Emergency Medicine Journal

NOVEMBER 28, 2023

Manipulation performed under ultrasound guidance has the potential to decrease the number of reduction attempts. Methods This multicentre randomised controlled trial was undertaken between December 2018 and July 2020 in the ED of four hospitals in the Netherlands.

Fractures 40

Fractures Ultrasounds Emergency Department Operations 40

The Skeptics' Guide to EM

JULY 30, 2022

Point-of-Care Ultrasound-First for the Evaluation of Small Bowel Obstruction: National Cost Savings, Length of Stay Reduction, and Preventable Radiation Exposure. AEM July 2022 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. specificity with ultrasound [1].

Ultrasounds 52

Ultrasounds Operations Outcomes Documentation/Coding 52

Northwestern EM Blog

SEPTEMBER 16, 2024

For those new to the probe, we recommend first reviewing the basics in the incredible FOAMed Introduction to Bedside Ultrasound Book , 5 Minute Sono , and POCUS Atlas. The one absolute contraindication for ocular ultrasound is any suspicion for globe rupture, as placing any pressure on the globe can worsen extrusion of intraocular contents.

Ultrasounds 52

Ultrasounds Emergency Department Academics EMS 52

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 91

Ultrasounds Emergency Department Pediatrics Radiology 91

Taming the SRU

MAY 13, 2024

Discussion Acute appendicitis is one of the most common causes of acute abdomen that present to the Emergency Department requiring surgical intervention. [1] A clinical suspicion of stump appendicitis may be confirmed with various imaging modalities, abdominal ultrasound or CT imaging being most common. Clin Case Rep.

Ultrasounds 96

Ultrasounds Emergency Department Wellness Operations 96

ALiEM

FEBRUARY 2, 2024

Laboratory Data Ultrasound reveals a 1.7 Because of the concern for malignancy, a biopsy was performed in the emergency department after the ultrasound and CT scan confirmed there was no extension into the thorax. 2018 Sep;40(9):631-641. There is no fluctuance. No other skin lesions are present. Am J Dermatopathol.

Ultrasounds 67

Ultrasounds Academics Emergency Department 67

RebelEM

MARCH 8, 2023

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. Emergency Department Management: Emergency ophthalmology consultation. Ophthalmology, in Marx J et al (eds): Rosens Emergency Medicine: Concepts and Practice, ed 9.

Stroke 52

Stroke Emergency Department Ultrasounds Outcomes 52

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 Emergency Department Radiology 70

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 71

Ultrasounds Documentation/Coding Wellness EMS 71

RebelEM

FEBRUARY 12, 2024

There are greater than 2 million annual emergency department visits for suspected renal colic in the US, and Ct scanning is performed for more than 90% of patients who receive a diagnosis of kidney stone. ” The Journal of Urology 199.4S (2018): e683-e684. What Your Gut Says: We need a CT report to diagnose a kidney stone.

Radiology 69

Radiology Radiology Emergency Department Ultrasounds 69

The Skeptics' Guide to EM

MAY 26, 2018

[display_podcast] Date: May 16th, 2018 Reference: Beltaief K et al. 2018 Guest Skeptic: Dr. Tony Seupaul is the Chairman of the Department of Emergency Medicine, University of Arkansas. display_podcast] Date: May 16th, 2018 Reference: Beltaief K et al. J Pain Res. J Pain Res.

Emergency Department 52

Emergency Department Ultrasounds 52

ACEP Now

OCTOBER 30, 2023

A notable achievement was ESEM’s co-organization of the International Federation of Emergency Medicine Trauma Update Symposium in 2015. 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

The Skeptics' Guide to EM

SEPTEMBER 22, 2018

[display_podcast] Date: September 17th, 2018 Reference: Meltzer, A. JAMA Internal Med, 2018. Guest Skeptics: Dr. Tony Seupaul, Professor and Chair, University of Arkansas for Medical Sciences Department of Emergency Medicine. display_podcast] Date: September 17th, 2018 Reference: Meltzer, A.

Ultrasounds 52

Ultrasounds Emergency Department 52

EMDocs

NOVEMBER 18, 2023

A point of care ultrasound of the liver reveals the following: Image 1: Ultrasound of the liver showing abnormal hepatic artery flow and resistance index 1 Question: What is the diagnosis? Emergency department visits and unanticipated readmissions after liver transplantation: A retrospective observational study.

EMS 69

EMS Ultrasounds Emergency Department Outcomes 69

Taming the SRU

FEBRUARY 5, 2024

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). 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. WHY - Why Not? REFERENCES 1.

Infectious Diseases 95

Infectious Diseases Seizures Ultrasounds Sepsis 95

The Skeptics' Guide to EM

JANUARY 14, 2018

[display_podcast] Date: January 9th, 2018 Reference: Soleimanpour H et al. Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergency department. Dr. Rachel Littlefield is a PGY2 in Emergency Medicine at the University of […] The post SGEM#202: Lidocaine for Renal Colic?

Emergency Department 52

Emergency Department Ultrasounds Hospitals 52

Urgent Care Ultrasounds

OCTOBER 24, 2018

An Anomalous Incidental – and ode to #POCUS #FOAMed Point of Care Ultrasound is based on the ability to answer binary, yes / no questions. Unfortunately ultrasound is not binary, but rather multiple shades of grey. Building a memory bank of normal and abnormal ultrasound findings is vital to help make sense of the unexpected.

Ultrasounds 52

Ultrasounds Urgent Care Emergency Department Hospitals 52

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). 2018; 28(1):40. Ultrasound quarterly.

