-operatively. 2013 Sep;184(1):352-7. 2013 Nov;206(5):655-60. 2013 Jun;48(6):1377-83.

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Taming the SRU

AUGUST 30, 2023

Similarly, a 2013 meta-analysis of 6 studies with 1,006 patients published in the American Journal of Emergency Medicine showed neither CRP nor PCT are sufficient to rule-in or rule-out infective endocarditis, with PCT having a pooled sensitivity of 64% and specificity of 73% and CRP having a pooled sensitivity of 75% and specificity of 73% [40].

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Mind The Bleep

AUGUST 5, 2023

Example of pneumoperitoneum following perforated NEC Other Investigations Blood tests and abdominal ultrasound. Abdominal ultrasound may show bowel wall thickening, altered vascular state and free fluid. England: Oxford University Press; 2013. Necrotizing Enterocolitis. Updated 2022 Aug 8]. In: StatPearls [Internet].

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PulmCCM

SEPTEMBER 23, 2021

With the explosion of bedside ultrasound and automated methods to capture LVEF, the ejection fraction will grow in clinical prominence and affect decisions for the acutely-ill. Critical Care 2013, 17(2):213. Guarracino F, Ferro B, Morelli A, Bertini P, Baldassarri R, Pinsky MR: Ventriculoarterial decoupling in human septic shock.

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EB Medicine

JULY 8, 2019

Jeff: Do note, however that 2013 guidelines do not recommend one procedure over another and leave that decision up to local surgical expertise, patient specific risk factors, and treatment goals. Consider performing a RUSH exam (that is rapid ultrasound for shock and hypotension) to identify the cause.

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EB Medicine

AUGUST 6, 2019

But next we should talk about ultrasound. Jeff: That is simply shocking! 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% Let’s also talk lab studies.

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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. This corresponds nicely to a 2013 retrospective study demonstrating a bHCG threshold for the fetal pole to be just below 1400. For a threatened abortion, the os would be closed with an IUP seen on ultrasound.

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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. JAMA Paediatrics , 1053-1060. 2023, June 14).

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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. JAMA Paediatrics , 1053-1060. 2023, June 14).

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Dr. Smith's ECG Blog

DECEMBER 23, 2024

Written by Willy Frick A woman in her 70s is hospitalized with undifferentiated shock after being found down at home. The transcutaneous pads are delivering shocks at a rate of 70 per minute. This patient is getting painful electrical shocks at a rate of 70 per minute which is providing no benefit whatsoever. How can you tell?

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EMDocs

NOVEMBER 13, 2023

However, IgE-mediated or not, anaphylactic shock is possible in either case. Semin Ultrasound CT MR 2017, 38 (4), 345-356. Am Surg 2013, 79 (1), 23-29. Eur Radiol 2013, 23 (6), 1443-1449. Neurology 2013, 81 (11), 1004-1011. AJNR Am J Neuroradiol 2013, 34 (5), 1077-1081. DOI: 10.1161/strokeaha.118.023173

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EMDocs

JANUARY 20, 2025

Patients were enrolled in these trials if they had signs of shock, with mortality ranging from 18-29%. 13 While there is good data that early antibiotics for patients in septic shock reduce mortality 18-19 the role of early and aggressive volume resuscitation and its impacts on patient-centered outcomes remain unclear. Inwald et al.

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