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 125

Ultrasounds Outcomes COPD Hospitals 125

Greater Sydney Area HEMS

FEBRUARY 20, 2024

The cohort of patients that require this intervention in the pre-hospital setting are likely to be the most critically unwell patients we encounter. The evidence for improved safety and quality with the use of ultrasound for CVC implementation is well established [i]. One approach to obtaining BCV origin access (fig.1)

Ultrasounds 98

Ultrasounds Shock Research Operations 98

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 Documentation/Coding Outcomes 52

The Trauma Pro

OCTOBER 25, 2024

To sum up, both are equally effective in controlling hemorrhage, but the hospital costs for patients undergoing angioembolization are significantly less. The primary outcome was the development of VTE during the hospitalization. DVT was detected using duplex ultrasound, and PE was detected by CT angiography.

Fractures 113

Fractures Head Injuries Operations Ultrasounds 113

Taming the SRU

MAY 13, 2024

Acute stump appendicitis without evidence of perforation or abscess (Figure 1) HOSPITAL Course Acute Care Surgery was consulted from the ED and recommended admission for operative resection of a 3 cm remnant of the appendix. The patient was discharged on hospital day 5. World J Emerg Surg 13, 22 (2018). Clin Case Rep.

Ultrasounds 98

Ultrasounds Emergency Department Wellness Operations 98

EMDocs

MARCH 4, 2024

12 Ultrasound and computed tomography (CT) can both identify CBD and are available in most emergency departments. Ultrasound is cost-effective and radiation-sparing. Ultrasound has approximately 90% sensitivity for detecting common bile duct dilation. 13 CT is also superior to ultrasound in its ability to detect malignancy.

Emergency Department 104

Emergency Department Ultrasounds EMS Radiology 104

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 133

Stroke Outcomes Hospitals Administration 133

EMDocs

FEBRUARY 12, 2025

The patient also reported significant pain and had a Hospital Anxiety and Depression Scale (HADS) score indicating severe anxiety and depression. She had previously undergone carbon ion radiotherapy, receiving a cumulative dose of 75 GyE in 20 fractions over two courses from December 2020 to January 2021. a: Fluoroscopy dose management.

Best Practices 55

Best Practices Documentation/Coding Radiology Radiology 55

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. Ultrasound. 2011;31(1):1-5.

Ultrasounds 92

Ultrasounds Documentation/Coding Wellness EMS 92

Mount Sinai EM

OCTOBER 11, 2024

2018 , compared a random sampling of patients from 12 Southern California Kaiser centers which adopted a PTA algorithm of medical management and ENT follow up the next day, with subsequent I+D if needed vs patients from seven centers in the same system that opted for initial surgical drainage. in the medical cohort and 6.2%

Ultrasounds 100

Ultrasounds Wellness Outcomes Hospitals 100

The Skeptics' Guide to EM

MARCH 15, 2019

Ann Emerg Med 2018. Guest Skeptic: Chip Lange is an Emergency Medicine Physician Assistant (PA) working primarily in rural Missouri in community hospitals. Ann Emerg Med 2018. Guest Skeptic: Chip Lange is an Emergency Medicine Physician Assistant (PA) working primarily in rural Missouri in community hospitals.

Ultrasounds 52

Ultrasounds Fractures EMS Hospitals 52

Don't Forget the Bubbles

NOVEMBER 20, 2023

These may require surgical drainage following confirmation on ultrasound scan. Royal Children’s Hospital. Royal Children’s Hospital, Melbourne. Difficulty swallowing, stridor or altered voice should prompt urgent ENT assessment. Simple lymphadenitis can progress into fluctuant masses, suggesting abscess formation.

Pediatrics 124

Pediatrics Documentation/Coding Emergency Department Ultrasounds 124

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

The Skeptics' Guide to EM

SEPTEMBER 29, 2018

[display_podcast] Date: September 21st, 2018 Reference: Kawano et al. Intraosseous Vascular Access Is Associated With Lower Survival and Neurologic Recovery Among Patients With Out-of-Hospital Cardiac Arrest. display_podcast] Date: September 21st, 2018 Reference: Kawano et al. BLS for out-of-hospital cardiac arrest (OHCA).

