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. Physical therapy is probably under-provided to critically ill patients, and improving this might improve outcomes for many. Is this safe?

Ultrasounds 40

Ultrasounds Operations Outcomes Research 40

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? Early hepatic artery thrombosis after liver transplantation: a systematic review of the incidence, outcome and risk factors. Pediatr Radiol.

EMS 69

EMS Ultrasounds Emergency Department Outcomes 69

ACEP Now

JUNE 21, 2023

The lack of differences in the observed outcomes do not suggest one EM training length is superior. The additional year may improve career trajectory or longevity, entrance into fellowship or academic practice, or other longer-term outcomes including successful development of a niche in the specialty. 11 What should we take away?

EMS 114

EMS Academics Telemedicine Research 114

The Skeptics' Guide to EM

DECEMBER 28, 2019

Date: December 16th, 2019 Reference: Moore et al. Annals of EM, JU, and JACR 2019. He is also the Chief for the Section of Emergency Ultrasound and […] The post SGEM Xtra: Come Together, Right Now – Over Renal Colic first appeared on The Skeptics Guide to Emergency Medicine. Date: December 16th, 2019 Reference: Moore et al.

Radiology 40

Radiology Radiology Ultrasounds Emergency Department 40

ACEP Now

MAY 9, 2024

These questionable practices led to a rash of bad outcomes. Unfortunately, at least 13 deaths were subsequently reported in Miami-Dade County from 2019–2022, the three years immediately following the implementation of the subcutaneous injection regulation. References Garcia SE. Butt Lifts Are Booming. Healing Is No Joke.

Emergency Department 52

Emergency Department Operations Ultrasounds Hospitals 52

Taming the SRU

MAY 5, 2023

2019, Bauer, Gerlach et al. 2019, Evans, Rhodes et al. The ANDROMEDA-SHOCK trial published in 2019 demonstrated that only one-quarter (25%) of patients were fluid-responsive at baseline, as determined most frequently by velocity time integral or passive leg raise methods (Hernández, Ospina-Tascón et al. 2021, Im, Kang et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

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

EMDocs

MAY 11, 2024

Semin Ultrasound CT MR. 2013 Apr;34(2):131-41. Endovascular and Clinical Outcomes of Vertebrobasilar Intracranial Atherosclerosis-Related Large Vessel Occlusion. 2019 Mar 19;10:215. Epub 2019 Dec 9. Reference article, Radiopaedia.org (Accessed on 28 Aug 2023) [link] Ortiz de Mendivil A, Alcalá-Galiano A, et al.

Stroke 89

Stroke EMS EKG/ECG Radiology 89

EMDocs

JANUARY 16, 2024

Patients can have excellent outcomes despite prolonged resuscitation. 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. This is a good time to utilize an arterial line or use the ultrasound to find a central pulse.

Hyperthermia / Hypothermia 84

Hyperthermia / Hypothermia Resuscitation CPR EMS 84

The Skeptics' Guide to EM

JANUARY 25, 2020

NEJM February 2019 Guest Skeptic: Andrew Merelman is a critical care paramedic and second year medical student at Rocky Vista University in Colorado. His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults.

EMS 40

EMS Airway Management Administration Resuscitation 40

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Her point-of-care ultrasound (POCUS) shows appropriate-appearing global ejection fraction and no marked wall motion abnormalities. There is evidence that taking those patients with ROSC and EKG showing STEMI directly for angiography +/- angioplasty is associated with positive patient-oriented outcomes.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

ACEP Now

NOVEMBER 16, 2023

The lack of differences in the observed outcomes do not suggest one EM training length is superior. The additional year may improve career trajectory or longevity, entrance into fellowship or academic practice, or other longer-term outcomes, including successful development of a niche in the specialty. Published 2019.

