The Skeptics' Guide to EM

APRIL 20, 2024

Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergency department: A randomized controlled trial. Background: We have covered rib fractures once before on the Skeptics’ Guide to Emergency Medicine.

Fractures 82

Fractures Ultrasounds Emergency Department CDC 82

Taming the SRU

APRIL 14, 2024

2) Management: Confirmed by CT Surgical consult Utility of Ultrasound Ultrasound can be helpful in identifying hernias and in assisting in reduction. 8) “Ultrasound may decrease the emergency surgery rate of incarcerated inguinal hernia” by Chen et al. (1) The results revealed a rate of emergency surgery of 9.8%

Ultrasounds 92

Ultrasounds Emergency Department Pediatrics Radiology 92

Dr. Smith's ECG Blog

DECEMBER 16, 2024

And almost all of them could be detected by bedside ultrasound. Conclusion: you may take a few moments to look for dissection with your bedside ultrasound, but when it is a clear STEMI, do NOT waste time with a CT scan. It is not a waste of time to use bedside ultrasound to look for dissection 3. Ultrasound Med.

Ultrasounds 86

Ultrasounds EKG/ECG Operations Emergency Department 86

Don't Forget the Bubbles

NOVEMBER 20, 2023

Neck lumps are a common presenting complaint to the paediatric emergency department with many aetiologies, sometimes resulting in a diagnostic conundrum. These may require surgical drainage following confirmation on ultrasound scan. December 2014 Soldes O, Yunger J, Hirschl R. Cervical Lymphadenopathy.

Pediatrics 124

Pediatrics Documentation/Coding Emergency Department Ultrasounds 124

RebelEM

DECEMBER 10, 2023

Background: The use of ultrasound is well established for trauma patients in the emergency department, with almost every patient receiving a FAST (Focused Assessment with Sonography in Trauma) examination as part of the “ABC’s” of trauma. As always, we should consider new data as it emerges. PMID: 34932040.

Ultrasounds 40

Ultrasounds Emergency Department Wellness EMS 40

ALiEM

AUGUST 30, 2024

A 5-year-old female presented to the emergency department (ED) with a one-year history of gradually increasing anterior neck swelling. NG/DL) Ultrasound of the neck revealed an enlarged thyroid gland with lobular contours and diffuse hypoechoic echogenicity, without noticeable nodules, fluid collection, or lymphadenopathy.

Pediatrics 64

Pediatrics Ultrasounds Academics Emergency Department 64

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. Saunders 2014, Chapter 31 Beaudoin, F.

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

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. Of course we were skeptical and wanted to review the evidence.

Emergency Department 52

Emergency Department Ultrasounds Hospitals 52

Don't Forget the Bubbles

JULY 17, 2023

Reviews and opinion articles Point-of-care ultrasound in pediatric nephrology. 2023 Jun 1;76(6):731-736 The Association Between Media-Based Exposure to Nonsuicidal Self-Injury and Emergency Department Visits for Self-Harm. coli urine tract infections in children treated in primary care and emergency department.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

The Skeptics' Guide to EM

DECEMBER 28, 2019

Guest Skeptics: Dr. Christopher Moore is an Associate Professor of Emergency Medicine a Yale School of Medicine. He is also the Chief for the Section of Emergency Ultrasound and […] The post SGEM Xtra: Come Together, Right Now – Over Renal Colic first appeared on The Skeptics Guide to Emergency Medicine. NEJM 2014 ).

Radiology 40

Radiology Radiology Ultrasounds Emergency Department 40

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. Jeff: A 2014 study even showed an up to 80% reduction in the likelihood of developing DM2 postoperatively at the 7-year mark.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

The Skeptics' Guide to EM

SEPTEMBER 14, 2019

She is interested in social determinants of health in the emergency department and health policy. Dr. Ian Holley is also a PGY-3 resident in Emergency Medicine at Washington University School of Medicine in St. He is interested in ultrasound and international emergency medicine.

