RebelEM

JANUARY 25, 2024

Background: Point-of-care ultrasound (PoCUS) is a valuable clinical tool in the assessment of acute dyspnea. Impact of serial cardiopulmonary point-of-care ultrasound exams in patients with acute dyspnoea: a randomized, controlled trial. PoCUS evaluations included lung ultrasound (LUS) and focused cardiac ultrasound (FoCUS).

Ultrasounds 129

Ultrasounds Outcomes COPD Hospitals 129

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 Radiology Radiology 70

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. A clinical decision tool called the STUMBL score was derived and validated by Battle et al in 2014 [3].

Fractures 87

Fractures Ultrasounds Emergency Department CDC 87

Pediatric EM Morsels

JUNE 16, 2023

Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment.

Soft Tissue Injuries 154

Soft Tissue Injuries Dehydration Fractures Operations 154

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) If the ultrasound-guided attempt failed, emergency surgery was scheduled.

Ultrasounds 93

Ultrasounds Emergency Department Pediatrics Radiology 93

ACEP Now

MAY 10, 2024

While waiting for laboratory investigations, including troponin and d-dimer, you wonder if a quick point-of-care ultrasound (POCUS) examination looking for three sonographic findings could help determine the likelihood of this being an AoD. They received a four-hour introductory course taught by emergency ultrasound faculty.

Ultrasounds 52

Ultrasounds Outcomes Academics Documentation/Coding 52

Dr. Smith's ECG Blog

SEPTEMBER 23, 2024

Answer : Bedside ultrasound! Smith : RV infarct may also have this appearance on ultrasound. So hypoxia without B lines on lung ultrasound strongly weights toward PE. What do you do clinically when the ECG looks like this? How do you emergently triage the patient to cath lab or possibly IR suite for thrombectomy?

EKG/ECG 128

EKG/ECG Ultrasounds Shock EMS 128

Don't Forget the Bubbles

AUGUST 9, 2023

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.

Ultrasounds 98

Ultrasounds Pediatrics Wellness 98

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. Not so FAST- Chest ultrasound underdiagnoses traumatic pneumothorax. PMID: 34932040.

Ultrasounds 40

Ultrasounds Emergency Department Wellness EMS 40

EMDocs

APRIL 22, 2024

Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. Multiorgan POCUS The diagnostic power of POCUS often resides in combining multiple ultrasound exams. 2014 May;145(5):950-957. doi: 10.1378/chest.13-1087. PMID: 24092475.

Ultrasounds 98

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 98

EMDocs

APRIL 2, 2024

Check the pulse RSI= Resuscitation Sequence Intubation Hypoxia, Hypotension, and Acidosis are the reason patients code during/post intubation These patients are super high risk for all 4 Optimize first pass success – Induction agent + paralytic Unconscious patients will still have muscle tone Induction Ketamine or Etomidate at half doses (i.e.,

Documentation/Coding 115

Documentation/Coding CPR EKG/ECG Sepsis 115

Taming the SRU

MAY 27, 2024

Ultrasound in recent years has become a very helpful tool in diagnosing smaller effusions, and is noted to be almost 100% sensitive for effusions > 100 mL (2). While historically reported rates were ~20%, more recent literature with ultrasound guidance suggests much lower rates of ~3% (3, 4).

Emergency Department 87

Emergency Department Ultrasounds Radiology Radiology 87

ALiEM

AUGUST 30, 2024

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. An ultrasound and thyroid antibodies may also be helpful to confirm diagnosis. 2014 Dec;24(12):1670-751. No distention or tenderness.

Pediatrics 64

Pediatrics Ultrasounds Academics Emergency Department 64

Don't Forget the Bubbles

NOVEMBER 20, 2023

These may require surgical drainage following confirmation on ultrasound scan. December 2014 Soldes O, Yunger J, Hirschl R. Difficulty swallowing, stridor or altered voice should prompt urgent ENT assessment. Simple lymphadenitis can progress into fluctuant masses, suggesting abscess formation. Cervical Lymphadenopathy.