Academics 52

Academics EMS Research Telemedicine 52

PulmCCM

JULY 10, 2023

At 28 days, there were no observed differences in the primary outcome (an odd composite of mortality and emergence of antibiotic resistance), and no difference in survival at 90 days. Mortality was about 30% in each group, and most patients had hospital-acquired sepsis. A sequel to that trial, BLING III, is underway. access, etc.,

Stroke 52

Stroke Sepsis Infectious Diseases Outcomes 52

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 52

Documentation/Coding Operations Academics Ultrasounds 52

The Skeptics' Guide to EM

SEPTEMBER 14, 2019

Date: September 10th, 2019 Reference: Fournier et al. Emergency Medicine Journal 2019. Date: September 10th, 2019 Reference: Fournier et al. Emergency Medicine Journal 2019. He is interested in ultrasound and international emergency medicine.

Head Injuries 52

Head Injuries Emergency Department Seizures EMS 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. Transfusion harms are usually clinically inapparent, showing up in data sets as slightly worsened outcomes among a few more of the transfused, as compared to the not-transfused.

Blood Transfusions 96

Blood Transfusions Hospitals Outcomes Operations 96

Taming the SRU

OCTOBER 1, 2023

As these patients are typically already at a high risk for poor health outcomes, secondary spontaneous PTX is often more serious in presentation and management more complex [11]. Accuracy of Ultrasound in Diagnosis of Pneumothorax: A Comparison between Neonates and Adults-A Systematic Review and Meta-Analysis. Published 2019 Dec 3.

Fractures 94

Fractures COPD Hospitals Emergency Department 94

Taming the SRU

SEPTEMBER 8, 2023

2019 Jan 5;1(1):CD011451. Prognosis of acute severe autoimmune hepatitis (as-AIH): The role of corticosteroids in modifying outcome.” Diagnostic accuracy of Doppler ultrasound, CT and MRI in Budd Chiari Syndrome: Systematic Review and meta-analysis.” PMID: 34006606; PMCID: PMC8137169. Cochrane Database Syst Rev. Hepatology, vol.

Radiology 59

Radiology Radiology Ultrasounds EMS 59

Emergency Medicine Journal

JULY 22, 2024

Background and objectives The ability to rule appendicitis in or out using ultrasound is limited by studies where the appendix is not visualised. For those patients who had formal ultrasound, direct and indirect findings of ultrasound were abstracted from the ultrasound report. 95% CI 1.7 95% CI 3.8 95% CI 1.4

Ultrasounds 52

Ultrasounds Radiology Radiology Emergency Department 52

Dr. Smith's ECG Blog

OCTOBER 18, 2023

1-3] But these studies were very short duration and used cardiology interpretation of ECGs or emergent angiography rather than patient outcomes. Emergent cardiac outcomes in patients with normal electrocardiograms in the emergency department. 2019 ; 54 : 79 - 81. Acad Emerg Med. 2017 ; 24 ( 1 ): 120 - 124 2. Am J Emerg Med.

EKG/ECG 121

EKG/ECG Documentation/Coding Emergency Department Outcomes 121

Downeast Emergency Medicine

APRIL 26, 2021

4] We also know that severe TBI is commonly associated with the development of intracranial hemorrhage where the presence and volume of blood are associated with increased mortality and poor outcomes.[5] Lancet 2019; Vol 394, Iss 10210, P 1713-1723[ Full Text ]. There were no differences found in the secondary outcomes.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

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 122

Ultrasounds Outcomes COPD Hospitals 122

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Am J Med 2019, 132(5):622-630. Now there is a paper published in 2019 that proves the point beyond doubt, though makes it clear that this pattern is associated with very high mortality. American Journal of Medicine 132(5):622-630; May 2019. A emergent cardiology consult can be helpful for equivocal cases. link] Harhash AA et al.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

A bedside cardiac ultrasound was normal, with no effusion. However, in multiple studies, even in the absence of AMI, both acute and chronic myocardial injury (as diagnosed by any elevated cTn) are powerful markers of adverse outcomes in both the short and long term. He had the following EKG recorded: Low voltage, suggests effusion.

