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). This often is seen in trauma, cancer, post-operatively, and end-stage metabolic conditions with excessive colloid or protein leak.

Emergency Department 87

Emergency Department Ultrasounds Radiology Radiology 87

Don't Forget the Bubbles

MARCH 4, 2024

This study retrospectively identified 1,414 children, presenting to 15 UK EDs (2016 -2017), who had been screened for malaria. Reviewed by: Kieran McDonnell Article 4: Diagnosing Paediatric Distal Forearm Fractures with Ultrasound Snelling PJ, Jones P, Bade D, Bindra R, Davison M, Gillespie A, et al. Paediatr Int Child Health.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

Don't Forget the Bubbles

JANUARY 31, 2024

Edelman J, Taylor H, Goss A, et al Point-of-care ultrasound as a diagnostic tool in respiratory assessment in awake paediatric patients: a comparative study Archives of Disease in Childhood Published Online First: 14 December 2023 What’s it about? All of which leads to easier image acquisition. Accredited trainers are currently lacking.

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

RebelEM

AUGUST 31, 2023

CVC placement under ultrasound guidance has decreased overall complication rates and there is increased awareness of transfusion reactions, alloimmunization, acute lung injury, circulatory overload, as well as infection. Despite being common practice, the necessity of routine prophylactic transfusions is now being called into question.

Ultrasounds 58

Ultrasounds Outcomes Wellness Research 58

The Skeptics' Guide to EM

MAY 28, 2017

His blood work shows an elevated WBC count and the ultrasound is consistent with acute uncomplicated appendicitis (AUA). This is called Non Operative Treatment of Appendicitis (N.O.T.A). David Talan ( Ann Emerg Med 2016 ). Clinical Question: Is non-operative treatment (N.O.T.) We have covered N.O.T.A.

Pediatrics 40

Pediatrics Operations Emergency Department Ultrasounds 40

Dr. Smith's ECG Blog

DECEMBER 19, 2023

Two thirds of MINOCA cases are due to atherosclerotic causes One way to prove the diagnosis in this case would have been with intravascular imaging such as optical coherence tomography (OCT) or intravascular ultrasound (IVUS). Fortunately, that is exactly what happened. The patient did well afterward without any recurrence of symptoms. .

EKG/ECG 127

EKG/ECG EMS Wellness Operations 127

Advanced Medical Reviews

MAY 15, 2018

In 2016, a surgeon at Royal London hospital conducted a procedure streamed to 360-degree video and available via an online feed or a dedicated app designed for VR headsets capable of holstering compatible smartphones. Ultimately, they might be able to return to work sooner and require less extensive long-term care and WC benefits.

Telemedicine 45

Telemedicine Hospitals Operations Ultrasounds 45

EB Medicine

JULY 8, 2019

While it was < 15% in 1990, by 2016 it reached 40%. Nachi: Unfortunately this procedure is associated with a relatively high re-operation rate – one study found 20% of patients required removal or revision. Jeff: Even more shockingly, some series showed a 52% repeat operation rate. Jeff: Well that’s kind worrisome.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Taming the SRU

FEBRUARY 19, 2024

Failure rates An ambispective, observational cohort study from 2012 - 2016 found that femoral arterial lines fail significantly less often than radial arterial lines with an absolute risk reduction of line failure of 20%. Higher doses of vasopressors subsequently leads to even less correlation between central and peripheral measurements (11).

Shock 59

Shock Resuscitation Ultrasounds Research 59

Advanced Emergency Nursing from AENJ

NOVEMBER 24, 2016

While Point of Care Ultrasound has made limited entry in prehospital care, largely with physician-led services and some Advanced Paramedics; it has largely been as a proof of concept rather than everyday care. I am thankful for having a career of wonderful care at supportive institutions.

Emergency Nursing 40

Emergency Nursing Seizures CPR Wellness 40

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%. 2016 Dec;115(6):317-21. 2016 Aug 23;134(8):e113. PMID: 29094869. Brigden ML.

Infectious Diseases 89

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

Pediatric EM Morsels

JUNE 30, 2023

Prenatal and Postanatal Management of Congenital Pulmonary Airway Malformation. Neonatology. Apr 110 (2): 101-15. PMID: 27070354 Mehta AA, Viswanathan N, Vasudevan AK, Paulose, R, Abraham, M. Congential Cystic Adenomatoid Malformation: A Teritriay Care Hospital Experience. J Clin Diagn Res. Nov: 10 (11): SC01-SC04.

Ultrasounds 284

Ultrasounds Pediatrics Operations EMS 284

Pediatric EM Morsels

AUGUST 4, 2023

Oka, 2023) A systematic review linked SMA syndrome to the immediate post-operative period after surgery for scoliosis in pediatric patients, and found the mean days to onset of symptoms was 9. Reece, 2016) There is multiple cases of sudden death from undiagnosed SMA syndrome in the literature attributed to a variety of causes at autopsy.

Pediatrics 246

Pediatrics Burns Operations Ultrasounds 246

Don't Forget the Bubbles

NOVEMBER 1, 2023

This retrospective study, conducted between 2016 and 2018, looked at paediatric patients aged between 2 and 17 years presenting with severe exacerbation of asthma to a single tertiary paediatric Emergency Department in Memphis, Tennessee. Reviewed by: Leanne Lindenstruth, ENP Article 4: Can we treat appendicitis non-operatively?

