AENJ: Current Issue

MAY 8, 2024

Point-of-care ultrasound (POCUS) has emerged as a useful tool in the emergency department for quick diagnosis and treatment of many emergency conditions (Gonzalez et al.,

Emergency Nursing 50

Emergency Nursing Emergency Department Ultrasounds 50

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

EB Medicine

NOVEMBER 17, 2020

Write us at emplify@ebmedicine.net.

Emergency Department 40

Emergency Department Shock Resuscitation CPR 40

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

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? OPTN/SRTR 2020 Annual Data Report: Liver. Vital signs: HR 118, BP 103/68, RR 20, T 99.8. LFTs are in the thousands. Pediatr Radiol.

EMS 69

EMS Ultrasounds Emergency Department Outcomes 69

RebelEM

APRIL 29, 2024

The current standard of practice has moved away from landmark-based central line placement given the efficacy and safety of ultrasound-based techniques. World J Emerg Surg 2023 PMID: 36918947 3. Intraosseous vascular access in adults using the EZ-IO in an emergency department. Int J Emerg Med 2009 PMID: 20157465 4.

Resuscitation 102

Resuscitation Administration Emergency Department Hospitals 102

Don't Forget the Bubbles

JANUARY 17, 2024

After Meshram et al, 2020 When Orbeez are exposed to water, the water molecules diffuse into the polymer network through osmosis. Curious Ken is brought into your emergency department. Abdominal ultrasound, used in 34 cases, was able to visualize a rounded intraluminal image corresponding to a bead in 28 patients.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

The Skeptics' Guide to EM

MARCH 28, 2020

Date: March 27th, 2020 Reference: Secko et al. Ann Emerg Med Feb 2020 Guest Skeptic: Dr. Tony Zitek is an Emergency Medicine physician in Miami, Florida. Date: March 27th, 2020 Reference: Secko et al. Ann Emerg Med Feb 2020 Guest Skeptic: Dr. Tony Zitek is an Emergency Medicine physician in Miami, Florida.

Dislocations 52

Dislocations Ultrasounds Research Administration 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

ALiEM

MAY 19, 2023

A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. Additional trick: If the x-ray is delayed, you can pre-check with ultrasound [7]. PulmCrit Wee: Ultrasound-guided blakemore tube placement. Published June 1, 2020.

Emergency Department 98

Emergency Department Ultrasounds Wellness EMS 98

EMDocs

NOVEMBER 4, 2023

An ultrasound of the testes reveals the following: What is the diagnosis? aureus infections among patients in the emergency department. Skin and Soft Tissue Infections in the Emergency Department. Emerg Med Clin North Am. Managing a Cutaneous Abscess in the Emergency Department. Ann Emerg Med.

EMS 68

EMS Ultrasounds Emergency Department Infectious Diseases 68

EB Medicine

MARCH 19, 2020

COVID-19 Update 03-18-2020 - An interview with Andrea Duca, MD, Emergency Physician in Bergamo, Italy Time Stamps: 01:29 Dr. Andrea Duca introduction. 15:38 When did you create dirty and clean zones in the emergency department? 17:03 What is your annual emergency department volume? Daily volume?

PPE 40

PPE Emergency Department Ultrasounds Operations 40

EMDocs

APRIL 22, 2024

4 In an emergency department (ED) presentation of cardiac arrest, the diagnosis of PE is challenging without the use of CT angiography. Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. Dawson, Mallin, Hwang J.,

Ultrasounds 82

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 82

EMDocs

JULY 29, 2023

A 75-year-old male with past history of HTN, CVA, DM II presents to the emergency department with right facial swelling since last night. Transoral Ultrasound in the Diagnosis of Obstructive Salivary Gland Pathologies. Ultrasound Med Biol. WikEM, The Global Emergency Medicine Wiki. September 9, 2020.

EMS 71

EMS Dehydration Ultrasounds Emergency Department 71

Taming the SRU

OCTOBER 1, 2023

This post aims to broadly cover the types of PTX, the diagnostic modalities available, and the ideal management by PTX type in the Emergency Department. Chest ultrasonography versus supine chest radiography for diagnosis of pneumothorax in trauma patients in the emergency department. Published 2020 Jul 23.

Fractures 94

Fractures COPD Hospitals Emergency Department 94

EMDocs

MAY 11, 2024

Semin Ultrasound CT MR. 2013 Apr;34(2):131-41. Clinical Policy: Use of Intravenous Tissue Plasminogen Activator for the Management of Acute Ischemic Stroke in the Emergency Department. Ann Emerg Med. Erratum in: Ann Emerg Med. 2020 Feb;19(2):115-122. doi: 10.1053/j.sult.2013.01.004. 2013.01.004. 2015.06.031.

Stroke 89

Stroke EMS EKG/ECG Radiology 89

The Skeptics' Guide to EM

JANUARY 25, 2020

Date: January 9th, 2020 Reference: Casey et al. His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. Date: January 9th, 2020 Reference: Casey et al.

EMS 40

EMS Airway Management Administration Resuscitation 40

EMDocs

SEPTEMBER 9, 2023

The value of ultrasound for detecting hand fractures: A meta-analysis. 2021.0052 Emergency Department Management of Extensor Tendon Lacerations – Page 3 of 4. Ann Emerg Med. Emergency Medicine Residents’ Association; 2022:10-11. Extensor tendon repair in the emergency department. J Emerg Med.