Urgent Care 52

Urgent Care Ultrasounds Wellness Emergency Department 52

EB Medicine

SEPTEMBER 1, 2018

Jeff: Welcome back to Emplify, the podcast corollary to EB Medicine’s Emergency Medicine Practice. I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta and we’ll be taking you through the September 2018 issue of Emergency Medicine Practice - Emergency Department Management of North American Snake envenomations.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

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. Thorough history taking and detailed examination can aid in diagnosis. Dermatopathology.

Pediatrics 124

Pediatrics Documentation/Coding Emergency Department Hospitals 124

EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Resuscitation 2018. Am J Emerg Med. N Engl J Med.

Hyperthermia / Hypothermia 84

Hyperthermia / Hypothermia Resuscitation CPR EMS 84

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. 2018, Kuttab, Lykins et al. Sixty centers participated during the years 2018-2022. N Engl J Med. 2023;388(6):499-510. N Engl J Med.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

The Skeptics' Guide to EM

FEBRUARY 2, 2018

[display_podcast] Date: January 31st, 2018 Reference: Frohlich LC, et al. Guest Skeptic: Dr. Melissa Langhan is an Associate Professor of Pediatric Emergency Medicine at Yale University in New Haven, CT. display_podcast] Date: January 31st, 2018 Reference: Frohlich LC, et al. AEM Dec 2017. AEM Dec 2017. Time is testis.

Pediatrics 40

Pediatrics Ultrasounds Emergency Department Research 40

EB Medicine

AUGUST 6, 2019

But next we should talk about ultrasound. Nachi: Next up is recombinant coagulation factor Xa (brand name Andexxa), which was approved in 2018 for the FXa inhibitors. Jeff: Interestingly, though only a small retrospective study of 156 patients, one study found markedly reduced mortality, 4.9%

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

Don't Forget the Bubbles

AUGUST 28, 2023

Ultrasound can be used to identify any large pleural effusions. Five-year-old Ginny presents to the Emergency Department with a syncopal episode. doi:10.1136/archdischild-2018-315269 Hammer MM, Miskin N, Madan R, Hunsaker AR. Although CT is the gold standard imaging modality, the child may be too unstable. RadioGraphics.

Pediatrics 96

Pediatrics Research Emergency Department Wellness 96

EMDocs

MAY 11, 2024

Semin Ultrasound CT MR. 2013 Apr;34(2):131-41. Available from: [link] American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Use of Intravenous tPA for Ischemic Stroke:; Brown MD, Burton JH, Nazarian DJ, Promes SB. Ann Emerg Med. Erratum in: Ann Emerg Med. doi: 10.1053/j.sult.2013.01.004.

Stroke 89

Stroke EMS EKG/ECG Radiology 89

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.

Ultrasounds 40

Ultrasounds Emergency Department Wellness EMS 40

Taming the SRU

JULY 22, 2024

INDICATIONS Arthrocentesis is a common procedure performed in the Emergency Department, in which a needle is inserted into a joint to withdraw fluid from the joint capsule. Studies have shown that effusions of as little as 2 to 4 mL can be identified using ultrasound [6]. ANESTHETIZE THE AREA step 7. Step 1: Prepare STEP 2.

Ultrasounds 94

Ultrasounds Emergency Department EMS 94

Dr. Smith's ECG Blog

JANUARY 15, 2024

Colin is an emergency medicine resident beginning his critical care fellowship in the summer with a strong interest in the role of ECG in critical care and OMI. A patient in their 40s with type 1 diabetes mellitus and hyperlipidemia presented to the emergency department with 5 days of “flu-like” illness. Edits by Willy Frick.

EKG/ECG 67

EKG/ECG Wellness Point-of-Care Testing Shock 67

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. Sounds familiar. Jeff: We sure did!

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

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. Foot & Ankle Specialist.

Fractures 75

Fractures Dislocations Operations Radiology 75

Don't Forget the Bubbles

FEBRUARY 5, 2024

The study surveyed 2855 Canadian adolescents in 2018 and found that those who skipped breakfast were 2.55 Assessing fluid responsiveness with ultrasound in the neonatal intensive care setting: the mini-fluid challenge. times more likely to report higher psychosomatic symptoms(AOR = 2.55; 95% CI = 1.75-3.82). Brooks L, et al.

Pediatrics 52

Pediatrics Research Resuscitation Outcomes 52

Greater Sydney Area HEMS

FEBRUARY 20, 2024

The evidence for improved safety and quality with the use of ultrasound for CVC implementation is well established [i]. In fact, it’s use is so ubiquitous that the newer generation of emergency physicians are largely inexperienced in the insertion of central lines as a blind technique. One approach to obtaining BCV origin access (fig.1)

Ultrasounds 98

Ultrasounds Shock Research Emergency Department 98

EMDocs

JULY 17, 2023

3 Point of care ultrasound (POCUS) can be highly sensitive for free fluid and pneumoperitoneum when used by a trained physician in the appropriate patient population. 2017 WSES guidelines on colon and rectal cancer emergencies: obstruction and perforation. World J Emerg Surg. Published 2018 Aug 13. Published 2021 Apr 22.

Operations 77

Operations EMS Fluid Resuscitation Resuscitation 77

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

EB Medicine

NOVEMBER 1, 2018

But this month’s episode is special in its own way - we’ll be tackling Electrical Injuries in the emergency department - from low and high voltage injuries to the more extreme and rare lightning related injuries. In total, they pulled references from 1966 until 2018. Jeff: Let’s move on to evaluation in the emergency department.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

Dr. Smith's ECG Blog

MAY 19, 2020

She was unable to be defibrillated but was cannulated and placed on ECMO in our Emergency Department (ECLS - extracorporeal life support). The ways to tell for certain include intravascular ultrasound (to look for extra-luminal plaque with rupture) or "optical coherence tomography," something I am entirely unfamiliar with.

CPR 52

CPR EKG/ECG Shock Ultrasounds 52