Head Injuries 52

Head Injuries Emergency Department Seizures EMS 52

EMDocs

APRIL 22, 2024

4 In an emergency department (ED) presentation of cardiac arrest, the diagnosis of PE is challenging without the use of CT angiography. Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. 2014 May;145(5):950-957.

Ultrasounds 82

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 82

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

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. 2014) Emergency Care Institute, New South Wales. 2014) Tiny Tip: PRE -eclampsia. Stafford, I.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

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.

Blood Transfusions 52

Blood Transfusions Fractures EMS Emergency Department 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 Pediatr Surg 2014; 49:1619.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

ACEP Now

SEPTEMBER 13, 2023

But what if we could measure a patient’s spleen via ultrasound in the emergency department (ED) to guide specific patient care? Practitioners have looked at splenic size on ultrasound and its association with splenic dysfunction. Acad Emerg Med. US Department of Health and Human Services. Am J Roentgenol.

Pediatrics 40

Pediatrics Ultrasounds Emergency Department Poisoning 40

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

Taming the SRU

MAY 5, 2023

doi:10.1056/NEJMoa2212663 BACKGROUND Sepsis, including severe sepsis and septic shock, is a frequently encountered condition in the emergency department and carries a high mortality rate. 2014, Hjortrup, Haase et al. N Engl J Med. 2023;388(6):499-510. 2021, Jarczak, Kluge et al. 2016, Andrews, Semler et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

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. 2014 May;4(3):432-5.

Fractures 76

Fractures Dislocations Operations Radiology 76

Pediatric Emergency Playbook

DECEMBER 1, 2016

Ultrasound Not ready for prime time. Pros and Cons in Audio; the 2006 AAP Guidelines and the 2014 AAP Guidelines use same data to come to divergent recommendations. 2014 Jan 20;(1):CD009609. 2014 May;133(5):769-75. Discharged on supplemental oxygen from an emergency department in patients with bronchiolitis.

Pediatrics 40

Pediatrics Emergency Department Hospitals Wellness 40

Pediatric Emergency Playbook

JANUARY 1, 2017

A special note on codeine : Tylenol with codeine (“T3”) has never been a very effective pain medication, as up to 10% of patients lack enzymatic activity to metabolize it into morphine, its active form ( Crews 2014 ). New evidence is emerging on the erratic and unpredictable individual metabolism of codeine. Acad Emerg Med.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

Broome Docs

DECEMBER 22, 2024

It’s Not Cyclic Vomiting Syndrome Until Dietl’s is Ruled Out: A Case for Point of Care Renal Ultrasound. J Emerg Med. 2018 Nov 22;379(21):2002-2014. Piroxicam and paracetamol in the prevention of early recurrent pain and emergency department readmission after renal colic: Randomized placebo-controlled trial.

Blood Transfusions 52

Blood Transfusions Hospitals Outcomes Emergency Department 52

Dr. Smith's ECG Blog

JANUARY 10, 2020

Here is the parasternal short axis, performed by a real expert in emergency department point of care cardiac ultrasound: There does not appear to be an anterior wall motion abnormality. Beware a negative Bedside ultrasound. I excerpted Figure-2 from Section 12 on Pericarditis , from my ECG-2014-ePub. Pericarditis?

EKG/ECG 40

EKG/ECG Ultrasounds Emergency Department Wellness 40

PEMBlog

JANUARY 17, 2024

Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis 2014; 59:e10. If you think that there’s an abscess, you can diagnose it clinically by a localized area of induration or fluctuance or use an ultrasound.