Basic Life Support 52

Basic Life Support Airway Management CPR Resuscitation 52

EMDocs

JANUARY 16, 2024

He subsequently walks out of the hospital with a normal neurologic exam two weeks after admission. VF/asystole), a pulse cannot be identified via Doppler ultrasound for a full minute, or if lack of organized cardiac activity is confirmed on bedside echocardiogram. Resuscitation 2018. doi.org/10.1016/j.resuscitation.2018.11.004

Hyperthermia / Hypothermia 106

Hyperthermia / Hypothermia Resuscitation CPR EMS 106

PulmCCM

JUNE 26, 2023

Antipsychotics have been overused in hospitalized patients, in and out of ICUs. After the 2018 MIND-USA trial found neither haloperidol nor ziprasidone reduced delirium in the ICU, critical care guidelines advised against their wide use. But about 90% of the MIND-USA patients had hypoactive delirium, without agitation.

Outcomes 98

Outcomes Ultrasounds Hospitals Wellness 98

Urgent Care Ultrasounds

APRIL 17, 2019

Suspecting pneumonia, an ultrasound examination began over the site of the crackles at the left posterio-lateral chest. However the presence of fluid within the pleural and adjoining pericardial spaces has reduced the acoustic impedance mismatch allowing the unimpeded transmission of the ultrasound waves. What pathology can you see?

Ultrasounds 52

Ultrasounds Urgent Care Hospitals Wellness 52

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

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. 2018) Epidemiology of lumbar punctures in hospitalized patients in the United States.

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97

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

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? Published 2018 Mar 6. Vital signs: HR 118, BP 103/68, RR 20, T 99.8. LFTs are in the thousands. Pediatr Radiol. 2021;51(2):248-256.

EMS 91

EMS Ultrasounds Emergency Department Outcomes 91

The Skeptics' Guide to EM

JANUARY 14, 2018

[display_podcast] Date: January 9th, 2018 Reference: Soleimanpour H et al. display_podcast] Date: January 9th, 2018 Reference: Soleimanpour H et al. One issue that has been to use CT or ultrasound for the diagnosis. first appeared on The Skeptics Guide to Emergency Medicine. A study from Bindman et al.

Emergency Department 52

Emergency Department Ultrasounds Hospitals 52

Don't Forget the Bubbles

DECEMBER 25, 2023

In the BUCKLED trial that looked at whether ultrasound was non-inferior to X-ray in diagnosing forearm fractures, the primary outcome was physical function of the affected arm at four weeks. doi:10.1136/bmjebm-2018-110891 Perkins GD, Ji C, Deakin CD, et al. A randomized trial of epinephrine in out-of-hospital cardiac arrest.

Research 83

Research Outcomes Fractures Pediatrics 83

Taming the SRU

JANUARY 10, 2024

Additionally, ED boarding is a now a larger factor than in 2018. There are 38 states where it currently is a felony of some level to assault a healthcare worker BUT there is currently no federal law that protects hospital employees from assault or intimidation. Current bills in progress: US H.R.2663 2663 & S.1176 2584 & S.2768

EKG/ECG 93

EKG/ECG Shock Fractures Emergency Department 93

The Skeptics' Guide to EM

MAY 11, 2019

JAMA Surgery 2018 Guest Skeptic: Dr. Robert Leeper is an assistant professor of surgery at Western University and the London Health Sciences Centre. His practice is in trauma, emergency general surgery, and critical care with an academic interest in ultrasound and medical simulation. Reference: Sceats et al.

Documentation/Coding 40

Documentation/Coding Operations Academics Ultrasounds 40

ACEP Now

JUNE 21, 2023

14 On the contrary, hospitals may operationally and financially benefit from longer training lengths thus indirectly influencing curricula decisions. ultrasound and resuscitation procedures) may become a new standard for programs and require a longer training period. Ann Emerg Med. Jul 2022;80(1):74-83.e8. Ann Emerg Med. J Emerg Med.

EMS 114

EMS Academics Telemedicine Operations 114

Urgent Care Ultrasounds

SEPTEMBER 14, 2020

Next stop – ultrasound… Right anterior chest – multiple B lines Left anterior chest – again multiple B lines Normal LV systolic function Disposition The ultrasound findings of bilateral B lines (B profile) with normal LV systolic function supported the presumtive diagnosis of swimming induced pulmonary oedema.