Emergency Department 140

Emergency Department Hospitals Resuscitation Administration 140

Don't Forget the Bubbles

JANUARY 17, 2024

Forrester reported data from the Texas Poison Centers surrounding 110 cases of superabsorbent polymer bead ingestions between 2011 and 2016. Abdominal ultrasound, used in 34 cases, was able to visualize a rounded intraluminal image corresponding to a bead in 28 patients. They passed away a few days after a second operation.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

The Skeptics' Guide to EM

MAY 11, 2019

His practice is in trauma, emergency general surgery, and critical care with an academic interest in ultrasound and medical simulation. His practice is in trauma, emergency general surgery, and critical care with an academic interest in ultrasound and medical simulation. first appeared on The Skeptics Guide to Emergency Medicine.

Documentation/Coding 40

Documentation/Coding Operations Academics Ultrasounds 40

EMDocs

DECEMBER 18, 2023

When analyzing the receiver operating characteristic (ROC) curve of the pooled data, optimal diagnostic accuracy of MDW for sepsis prediction was seen (pooled sensitivity of 0.838 and specificity of 0.704 for Sepsis-3 criteria). 1 This is a change from the 2016 SSC guidelines which suggested against corticosteroids. West J Emerg Med.

Sepsis 91

Sepsis Fluid Resuscitation Resuscitation Shock 91

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Farrington] Rebuilding of outdated hospitals put emergency rooms on ground level with nearby X-ray service, and, ideally, sometimes closer to the Blood Bank and the Operating Rooms. Advances in Medical Imaging (CT, MRI, and Ultrasound) facilitating rapid, accurate, diagnosis affording new potential to save additional lives. Sakran, J.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

Pediatric Emergency Playbook

JUNE 1, 2017

Fontan Operation and the Single Ventricle. 2016; 203:138-140. Cardiovasculr Ultrasound. 2016; 10(6):14-15. 2016; 17:2. Summary Acute MI is a challenging presentation in children: Easily missed: uncommon and atypical Varied etiology Respect vague symptoms with a non-reassuring H&P Try to detect it: CATH IT!

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

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: For more information on HIV and its management, check out the February 2016 issue of Emergency Medicine Practice , which covered this and more in depth. Jeff: Indeed.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

EB Medicine

AUGUST 1, 2018

It was peer-reviewed by Joseph Habboushe, assistant professor at NYU and Nadia Maria Shaukat, director of the emergency and critical care ultrasound at Coney Island Hospital in Brooklyn, New York. Make sure that the patient knows not to operate vehicles or heavy machinery under the influence of drugs. Counsel them on drug abuse also.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EMDocs

NOVEMBER 4, 2024

Evaluation by ultrasound of traumatic rib fractures missed by radiography. doi:10.1136/tsaco-2016-000064 Zink KA, Mayberry JC, Peck EG, Schreiber MA. CDC Guideline for Prescribing Opioids for Chronic Pain–United States, 2016. Osteopathic Manipulative Treatment for Inhaled Rib Somatic Dysfunction. 2020;120(10):696-697.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

Pediatric Emergency Playbook

JANUARY 1, 2017

Neonatal observational scales have been validated in the intensive care and post-operative settings; ED-specific quantitative scales are lacking. CRIES ( Table 1 ) was validated for post-operative patients; to adapt its use for the ED, the most conservative approach is to substitute “preoperative baseline” with normal range for age.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EB Medicine

JANUARY 2, 2019

Jeff: Perhaps most importantly, no history or physical alone can rule in or out an ectopic pregnancy, for that you’ll need testing and imaging or operative findings. 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. Jeff: Up first is the urine pregnancy test.

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. 95% CI = 1.9

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

ACEP Now

APRIL 4, 2024

The diagnosis is confirmed with bedside ultrasound (US) or CT. Other exceptions are patient refusal, patient death or immediate transfer to the operating room. Ultrasound of the aorta is a core competency of emergency physicians, but resources such as Sonoguide are available for a refresher at acep.org/sonoguide. J Vasc Surg.

Operations 40

Operations Ultrasounds Emergency Department 40

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 105

Ultrasounds EKG/ECG Operations Emergency Department 105

Dr. Smith's ECG Blog

MARCH 17, 2025

Nevertheless, the operator performed intravascular ultrasound and saw erupted calcium nodule consistent with plaque erosion. showed that use of intravascular imaging (intravascular ultrasound [IVUS] or optical coherence tomography [OCT]) reduces all cause mortality by 25% compared to angiography guided intervention.

EKG/ECG 81

EKG/ECG Documentation/Coding Burns Research 81

EMDocs

NOVEMBER 13, 2023

in 2016, is a more succinct evaluation for LVO that has been shown to be as sensitive and more specific than the NIHSS. 26 With regards to penetrating neck injuries, particularly those in which the platysma is violated, CTA of the neck has allowed a shift away from mandatory operative exploration of Zone 2 neck wounds (those in the mid-neck).

Stroke 105

Stroke Radiology Radiology Emergency Department 105

SheMD

APRIL 23, 2023

While most of the attributed blame for these findings has focused on older age and demanding working conditions of pregnant surgeons [or one might extrapolate this to physicians in general]; the authors note that “there are reproductive hazards present in the operating room that might also be contributing.” Aghajanova et al. Aghajanova et al.

Ultrasounds 52

Ultrasounds Wellness Operations 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]. weight-bearing status, operative vs. non-operative) If necessary/helpful to ensure adequate follow-up At time of discharge: Counsel on expected course of injury, supportive care (e.g.,

Fractures 77

Fractures Dislocations Operations Radiology 77

EMDocs

SEPTEMBER 9, 2023

The value of ultrasound for detecting hand fractures: A meta-analysis. Results of primary extensor tendon repair in relation to the zone of injury and pre-operative outcome estimation. July 11, 2016. Plast Reconstr Surg. 2013;132(4):560e-566e. doi:10.1097/PRS.0b013e3182a0148c 0b013e3182a0148c Zhao W, Wang G, Chen B, et al.

EMS 103

EMS Fractures Soft Tissue Injuries Ultrasounds 103