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

Don't Forget the Bubbles

JULY 5, 2023

A 6-year-old girl from Saudi Arabia was referred by her General Practitioner to the local emergency department. The high blood flow velocities through these stenotic segments can be detected using transcranial doppler ultrasound (TCD). 2014; 349–356. She complained of cough and runny nose for 3 days. Macharia AW et al.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

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. Methods STEMI activations between January 2014 and April 2018 at the University of Arizona Medical Center were identified.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52

Don't Forget the Bubbles

NOVEMBER 1, 2023

This month, Bubble Wrap has teamed up with Sheffield Children’s Hospital Emergency Department to have a look at what’s new in paediatric literature. Lactate as a screening tool for critical illness in a pediatric emergency department. Pediatric Emergency Care. 2023 Oct 1;39(10):735-8. What’s it about?

Emergency Department 140

Emergency Department Hospitals Resuscitation Administration 140

ACEP Now

MAY 10, 2024

A 59-year-old man presents to your community emergency department (ED) with chest pain that is radiating to his back. Ultrasonographers: POCUS was performed by PGY1–PGY3 emergency medicine residents. They received a four-hour introductory course taught by emergency ultrasound faculty. Emerg Med Australas.

Ultrasounds 52

Ultrasounds Outcomes Documentation/Coding Academics 52

ALiEM

OCTOBER 2, 2023

A 6-year-old male presented to the pediatric emergency department (PED) for scalp lesions. An outpatient ultrasound was performed showing “multiple scalp echogenic nodular lesions measuring from 0.5 A point-of-care ultrasound (POCUS) using a high-frequency, linear transducer was performed during the PED visit (Image 2).

Ultrasounds 75

Ultrasounds Pediatrics Academics Emergency Department 75

Mind The Bleep

JUNE 17, 2023

Bluman J, 2014) The abdominal pain is colicky / crampy, intermittent and diffuse, the child may struggle to point to a single area of pain. Ultrasound (USS) should be urgently requested for suspected appendicitis, or ovarian torsion. Diagnosis and Management of Paediatric Ovarian Torsion in the Emergency Department: Current Insights.

Shock 93

Shock Wellness Emergency Department Ultrasounds 93

ACEP Now

OCTOBER 30, 2023

These initiatives aim to equip physicians with an evidence-based approach and effective management strategies for common emergency-department scenarios. ESEM hosted the second Global Network Collaborative Conference on Emergency Medicine in 2013 and organized its first large scientific conference in Dubai in December 2014.

Leadership 52

Leadership Emergency Department Ultrasounds CPR 52

EMDocs

DECEMBER 18, 2023

1 The rationale for the shift away from normal saline in 2021 derived from multiple trials, including the Isotonic Solutions and Major Adverse Renal Events Trial (SMART) and Saline Against Lactated Ringer’s or Plasma-Lyte in the Emergency Department (SALT ED). Procalcitonin and sepsis in the Emergency Department: an update.

Sepsis 65

Sepsis Fluid Resuscitation Resuscitation Shock 65

EMDocs

JULY 15, 2023

A lower extremity radiograph does not reveal any gas formation and an ultrasound of the lower extremity is negative for DVT or cobblestoning, WBC is within normal limits and there are mild elevations in ESR and CRP. 2014 Jul 15;59(2):e10-52. No fungal infections are identified on the feet. What is the most likely diagnosis?

EMS 66

EMS Infectious Diseases Shock Ultrasounds 66

Mind The Bleep

JUNE 17, 2023

Bluman J, 2014) The abdominal pain is colicky / crampy, intermittent and diffuse, the child may struggle to point to a single area of pain. Ultrasound (USS) should be urgently requested for suspected appendicitis, or ovarian torsion. Diagnosis and Management of Paediatric Ovarian Torsion in the Emergency Department: Current Insights.

Shock 52

Shock Wellness Emergency Department Ultrasounds 52

EMDocs

JANUARY 6, 2024

You review his chart and note that he had a heart transplant in 2014 but has not followed up with a cardiologist for at least 3 years. A bedside cardiac ultrasound is performed which shows biventricular failure with a dilated inferior vena cava. A 63-year-old man presents to the emergency department for dyspnea on exertion.

EMS 63

EMS Infectious Diseases Shock Emergency Department 63