Taming the SRU

OCTOBER 23, 2023

A bedside ultrasound is completed to assess the location of the pregnancy. A radiology performed ultrasound is ordered and has similar findings– Impression: no definitive IUP with a small amount of free fluid within physiologic limits. Laboratory evaluation reveals a hemoglobin and hematocrit of 12.6/37.1

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

Taming the SRU

JULY 24, 2023

A bedside right upper quadrant ultrasound was performed, and the images are below. The presence of gallstones outside of the gallbladder wall, striated appearance of the gallbladder wall, and adjacent fluid collections, abscesses or fistulas are other findings that could be seen on ultrasound (5, 8). 2015 Oct;16(5):509-12.

Ultrasounds 79

Ultrasounds Sepsis Radiology Radiology 79

ALiEM

MAY 13, 2024

Take the ALiEMU PEM POCUS: Soft Tissue Quiz Case Goals List the indications of performing a pediatric soft tissue point-of-care ultrasound (POCUS). Pediatric Soft Tissue POCUS Ultrasound Technique Figure 1. Linear ultrasound transducer Probe Use a linear, high-frequency transducer. Describe the limitations of soft tissue POCUS.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

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

PHEM Cast

JULY 27, 2021

Some useful videos: Hopefully you found the podcast interesting, but since this is quite a visual topic we have put together some videos to demonstrate some of the pathologies discussed and what they look like on ultrasound: How does ultrasound work? Want to know how to use ultrasound? 2015 Marik PE, Cavallazzi R.

Ultrasounds 52

Ultrasounds Fractures Resuscitation EMS 52

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

PulmCCM

SEPTEMBER 4, 2024

Kenny MD [ @heart_lung ] Since its first description [1], the Venous Excess Ultrasound Score [VExUS] has received much research attention. Subsequently in the late 1970s, Sivaciyan and Ranganathan [9] confirmed these findings with Doppler ultrasound of the IJV. The ultrasound journal 12: 1-12 2. Jon-Emile S. Echocardiography 7.

Ultrasounds 84

Ultrasounds Operations Research Outcomes 84

Downeast Emergency Medicine

FEBRUARY 14, 2023

Credits: Andrew fried, md A point-of-care lung ultrasound is performed, with the following findings on the left lung fields. Point of Care Ultrasound of the Left Lung Fields. Point of Care Ultrasound of the Left Lung Fields. One study from 2012 found lung ultrasound to be 93% sensitive for pneumonia [4]. Emerg Med J.

Ultrasounds 52

Ultrasounds Emergency Department Pediatrics 52

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

Don't Forget the Bubbles

JANUARY 17, 2024

2015 But we all know that what happens in the lab does not always mirror what happens in real life. Abdominal ultrasound, used in 34 cases, was able to visualize a rounded intraluminal image corresponding to a bead in 28 patients. A case of ingested water beads diagnosed with point-of-care ultrasound. ” ( Ed. Darracq, M.A.,

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

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. Total Achilles tendon rupture. Sports Med. 1998; 25(2): 79-100. PMID: 9519398 Kayser R et al. Br J Sports Med. 2005; 39(11): 838-42. PMID: 16244194 Margetic P et al.

Operations 101

Operations Ultrasounds Fractures Outcomes 101

EMDocs

DECEMBER 4, 2023

The facility does not have ultrasound (US) availability at the time of the patient’s presentation, as the sonographer comes to the hospital only 2 days a week. First, examine the patient and risk-stratify them for the diagnosis of DVT before deciding on the clinical utility of an ultrasound. Thrombosis J 13, 18 (2015).

