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Lung Abscess in Children

Pediatric EM Morsels

Lung abscess is a rare subset of these (< 1% of admitted cases of pneumonia ( Wojsyk-Banaszak, 2018 ) Lung abscess = collection of fluid within a thick-walled localized area of necrotic lung parenchyma. Scrutinize that CXR for an Air-Fluid Level… and maybe use your Ultrasound to increase your sensitivity!! ANZ J Surg.

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emDOCs Podcast – Episode 110: Primary Spontaneous Bacterial Peritonitis

EMDocs

Paracentesis performed within 12 hours was associated with lower in-hospital mortality and shorter length of stay when compared to paracentesis performed within 12-72 hours (13% compared to 27%). Ultrasound can assist: confirm ascites, evaluate for best site, abdominal wall thickness, blood vessels along needle track. Am J Emerg Med.

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How Good is Ultrasound at Diagnosing PTA?

RebelEM

Background: The increased utility and accessibility of point-of-care ultrasound (POCUS) has allowed clinicians the freedom to rethink their diagnostic approach for many common diseases, including peritonsillar abscess (PTA). Test characteristics of ultrasound for the diagnosis of peritonsillar abscess: A systematic review and meta-analysis.

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The Ultrasound-Guided Genicular Nerve Block

ACEP Now

The innervation of the knee is complex, but much of its sensory innervation is supplied by the genicular nerves, which are easy targets for ultrasound-guided nerve blocks. Step 2 Place the ultrasound system contralateral to the affected knee so that you have a clear line of sight of the ultrasound screen when performing the block.

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Ultrasound of the Month: No Definitive Yolk Sac, No Definitive IUP!

Taming the SRU

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

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EM@3AM: Murine Typhus

EMDocs

Treatment significantly shortens the duration of illness, and early initiation of therapy can prevent severe complications and reduce the length of hospitalization. 2018 Oct-Dec;55(4):258-264. The RUSH exam: Rapid Ultrasound in SHock in the evaluation of the critically lll. pregnant patients). J Vector Borne Dis. 2009.09.010.

EMS 101
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Ultrasound of the Month: Gallbladder Perforation

Taming the SRU

A bedside right upper quadrant ultrasound was performed, and the images are below. He was transitioned to cefdinir and fluconazole for a full 7-day course of antibiotics and discharged from the hospital on day three, with instructions to follow up with general surgery for an outpatient cholecystectomy. World J Emerg Surg 13, 9 (2018).