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

EMDocs

DECEMBER 4, 2023

Johnson, MD ( Community EM, Salina Regional Health Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra, MD (Cleveland Clinic Foundation, EM-CCM); Brit Long, MD (@long_brit) Case A 40-year-old woman presents to a rural emergency department (ED) with left leg pain and swelling for the past 5 days.

Ultrasounds 96

Ultrasounds Documentation/Coding Wellness EMS 96

RebelEM

APRIL 29, 2024

In these situations, the American Heart Association (AHA) and the European Resuscitation Council (ERC) of 2015 recommend the intraosseous (IO) route after the peripheral route and before the central venous route ( 1). 2015 PMID: 25768683 8 Leidel BA. This can often lead to significant delays in proper resuscitation. minutes CVC group.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

RebelEM

JANUARY 24, 2024

Partial rupture of the proximal Achilles tendon: a differential diagnostic problem in ultrasound imaging. 2015; 3(4): PMID: 26665055 Post Peer Reviewed By: Salim R. Rezaie, MD (Twitter/X: @srrezaie ) The post REBEL Core Cast 116.0 – Achilles Tendon Rupture appeared first on REBEL EM - Emergency Medicine Blog. Sports Med.

Operations 101

Operations Ultrasounds Fractures Outcomes 101

EM Curious

AUGUST 19, 2015

The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest. A must listen here at EM Crit.

Airway Management 52

Airway Management Ultrasounds EMS Emergency Department 52

EM Curious

JULY 22, 2015

The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest. Find out here at Ultrasound Of The Week.

Infectious Diseases 52

Infectious Diseases EMS Ultrasounds Emergency Department 52

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

PHEM Cast

APRIL 16, 2018

It might be better to consider traumatic cardiac arrest as a completely different disease eg LOST: Low Output State due to Trauma The 2015 European Resuscitation Council and UK Resuscitation Council Algorithms for Traumatic Cardiac Arrest: To read the whole ERC guideline on special circumstances cardiac arrest including trauma, click here.

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 52

Taming the SRU

JUNE 24, 2024

MedEdPORTAL Publications; 2015. Circulation , vol. 1103–1104, [link] Cousar J, Bohanske M, Hill J. Transvenous Cardiac Pacemaker Educational Resource. Available from: [link] Siamak Moayedi, Priya Patel, Nicholas Brady, Michael Witting, Timm-Michael L.

Advances Cardiac Life Support (ACLS) 90

Advances Cardiac Life Support (ACLS) CPR Burns Resuscitation 90

EM Curious

JULY 29, 2015

The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest. Read the post from EM Nerd here.

Sepsis 52

Sepsis EMS Emergency Department Ultrasounds 52

ALiEM

MAY 19, 2023

Esophageal Balloon Tamponade Devices – Linton-Nachlas, Sengstaken-Blakemore, Minnesota Tubes (image courtesy of Dr. Mark Ramzy at REBEL EM) What are esophageal balloon tamponade devices? Additional trick: If the x-ray is delayed, you can pre-check with ultrasound [7]. Published July 13, 2015. Deranged Physiology.

Emergency Department 98

Emergency Department Ultrasounds Wellness EMS 98

EM Curious

JULY 1, 2015

The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest. Should we all be jumping on board?

EMS 52

EMS Ultrasounds EKG/ECG Fractures 52

ALiEM

OCTOBER 30, 2024

Case A patient arrives via EMS from the bus station complaining of fever, vomiting, and back pain. Clinical impact: The patient’s DVT ultrasounds were negative. Our experience: It was not long ago that we instructed our staff that: ‘COWS >8, give ’em 8 (mg of buprenorphine).’ 2015 Apr 28;313(16):1636-44.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. The TOMAHAWK Investigators.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

Dr. Smith's ECG Blog

DECEMBER 19, 2023

EMS obtained the following vital signs: pulse 50, respiratory rate 16, blood pressure 96/49. It appears EMS obtained two EKGs, but unfortunately these were not saved in the medical record. The EMS crew was only BLS certified, so EKG interpretation is not within their scope of practice. Fortunately, that is exactly what happened.

EKG/ECG 127

EKG/ECG EMS Wellness Operations 127

RebelEM

MARCH 8, 2023

Bagheri 2015 ). Signs Shafer’s sign (tobacco dust) May see a Weiss ring when the posterior vitreous (PV) detaches from the optic disc margin Visualization with ultrasound. 790-819 Core Ultrasound: Vitreous vs Retinal Detachmen t Post Created By: Anand Swaminathan MD, MPH Post Peer Reviewed By: Salim R.

Stroke 52

Stroke Emergency Department Ultrasounds Outcomes 52

PHEM Cast

DECEMBER 1, 2017

For example, here are the locations identified as ‘2nd ICS mid clavicular line’ amongst 25 EM physicians in a 2005 EMJ paper. Ultrasound determination of chest wall thickness: implications for needle thoracostomy. Ultrasound in Emergency Medicine. Note – again please do not use this location! C., & MD, J.

Academics 52

Academics Radiology Radiology Resuscitation 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. Smith comment: This patient did not have a bedside ultrasound. En route, EMS administered aspirin 325mg by mouth, but withheld nitroglycerin due to initial hypotension.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

EB Medicine

JULY 8, 2019

Jeff: And while it’s not exactly core EM, we’re going to briefly discuss indications for bariatric surgery, as this is something we don’t often review even in academic training programs. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in. Jeff: Next up is ultrasound.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Pediatric EM Morsels

AUGUST 4, 2023

Record, 2015) Normal aortomesenteric angle ranges from 28 o to 65 o and the normal distance from 10 to 34 mm. Record, 2015) Nausea and pain are typically post-prandial. Record, 2015). Record, 2015) Secondary findings on imaging including gastric distension and distension of the proximal duodenum. The Oschner Journal.