Urgent Care 40

Urgent Care Ultrasounds Hospitals 40

ACEP Now

MAY 9, 2024

1,2 You’ll also find the story of Sheila Powell, a woman who suffered a pneumothorax during her 2018 Miami BBL and whose 16-year-old daughter worried that in “just a blink of the eye, I could have lost my mom.” 6 Theoretically, ultrasound guidance should decrease this risk, which formed the basis for the 2022 Florida Medical Board regulation.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

Urgent Care Ultrasounds

JANUARY 17, 2019

The patient was referred to hospital to further investigate the cause of her collapse, in light of the uncertain aetiology of the echo findings. Cardiovascular ultrasound. Disposition A mass can be seen in the posterior mediastinum, immediately behind the the left atrium and anterior to the descending thoracic aorta. pubmed ] 3.Koskinas

Urgent Care 40

Urgent Care Ultrasounds Radiology Radiology 40

Don't Forget the Bubbles

AUGUST 28, 2023

Ultrasound can be used to identify any large pleural effusions. One such case series analysis looked at 29 consecutive children presenting to the Women’s and Children’s Hospital in Singapore. doi:10.1136/archdischild-2018-315269 Hammer MM, Miskin N, Madan R, Hunsaker AR. RadioGraphics. 2017;37(2):413-436.doi:10.1148/rg.2017160095

Pediatrics 97

Pediatrics Research Emergency Department Ultrasounds 97

The Skeptics' Guide to EM

MARCH 4, 2018

[display_podcast] Date: February 27th, 2018 Reference: Moran et al. Guest Skeptic: Chip Lange is an Emergency Medicine Physician Assistant (PA) working primarily in rural Missouri in community hospitals. display_podcast] Date: February 27th, 2018 Reference: Moran et al. JAMA May 2017. JAMA May 2017.

Infectious Diseases 40

Infectious Diseases Documentation/Coding Outcomes Ultrasounds 40

PulmCCM

APRIL 1, 2024

That could (and should) change if improved functional outcomes, persisting for months after hospital discharge, are ever confirmed in large, well-conducted trials. ” But less than half of the included studies used ultrasound guidance during central line placements.

Ultrasounds 40

Ultrasounds Operations Outcomes Research 40

PEMBlog

SEPTEMBER 24, 2024

With improved access to prenatal care and ultrasounds, CLMs are commonly detected prenatally. Pulmonology and surgery were consulted during his hospital stay, and he has since had a left lower lobectomy after healing from his pneumonia. 2018 Jul;48(3):247-250. Epub 2018 Apr 6. Singh J, Dalal P, Rattan KN. 2017 Jan;5(1).

Pediatrics 52

Pediatrics Ultrasounds Hospitals Wellness 52

Taming the SRU

AUGUST 30, 2023

In a small study involving 79 hospitalized children, PCT was found to be elevated in bacterial infections, with a decrease after appropriate antibiotic therapy, and decreased in viral infections [24]. Instead, they strongly advocated for the use of lung ultrasound to diagnose bacterial CAP [45]. 2018 Aug 1;10(8):a028456.

Infectious Diseases 89

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

Taming the SRU

MAY 5, 2023

2018, Kuttab, Lykins et al. vs 42.1%), as were days alive outside of the hospital and days without life support (Meyhoff, Hjortrup et al. Sixty centers participated during the years 2018-2022. 2019, Evans, Rhodes et al. 2021, Im, Kang et al. vs 33.2%; OR, 0.42; 95% CI 0.32-0.55; 0.55; P < 0.0001) (Malbrain, Marik et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

PulmCCM

JULY 10, 2023

A 2018 meta-analysis reviewed here suggested that prolonged infusion of antipseudomonal beta-lactams reduced mortality by 30% compared with shorter infusions, and more observational data has accumulated since that time. Mortality was about 30% in each group, and most patients had hospital-acquired sepsis.

Stroke 52

Stroke Sepsis Infectious Diseases Outcomes 52

Taming the SRU

FEBRUARY 19, 2024

Arterial lines require specialized monitoring and nursing resources which are not available in all hospital settings. 12) Axillary While axillary arterial line placement has been uncommon, in the age of facile ultrasound operators it may become a more advantageous and accessible site particularly in patients with high BMIs.

Shock 59

Shock Resuscitation Ultrasounds Research 59