Ultrasounds 97

Ultrasounds Documentation/Coding Wellness EMS 97

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 92

Emergency Department Ultrasounds Administration Burns 92

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

Mind The Bleep

AUGUST 18, 2024

Ultrasound scans are the gold standard to look at the gland itself and show any dilation in the ducts. Imaging A plain x-ray film can be used to locate possible salivary stones. However, it is important to remember that some may be radiolucent and not show up in traditional films. References Payne, K.F., Goodson, A.M., Tahim, A.S.,

Emergency Department 90

Emergency Department Ultrasounds 90

Broome Docs

MARCH 28, 2024

If you want to see Justin in the video format and his new Youtube series then click here: [link] If you would like to check out my current ultrasound training project then click here: WACHS Ultrasound Otherwise – enjoy the show and see you in a few weeks.

PPE 96

PPE Ultrasounds Resuscitation Emergency Department 96

EMDocs

MAY 11, 2024

Semin Ultrasound CT MR. 2013 Apr;34(2):131-41. 2015 Sep;66(3):322-333.e31. Nov 10 th , 2015. Reference article, Radiopaedia.org (Accessed on 28 Aug 2023) [link] Ortiz de Mendivil A, Alcalá-Galiano A, et al. Brainstem stroke: anatomy, clinical and radiological findings. doi: 10.1053/j.sult.2013.01.004. 2013.01.004. Ann Emerg Med.

Stroke 111

Stroke EMS EKG/ECG Radiology 111

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

Taming the SRU

FEBRUARY 5, 2024

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. This resource offers additional information on ultrasound assisted LP’s. WHY - Why Not? REFERENCES 1. Zambito Marsala, S., Gioulis, M., & Pistacchi, M.

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97

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

Resus Review

SEPTEMBER 29, 2015

Ultrasound can also be used once the patient is positioned. Acad Emerg Med 2015 Aug;22(8):908. Anesthesiol Clin 2015 Jun;33(2):357. Prep the neck with Betadine or chlorhexidine. Insert the dilator in the tracheostomy tube. Locate the cricothyroid membrane by direct palpation, four finger widths, or neck crease 2.

Airway Management 52

Airway Management Ultrasounds 52

Don't Forget the Bubbles

NOVEMBER 20, 2023

These may require surgical drainage following confirmation on ultrasound scan. Difficulty swallowing, stridor or altered voice should prompt urgent ENT assessment. Simple lymphadenitis can progress into fluctuant masses, suggesting abscess formation. Local guidelines should be consulted around antibiotic choice. Physician Assistant Clinics.

Pediatrics 124

Pediatrics Documentation/Coding Emergency Department Ultrasounds 124

ALiEM

MAY 19, 2023

Additional trick: If the x-ray is delayed, you can pre-check with ultrasound [7]. Published July 13, 2015. PulmCrit Wee: Ultrasound-guided blakemore tube placement. Then fill the gastric balloon with 50 cc of air. Verify the placement of the gastric balloon with a chest x-ray. Deranged Physiology. Accessed April 6, 2023.

Emergency Department 98

Emergency Department Ultrasounds Wellness EMS 98

EM Curious

AUGUST 19, 2015

Anesthesiology World RIGHT HEART ULTRASOUND PEARLS [PODCAST]: The guys from Ultrasound Podcast sit down with Haney Mallemat to discuss key questions in right heart ultrasound. Make sure to also listen to Part 1 of this series here.

Airway Management 52

Airway Management Ultrasounds EMS Emergency Department 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 22, 2015

ULTRASOUND CASE OF THE WEEK [BLOG]: A 38 year old male presents from jail with the pathology seen below. Find out here at Ultrasound Of The Week. Excellent teaching videos from George Kovacs. Check you his Youtube page for more content. Which nerve block will facilitate drainage?

Infectious Diseases 52

Infectious Diseases EMS Ultrasounds Emergency Department 52

Taming the SRU

AUGUST 30, 2023

A 2015 prospective, cross-sectional study of 78 Thai patients published in the International Journal of Rheumatic Disease demonstrated a sensitivity of 59% and specificity of 84% for PCT with a cut-off of 0.5 Instead, they strongly advocated for the use of lung ultrasound to diagnose bacterial CAP [45].