Pediatrics 124

Pediatrics Documentation/Coding Emergency Department Ultrasounds 124

RebelEM

JANUARY 29, 2024

Randomized, Controlled Trial of Ultrasound-Assisted Catheter-Directed Thrombolysis for Acute Intermediate-Risk Pulmonary Embolism. A prospective, Single-Arm Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism: The SEATTLE II Study. CHEST 2010.

Stroke 136

Stroke Outcomes Hospitals Administration 136

Pediatric Emergency Playbook

JANUARY 1, 2022

Ultrasound shows a pylorus of greater than 3 mm wide and 14 mm long. 2014 Jun;49(6):995-9. 2014 Mar;63(3):289,308. Memory aid: 3.14 In pyloric stenosis, π-lorus > 3 x 14 Treatment Various options, may be deferred depending on age, availability, severity of illness, including: Pyloromyotomy — definitive. J Pediatr Surg.

Dehydration 52

Dehydration Pediatrics Ultrasounds 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. Saunders 2014, Chapter 31 Beaudoin, F. Ultrasound-Guided Three-In-One Nerve Block for Femur Fractures.

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

RebelEM

NOVEMBER 30, 2022

History, physical examination and ultrasound are all flawed in making the diagnosis. History, physical examination and ultrasound are all flawed in making the diagnosis. 2014, (Ch) 99: p 1326-1356. The gold standard is surgical exploration. Physical exam, history and imaging all have significant limitations. 10, (-) LR = 0.13

Ultrasounds 52

Ultrasounds Pediatrics Operations EMS 52

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

FEBRUARY 12, 2025

Imaging: In severe cases, imaging with ultrasound, CT or MRI may be useful in assessing the extent of tissue injury and in further evaluating other etiologies including infection and worsening malignancy. Published 2014 Jan 31. Physical Examination: Inspect for erythema, blistering, and ulceration. BMC Cancer. 2014;14:53.

Best Practices 56

Best Practices Documentation/Coding Radiology Radiology 56

EM Curious

APRIL 29, 2015

You can view the TTE recordings for each of the 20 standard views used in a full cardiology exam and see the corresponding 3D model of the probe, ultrasound plane, heart and rib cage for that view. Listen to a great review of the top 10 trauma papers in 2014-2015 @ St. Emlyns Blog.

Head Injuries 52

Head Injuries EMS Pediatrics CPR 52

The Skeptics' Guide to EM

DECEMBER 28, 2019

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. He is also the Chief for the Section of Emergency Ultrasound and Director of the Emergency Ultrasound Fellowship. NEJM 2014 ).

Radiology 40

Radiology Radiology Ultrasounds Emergency Department 40

Pediatric Emergency Playbook

AUGUST 1, 2017

J Pediatr Surg 2014; 49:1619. Hypertrophic pyloric stenosis: tips and tricks for ultrasound diagnosis. 2014; 8(5):533-541. J Ultrasound. The non-diagnostic ultrasound in appendicitis: is a non-visualized appendix the same as a negative study? Ultrasound Evaluation for Appendicitis. Semin Pedaitr Surg.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

Keep your ultrasound handy. 2014) Emergency Care Institute, New South Wales. 2014) Tiny Tip: PRE -eclampsia. 2014) Medscape.com Sullivan, MG (2007) Time Is Critical for Success in Perimortem C-Section ACEP News. Here, then, are some links for Third Trimester Emergencies. Stafford, I. Leibowitz, A. B., & Beilin, Y.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

The Skeptics' Guide to EM

JANUARY 14, 2018

One issue that has been to use CT or ultrasound for the diagnosis. The typical acute presentation is sudden onset of pain radiating from the flank to lower abdomen accompanied by microscopic hematuria, nausea, and vomiting [2]. The issue of renal colic a number of times on the SGEM. A study from Bindman et al. A study from Bindman et al.

Emergency Department 52

Emergency Department Ultrasounds Hospitals 52

Emergency Medicine Ireland

OCTOBER 14, 2024

Similarly loculations can be very easily seen with ultrasound, better than CT it seems but again don’t necessarily correlate that well with empyema. This has been moderately well studied with MIST-2 2011 and the Picollo trial (2014) being commonly quoted trials suggesting benefit. 11, 1419–1425 (2014). – M.,

Wellness 52

Wellness Ultrasounds 52

Rural Doctors Net

JANUARY 21, 2014

So here’s today’s case, one which I’m also working though with the PRCC students attached to Kangaroo Island in 2014 in sim and theory. There is also an old SonoSite Titan ultrasound unit with linear and curvilinear transducers. Then listen to RAGE podcast #2 THE SCENARIO The setting, as always, is a small rural ED in Australia.