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

Dr. Smith's ECG Blog

NOVEMBER 15, 2023

The problem is difficult to study because angiographic visualization of arteries is not perfect, and not all angiograms employ intravascular ultrasound (IVUS) to assess for unseen plaque or for plaque whose rupture and ulceration cannot be seen on angiogram. Thus, intracoronary imaging modalities are crucial in this setting. References: 1.

EKG/ECG 103

EKG/ECG Ultrasounds Wellness Stroke 103

Emergency Medicine Journal

SEPTEMBER 27, 2023

Background Serial point-of-care ultrasound (PoCUS) can potentially improve acute patient care through treatment adjusted to the dynamic ultrasound findings. Methods This was a randomised, controlled, blinded-outcome trial conducted in three EDs in Denmark between 9 October 2019 and 26 May 2021.

Ultrasounds 52

Ultrasounds Outcomes 52

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? Do outcomes for patients with suspected nephrolithiasis differ based on the initial imaging? How do you proceed?

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

Taming the SRU

NOVEMBER 3, 2023

Ultrasound‐Guided Serratus Anterior Plane Block (SAPB) Improves Pain Control in Patients With Rib Fractures. Ultrasound Med. The primary outcome in this study was a change in pain score at rest 60 minutes after block. 41, 2695–2701 (2022).

Fractures 97

Fractures Ultrasounds Outcomes Research 97

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

EMDocs

AUGUST 8, 2023

Bimodal age of distribution: at birth and 12-18 years 14% of cases occur in adults; older patients have worse outcomes Bell clapper deformity – bilateral in 80% of patients Prior episode of torsion Family history Trauma (can be minor) Clinical Presentation: Sudden/severe testicular pain Often unilateral, may radiate.

Ultrasounds 68

Ultrasounds Outcomes Documentation/Coding Emergency Department 68

RebelEM

JUNE 26, 2023

Interventions such as early application of hemorrhage control, tranexamic acid, reduction of crystalloid fluid administration and balanced ratio blood product transfusion have improved many patients’ outcomes. However, mortality still remains high due to trauma-induced coagulopathy. Severe acute traumatic coagulopathy = PT >1.5

Administration 144

Administration Outcomes Resuscitation Radiology 144

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. Her primary interests are in ultrasound, machine learning, and health justice. Published September 5, 2019. Published July 22, 2019. References Pomorski C. The death of Hahnemann Hospital. The New Yorker.

Hospitals 69

Hospitals Radiology Radiology Administration 69

Don't Forget the Bubbles

JULY 17, 2023

Reviews and opinion articles Point-of-care ultrasound in pediatric nephrology. Clinical Outcomes of COVID-19 in Newborns and Infants: A Multicenter Experience of 576 Cases. 2023 Jun Oral food challenge outcomes in children and adolescents in a tertiary centre: A 5-year experience. Sethi SK, et al. Pediatr Nephrol. Eur J Pediatr.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

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. Consider performing a RUSH exam (that is rapid ultrasound for shock and hypotension) to identify the cause. Jeff: Next up is ultrasound. I hope everybody enjoyed a fantastic conference.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

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].

Infectious Diseases 86

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 86

RebelEM

FEBRUARY 19, 2024

of cases) Catheter ultrasound confirmation: 49.8% (i.e. Not met in 16.7% of cases) Catheter location: 66.5% (i.e. Not met in 33.5% Not met in 50.2% of cases) Appropriate vasopressor dose: 84.3% (i.e. Not met in 15.7% No Extravasation Event vs Extravasation Event Age: 63 vs 67 years BMI: 28.3 All Catheter Criteria Met: 44.3%

Administration 134

Administration Sepsis EMS Shock 134

EMDocs

JUNE 21, 2023

Functional outcomes Severe soft tissue injuries and damage to the bony structures => poor functional outcomes. 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%. 2019 Sep;57(3):362-366. 2019 Jun;23(2):59-61.

Soft Tissue Injuries 68

Soft Tissue Injuries Fractures Dislocations Radiology 68