Infectious Diseases 89

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

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

Cook County EM Blog

APRIL 22, 2022

Point of Care Ultrasound is shown below: Clip 1. Right upper quadrant ultrasound. Q1: What abnormal finding is visible in the thorax on this lung ultrasound? Notably, lung ultrasound is limited in the ability to distinguish between types of pleural effusions (i.e. J Ultrasound Med. 2015 Sep;34(9):1555-61.

Ultrasounds 40

Ultrasounds COPD Emergency Department 40

Urgent Care Ultrasounds

JULY 17, 2019

Left PLAPS point Despite the obvious consolidation on ultrasound the CXR is clear. In all three there was clear ultrasound evidence of pneumonia. However I am becoming increasingly convinced that an answer to this question is the use of point of care lung ultrasound (LUS). Ultrasound quarterly. 2015; 10(6):e0130066.

Urgent Care 52

Urgent Care Ultrasounds Wellness Emergency Department 52

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

Broome Docs

JANUARY 30, 2023

Covered or uncovered: A randomized control trial of Tegaderm versus no Tegaderm for ocular ultrasound. 2015 Apr;72(4):668-73. Epub 2015 Jan 23. 2015 Dec;21(6):1244-6. Epub 2015 Dec 29. PMID: 29211671 Marks A, Patel D, Chottiner M, Kayarian F, Peksa GD, Gottlieb M. Am J Emerg Med. 2022 Nov;61:87-89. 2022.08.044.

Emergency Department 52

Emergency Department Outcomes Ultrasounds Pediatrics 52

EM Curious

JULY 1, 2015

ULTRASOUND IN CHEST PAIN: [BLOG]: It is never a bad idea to throw an ultrasound probe on your patient with chest pain. ER Cast Part 1 Part 2 SMACC-stalgia SMACC CHICAGO 2015 PEARLS [PODCAST]: Missed SMACC Chicago and want to hear what all the buzz was about? Should we all be jumping on board?

EMS 52

EMS Ultrasounds EKG/ECG Fractures 52

EM Curious

JULY 29, 2015

NO RESPECT FOR THE RIGHT VENTRICLE [PODCAST]: The boys from Ultrasound Podcast sit down with critical care guru, Dr. Haney Mallemat, to discuss the assessment of the right ventricle with ultrasound. S-E-P-S-I-S A SEPSIS SMACC-BACK [PODCAST]: If you were at SMACC 2015 you may have been confused after the sepsis expert panel discussion.

Sepsis 52

Sepsis EMS Emergency Department Ultrasounds 52

Pediatric Emergency Playbook

AUGUST 1, 2017

Hypertrophic pyloric stenosis: tips and tricks for ultrasound diagnosis. J Ultrasound. 2015; 18 Gilmore AW et al. The non-diagnostic ultrasound in appendicitis: is a non-visualized appendix the same as a negative study? 2015 Jun;50(6):923-7 Herliczek TW et al. Ultrasound Evaluation for Appendicitis.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

ALiEM

OCTOBER 30, 2024

Clinical impact: The patient’s DVT ultrasounds were negative. 2015 Apr 28;313(16):1636-44. Evaluation for nephrotic syndrome due to viral hepatitis, endocarditis, venous thromboembolism or other cause of chronic lymphedema is reasonable. PMID 28194688 D’Onofrio G, O’Connor PG, Pantalon MV, et al.

Emergency Department 64

Emergency Department Operations Psychiatric EMS 64

EMDocs

JULY 13, 2024

2015 Feb 2;2015(2):CD001067. Merck Manuals Professional Edition , Merck Manuals, 29 Jan. 2024, [link] Mackeen AD, Packard RE, Ota E, Speer L. Antibiotic regimens for postpartum endometritis. Cochrane Database Syst Rev. doi: 10.1002/14651858.CD001067.pub3. PMID: 25922861; PMCID: PMC7050613.

OB/GYN 91

OB/GYN EMS Sepsis Fluid Resuscitation 91