The Skeptics' Guide to EM

FEBRUARY 16, 2019

Date: February 15th, 2019 Reference: Gottileb, Holladay and Peksa. Point-of-Care Ocular Ultrasound for the Diagnosis of Retinal Detachment: A Systematic Review and Meta-Analysis. AEM January 2019. Louis and the Emergency Medicine Point of Care Ultrasound Section Chief. AEM January 2019. to rule out a condition.

Ultrasounds 52

Ultrasounds Operations Emergency Department 52

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). Figure-4: I've labeled the first 2 ECGs shown in the November 14, 2019 post ( See text ).

EKG/ECG 127

EKG/ECG EMS Wellness Operations 127

PulmCCM

APRIL 24, 2024

Perc trachs do not require operating room time or a surgeon, and can significantly shorten ICU stays. Now, a few intensivists are going for the gut, with a new bedside ultrasound-guided Seldinger-style procedure that could displace percutaneous endoscopic gastrostomy tubes (PEGs) placed by gastroenterologists or interventional radiologists.

Ultrasounds 52

Ultrasounds Hospitals Operations Outcomes 52

RebelEM

NOVEMBER 30, 2022

History, physical examination and ultrasound are all flawed in making the diagnosis. Systematic review by Mellick demonstrates significant survival rates past 48 hours (Mellick 2019). History, physical examination and ultrasound are all flawed in making the diagnosis. 2019 Dec;35(12):821-82 References: Price DP.

Ultrasounds 52

Ultrasounds Pediatrics Operations EMS 52

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

PulmCCM

APRIL 1, 2024

Both a 2019 meta-analysis and a large 2022 trial by the ANZICS group raised concerns about increased adverse events among patients receiving intensive physical therapy in the ICU. ” But less than half of the included studies used ultrasound guidance during central line placements. Is this safe?

Ultrasounds 40

Ultrasounds Operations Outcomes Research 40

Mind The Bleep

JUNE 21, 2024

– B scan (ultrasound of the eye), for visualisation of the retina when there is a poor view (i.e This will not be an issue if oil is used, though this will require another operation to be removed and gain full visual potential. Laser/cryotherapy is applied to seal the break intra-operatively. Community Eye Health.

Operations 52

Operations Emergency Department Ultrasounds 52

Taming the SRU

AUGUST 30, 2023

The 2019 Journal of Arthroplasty practice guidelines to screen for periprosthetic joint infections recommend using ESR at 30mm/hr and CRP at 10mg/L, citing pooled sensitivities and specificities ranging from 75%-86% and 70-72.3%, respectively, for ESR and 88% and 73-74%, respectively, for CRP [32]. 2019 Feb;34(2S):S187-S195.

Infectious Diseases 89

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

ACEP Now

NOVEMBER 16, 2023

Therefore, applicant, funding, and operational factors may influence programs to offer a particular curriculum length. ultrasound and resuscitation procedures) may become a new standard for programs and require a longer training period. Published 2019. The 2019 model of the clinical practice of emergency medicine.

Academics 52

Academics EMS Telemedicine Research 52

Mind The Bleep

JANUARY 19, 2024

due to haemorrhage/ dense cataract), then a B scan (ultrasound of the eye) will be performed for better visualisation of the retina. Patients will be advised to posture in a particular position pre-operatively to reduce the risk further progression. (1) If there is a poor view to the retina (i.e Mark Allen Group.

Operations 52

Operations Ultrasounds 52

Dr. Smith's ECG Blog

DECEMBER 13, 2019

The next morning the patient went for his routine echocardiogram, where the operator noticed a dilated aortic root at 5.47 Beware a negative Bedside ultrasound. That said — I illustrate HOW this RATIO is arrived at in Figure-2 , which I have adapted from the 3/16/2019 post in Life-In-The-Fast-Lane. Pericarditis?