EMS 78

EMS Fractures Soft Tissue Injuries Ultrasounds 78

Taming the SRU

JANUARY 1, 2024

Ultrasound Guided Peripheral IV (USGIV) Access anatomy of arm veins when considering USGIV. unported license [link] Ultrasound allows us to visualize deeper, typically larger veins in the forearm and upper arm. Place ultrasound machine on the opposite side of the bed to minimize neck strain. Check for flash in the IV chamber.

Emergency Department 90

Emergency Department Ultrasounds Administration Burns 90

The Skeptics' Guide to EM

FEBRUARY 6, 2021

Annals of EM 2020. Case: A 32-year-old male patient presents to your emergency department (ED) with severe nausea, vomiting and abdominal pain. An ultrasound does not show any free fluids or any signs of an Ileus, appendicitis or gallbladder disease. Reference: Ruberto et al. Laboratory values are unremarkable.

Hospitals 40

Hospitals Emergency Department Ultrasounds EMS 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 – B scan (ultrasound of the eye), for visualisation of the retina when there is a poor view (i.e Emergency management: retinal detachment. Community Eye Health. 2018;31(103):63. Ninth Edition. 655–687 p.

Operations 52

Operations Emergency Department Ultrasounds 52

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

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. N Engl J Med. 2023;388(6):499-510. 2021, Jarczak, Kluge et al. 2019, Bauer, Gerlach et al. 2018, Kuttab, Lykins et al. 2019, Evans, Rhodes et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Dr. Smith's ECG Blog

OCTOBER 2, 2021

Because the patient's pain had resolved completely and cardiology had declined immediate intervention, the patient was admitted but continued to board in the emergency department. Approximately 4 hours after arrival, the patient was re-examined by the emergency physician. 1] Wereski, R., Chapman, A. Gray, A., &

EKG/ECG 52

EKG/ECG Ultrasounds EMS Documentation/Coding 52

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

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

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

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. 2020 Apr 15;28(8):309-315.

Fractures 75

Fractures Dislocations Operations Radiology 75

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

A bedside cardiac ultrasound was normal, with no effusion. Clin Chem [Internet] 2020;Available from: [link] Smith mini-review: Troponin in Emergency Department COVID patients Cardiac Troponin (cTn) is a nonspecific marker of myocardial injury. JAMA Cardiol [Internet] 2020;Available from: [link] 4.

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

SheMD

JULY 23, 2023

Some of the interview information may not be relevant during the 2020-2021 & 2021-2022 academic years. Another emergency medicine colleague I knew did a 2-week rotation in South America to teach ultrasound to physicians. For department chairs, think bigger picture; ask questions about bigger changes in the department.

Research 98

Research Academics Hospitals Administration 98

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

Written by Destiny Folk MD, with edits by Meyers, peer reviewed by Smith and Grauer A woman in her late 20s with a past medical history of cervical cancer status post chemotherapy and radiation therapy presented to the emergency department for shortness of breath, chest tightness, and two episodes of syncope. Her pulse is 125.

EKG/ECG 52

EKG/ECG Ultrasounds Documentation/Coding COPD 52

Dr. Smith's ECG Blog

MARCH 6, 2023

Regional wall motion abnormality-inferolateral (this is the formal ultrasound location of a posterior wall motion abnormality). 2022 ACC expert consensus decision pathway on the evaluation and disposition of acute chest pain in the emergency department: A report of the American college of cardiology solution set oversight committee. •

EKG/ECG 52

EKG/ECG Emergency Department Ultrasounds EMS 52

Don't Forget the Bubbles

NOVEMBER 8, 2023

7-year-old Tilly is brought to your emergency department at 11 p.m. Abdominal pain in children is common, accounting for over 1 in 20 attendances to paediatric emergency departments [1]. Clinical scoring tools have improved diagnostic performance in assessing suspected appendicitis in the emergency department.

Emergency Department 104

Emergency Department Ultrasounds Pediatrics Best Practices 104

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

Dr. Smith's ECG Blog

JANUARY 10, 2020

Here is the parasternal short axis, performed by a real expert in emergency department point of care cardiac ultrasound: There does not appear to be an anterior wall motion abnormality. Beware a negative Bedside ultrasound. Exam revealed no friction rub What do you want to do? A bedside echo was done immediately.

EKG/ECG 52

EKG/ECG Ultrasounds Emergency Department Wellness 52

Don't Forget the Bubbles

SEPTEMBER 20, 2023

Do not obtain abdominal radiographs for suspected constipation The parents of 4-year-old Matthew bring him into the Emergency Department with abdominal pain. Functional constipation and nonspecific, generalized abdominal pain are common presenting complaints for children in emergency departments. Published 2020 Mar 15.

Pediatrics 133

Pediatrics Emergency Department Radiology Radiology 133

ALiEM

FEBRUARY 12, 2024

A 28-year-old female G3P2002 presented to the emergency department for one month of vaginal bleeding. The patient was seen in the emergency department one month earlier for vaginal bleeding in the first trimester of pregnancy. Case Question: How would you describe the uterine cavity from the ultrasound images?

Ultrasounds 64

Ultrasounds Emergency Department Academics Operations 64