Pediatrics 246

Pediatrics Burns Operations Ultrasounds 246

Pediatric EM Morsels

JUNE 30, 2023

link] PMID: 36553274 The post Congenital Pulmonary Airway Malformation (CPAM) appeared first on Pediatric EM Morsels. I know we already know this, but it especially true when you are talking about trying to obtain images on a wiggling fetus somewhere around the size of a banana. Dec: 9 (12): 1830.

Ultrasounds 284

Ultrasounds Pediatrics Operations EMS 284

EMDocs

JULY 15, 2023

We’ll keep it short, while you keep that EM brain sharp. 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. 2015, July 31). What is the most likely diagnosis?

EMS 92

EMS Infectious Diseases Shock Ultrasounds 92

EB Medicine

AUGUST 6, 2019

Jeff: Edoxaban is up next, approved by the FDA in 2015 for similar indications as the other Factor Xa inhibitors. Interestingly, one retrospective study found limited agreement between EMS records and hospital documentation on current DOAC usage. But next we should talk about ultrasound.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

EM Curious

APRIL 29, 2015

The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest. Listen here @ EM Crit. Emlyns Blog.

Head Injuries 52

Head Injuries EMS Pediatrics CPR 52

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

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. EMS have already splinted an obvious mid-shaft femoral fracture, but he continues to be tachycardic and hypotensive.

Blood Transfusions 52

Blood Transfusions Fractures EMS Emergency Department 52

EMDocs

OCTOBER 23, 2023

Author: Kristine Jeffers, MD ( EM Physician , San Antonio Uniformed Services Health Education Consortium) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Half of all embolisms occur within the first 24 hours and 75% will present by postoperative day 3. 2020 Sep;127(10):1269-1279.

OB/GYN 93

OB/GYN Operations EMS Ultrasounds 93

PHEM Cast

DECEMBER 1, 2017

If you want to know about ultrasound findings of pneumothorax, check out this great R.E.B.E.L. 2015; 261: 1068-78. And you can see what a CT scan of a patient with tension pneumothorax looks like in this vimeo shared on the Life in the Fast Lane website. References: Leigh-Smith S, Harris T. Tension pneumothorax—time for a re-think?

Ultrasounds 52

Ultrasounds EMS 52

Dr. Smith's ECG Blog

JUNE 2, 2023

My bedside ultrasound was of insufficient quality, but showed somewhat reduced overall EF, distended IVC without respiratory variation, no pericardial effusion, and diffuse bilateral B lines. == What do you think of her ECG?

EKG/ECG 95

EKG/ECG Wellness Ultrasounds EMS 95

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Advocacy for Trauma Care and EMS Development. Development of EM Residencies. Advances in Medical Imaging (CT, MRI, and Ultrasound) facilitating rapid, accurate, diagnosis affording new potential to save additional lives. Organized EM supporting Rapid Sequence Intubation and other airway advances. EDNA->ENA.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

EB Medicine

NOVEMBER 1, 2018

Thankfully, fatalities are declining, with just 565 in 2015. Jeff: With your initial stabilization underway, you can begin to gather a more thorough history either from bystanders or EMS if they are still present. Jeff: Real quick – in case you missed it – ultrasound sneaks in again. Let’s move on to treatment.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

EB Medicine

JUNE 6, 2019

CT is good but you really should learn ultrasound, and lastly, sick patients need prompt consultation and resuscitation, not rapid trips to radiology. Nachi: Diagnosis of appendicitis, in a pregnant patient, ultrasound vs. mri. Jeff: Next we have everybody’s favorite, the ultrasound. Jeff: Indeed. Sounds familiar.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

EB Medicine

MARCH 1, 2019

Nachi: And if the prehospital team is lucky enough, or maybe unlucky enough, i don’t know, to have a credentialed provider who can perform ultrasound for those suspected of having a blunt cardiac injury, the general prehospital data on ultrasound is sparse. Jeff: Great, let’s move onto ED care, beginning with the H&P.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

EB Medicine

AUGUST 1, 2018

Nachi: Sometimes… Jeff: This month’s issue was authored by Mollie Williams, who is the EM residency program director at the Brooklyn Hospital Center. Acute effects of synthetic cannabinoids: update 2015. Cannabinoids for medical use: a systematic review and meta-analysis. 2015;313(24):2456-2473. Retrospective chart review; 4 cases) 64.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EB Medicine

SEPTEMBER 1, 2018

As some background, from 2006-2015 there were almost 66,000 reported snake exposures and 31 deaths from snake envenomation in the US. If EMS has placed bandages, leave them in place until antivenom and resuscitative equipment is ready. Jeff: What a team! But, let’s get back to the snakes. Jeff: What a team!

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

EB Medicine

JANUARY 2, 2019

I know this is a HOTLY debated topic among EM Docs. 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. Nachi: Definitely concerning, but this is all the more reason you need to employ our favorite imaging modality… the ultrasound.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

Dr. Smith's ECG Blog

APRIL 8, 2015

Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade. Good History and Physical exam, including a. Quinn et al.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52