EKG/ECG 52

EKG/ECG Operations Ultrasounds Wellness 52

EB Medicine

JULY 8, 2019

I’m Jeff Nusbaum and I’m back with Nachi Gupta for the 30 th episode of EMplify and the first Post-Ponte Vedra Episode of 2019. Nachi: Unfortunately this procedure is associated with a relatively high re-operation rate – one study found 20% of patients required removal or revision. I hope everybody enjoyed a fantastic conference.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

This case was provided by Spencer Schwartz, an outstanding paramedic at Hennepin EMS who is on Hennepin EMS's specialized "P3" team, a team that receives extra training in advanced procedures such as RSI, thoracostomy, vasopressors, and prehospital ultrasound. Takotsubo is a sudden event, not one with crescendo angina.

EKG/ECG 52

EKG/ECG Emergency Department Ultrasounds Hospitals 52

Pediatric EM Morsels

JUNE 30, 2023

I know we already know this, but it especially true when you are talking about trying to obtain images on a wiggling fetus somewhere around the size of a banana. Fetal Congenital Cystic Adenomatoid Malformation (CCAM): Pathogenesis, Diagnosis, and Clinical Management: A Case Report. Clinical and Experimental Obstetrics & Gynecology.

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. Okamoto, 2019) In unable to tolerate PO intake next steps include nasojejunal tube feed or TPN if necessary. Ann Vasc Surg. 76: 514-535.

Pediatrics 246

Pediatrics Burns Operations Ultrasounds 246

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? Liver Transplantation: Operative Techniques and Medical Management. Vital signs: HR 118, BP 103/68, RR 20, T 99.8. Pediatr Radiol.

EMS 95

EMS Ultrasounds Emergency Department Outcomes 95

Don't Forget the Bubbles

NOVEMBER 1, 2023

The study included all patients (aged 0-17 years) admitted to Copenhagen University Hospital’s PED between 1st Jan 2019 and 1 Jan 2021. Reviewed by: Leanne Lindenstruth, ENP Article 4: Can we treat appendicitis non-operatively? No CT or ultrasound evidence of complications (including appendicolith, perforation, abscess or peritonitis).

Emergency Department 140

Emergency Department Hospitals Resuscitation Administration 140

Don't Forget the Bubbles

JANUARY 17, 2024

Abdominal ultrasound, used in 34 cases, was able to visualize a rounded intraluminal image corresponding to a bead in 28 patients. Point-of-care ultrasound may show well-demarcated, round, and hypoechoic material in the stomach and first part of the duodenum, though it can underestimate the number of beads present. Darracq, M.A.,

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

Northwestern EM Blog

MAY 16, 2022

What is your initial imaging test of choice, ultrasound (US) or non-contrast CT, and why? Would you be confident in a point-of-care-ultrasound evaluation or a formal ultrasound? Many patients in the ultrasound groups did get additional imaging, but this was not the majority. How do you proceed? In this study, 40.7%

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

EMDocs

JUNE 21, 2023

US : under studied but not routinely recommended A 2019 study evaluating use of US in cadavers found a sensitivity of 65% and specificity of 75%. Common operator errors Failing to enter joint capsule before injecting STS. Can Ultrasound Identify Traumatic Knee Arthrotomy in a Cadaveric Model? 2019 Sep;57(3):362-366.

Soft Tissue Injuries 95

Soft Tissue Injuries Fractures Dislocations Radiology 95

The Skeptics' Guide to EM

MAY 11, 2019

Date: May 6th, 2019 Reference: Sceats et al. 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.

Documentation/Coding 40

Documentation/Coding Operations Academics Ultrasounds 40

ACEP Now

SEPTEMBER 3, 2024

Hahnemann University Hospital in Philadelphia closed in 2019, a year and a half after it was acquired along with St. While secrecy surrounds the operations of many PE-owned groups, Envision serves as a case study. Her primary interests are in ultrasound, machine learning, and health justice. Published September 5, 2019.