EKG/ECG 52

EKG/ECG Ultrasounds 52

ACEP Now

OCTOBER 30, 2023

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. These initiatives aim to equip physicians with an evidence-based approach and effective management strategies for common emergency-department scenarios.

Leadership 52

Leadership Emergency Department Ultrasounds CPR 52

Taming the SRU

SEPTEMBER 8, 2023

4, 2014, pp. 8, 2014, pp. Diagnostic accuracy of Doppler ultrasound, CT and MRI in Budd Chiari Syndrome: Systematic Review and meta-analysis.” Hepatology, vol. 2, 2013, pp. 612–621, [link] Yeoman, Andrew D., Prognosis of acute severe autoimmune hepatitis (as-AIH): The role of corticosteroids in modifying outcome.” 16, 2011, p.

Radiology 59

Radiology Radiology Ultrasounds EMS 59

Urgent Care Ultrasounds

JANUARY 17, 2019

link] Also note thoracic aorta posterior to hernia #POCUS #FOAMed pic.twitter.com/v0B2zAWXxm — VCU Ultrasound (@ultrasound_vcu) December 29, 2018 An elderly woman with chest discomfort #ACCFIT @JGrapsa @VLSorrellImages pic.twitter.com/LobfRATs01 — Edgar Argulian (@argulian) October 31, 2018 References 1. 2014; 27(5):540-6. pubmed ] 2.

Urgent Care 40

Urgent Care Ultrasounds Radiology Radiology 40

The Skeptics' Guide to EM

DECEMBER 17, 2022

After a bedside ultrasound shows fluid in the right hemithorax, you insert an intercostal drain which immediately fills with one litre of blood. Case: A 71-year-old man is brought to your emergency department (ED) by emergency medical serviced (EMS) having fallen two steps at home.

Blood Transfusions 52

Blood Transfusions Fractures EMS Emergency Department 52

PHEM Cast

DECEMBER 1, 2017

Ultrasound determination of chest wall thickness: implications for needle thoracostomy. Ultrasound in Emergency Medicine. Tension pneumothoraces not responding to needle thoracocentesis. Emergency Medicine Journal , 19 , 176–177. C., & MD, J. The American Journal of Emergency Medicine , 1–5. link] MD, B. B., & MD, J.-M.

Academics 52

Academics Radiology Radiology Resuscitation 52

The Skeptics' Guide to EM

SEPTEMBER 14, 2019

He is interested in ultrasound and international emergency medicine. million emergency department visits in the US in 2014 [1], with the most significant proportion of visits occurring in the elderly ≥75 (1,682/100,000) [1]. She is interested in social determinants of health in the emergency department and health policy.

Head Injuries 52

Head Injuries Emergency Department Seizures EMS 52

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Advances in Medical Imaging (CT, MRI, and Ultrasound) facilitating rapid, accurate, diagnosis affording new potential to save additional lives. EM makes a strong push into bedside use of ultrasound sonography. Emergency Ultrasound is one of the greatest advances in emergency care. Erratum in Mouth-to-Airway [adjunct] 4/22/2014.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

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 Emery Med J 2014; 31(3): 248-9. 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

Taming the SRU

MAY 5, 2023

2014, Hjortrup, Haase et al. It would be interesting to stratify the doses of vasopressor administration to the few potential adverse events (all of which resolved), or the location of the peripheral line, given the questions raised regarding safety and patency of ultrasound-guided IVs versus non-ultrasound guided-IVs.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Taming the SRU

AUGUST 30, 2023

Notably, lung ultrasound for the diagnosis of bacterial CAP demonstrated exceptional stand-alone diagnostic accuracy in 33 studies including 4,901 adults and children in the emergency department, with a pooled sensitivity of 92% and specificity of 90%. Epub 2014 Dec 3. Epub 2014 Oct 27. Int J Rheum Dis. 2015 Mar;18(3):352-9.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89