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113

ACEP Now

MAY 9, 2024

A search for Brazilian Butt Lift (BBL) on any social media platform will yield thousands of before-and-after images, faja sales, operating room videos, recovery tips, and patients praising their plastic surgeon. 1 The Rise of the Miami BBL An entire industry has emerged around gluteal AFTs in Miami.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

PulmCCM

JANUARY 8, 2024

Twenty-five ICUs in Canada were switched to small-volume blood collection tubes at randomly assigned times (a so-called stepped-wedge cluster design) from 2019-2021. The Red Cross funds a large portion of its operations through its ~$2 billion transfusion business , and would seem to be unlikely to advocate for reducing its size.

Blood Transfusions 96

Blood Transfusions Hospitals Outcomes Operations 96

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. An RCT is underway in Canada on the use of ondansetron versus haloperidol with an estimated completion of July 2019.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Don't Forget the Bubbles

FEBRUARY 7, 2024

One systematic review of 1283 patients showed that if you got to the operating room within 6 hours, you had a 97% chance of saving the testicle. Urgent senior review, decision making and operation 31.3% What is the role of ultrasound? This dropped to 79.3% of patients were first seen by a junior specialist trainee.

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111

EB Medicine

JANUARY 2, 2019

Jeff: With that, let’s get into the first episode of 2019 – the topic this month is first trimester pregnancy emergencies: recognition and management. 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.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

EMDocs

NOVEMBER 13, 2023

2019) argue against a minimum NIHSS score to trigger the use of CTA, instead purporting that clinical suspicion of acute ischemic stroke presenting within 24 hours of the last known well was sufficient evidence to order the study. Stroke 2019, 50 (2), 365-372. Semin Ultrasound CT MR 2017, 38 (4), 345-356. DOI: 10.1161/strokeaha.118.023173

Stroke 105

Stroke Radiology Radiology Emergency Department 105

Mind The Bleep

DECEMBER 6, 2024

Initial Management (whilst Urology team are on their way) Bloods FBC, U/Es, CRP, Coagulation screen, Blood glucose levels, Blood cultures IV Antibiotics as per Trust guidelines (may be under section for Necrotising fasciitis) Urethral catheter- this will help with monitoring urine output and help identify the urethra during the operation.

Documentation/Coding 52

Documentation/Coding Operations Ultrasounds Hospitals 52

SheMD

APRIL 23, 2023

An article recently published in JAMA Surgery (2019), by Matilda Anderson, MBBS, MPH and Rose H. Some of these relevant hazards listed in the paper include radiation, surgical smoke, working conditions, sharps injury, anesthetic gases, and intra-operative use of toxic agents to name a few. Goldman, MD, MPH addressed this very topic.

Ultrasounds 52

Ultrasounds Wellness Operations 52

Don't Forget the Bubbles

OCTOBER 14, 2024

Introduction Whilst our news headlines may no longer filled with pictures of rubber dinghies arriving on the shores of the Mediterranean, the migrant crisis not only persists but continues to deteriorate, with numbers arriving in Greece in the first quarter of 2024, the highest they have seen since 2019. Harbingers’ Magazine. The BMJ.

Documentation/Coding 59

Documentation/Coding Hospitals Wellness Operations 59

Don't Forget the Bubbles

SEPTEMBER 23, 2024

suprapubic catheters, gastrostomy tubes, haemodialysis or peritoneal dialysis lines – may have been left in situ in the initial post-operative period), and central vascular catheters. Look for scars indicating previous central lines, peritoneal dialysis catheters or operations. If in doubt, ask. CAKUT, catheterization requirement).

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

Don't Forget the Bubbles

JULY 5, 2023

Afro-Caribbean patients should be screened for sickle cell before anaesthesia for possible pre-operative transfusion. The high blood flow velocities through these stenotic segments can be detected using transcranial doppler ultrasound (TCD). 2019, 3 rd edition. What could be the differential diagnosis?

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126