2021, Emergency Department and Ultrasounds

The Ultrasound-Guided Genicular Nerve Block

ACEP Now

MAY 10, 2024

Patients often seek care in the emergency department (ED) setting when flares of pain affect their ability to ambulate, climb stairs, or even stand up from sitting. 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.

Ultrasounds

Ultrasounds Emergency Department Hospitals Wellness

Brazilian Butt Lift Procedure Can Result in Emergency Department Visits

ACEP Now

MAY 9, 2024

The procedure has soared in popularity as beauty standards have shifted and cosmetic surgery has become increasingly transparent on social media platforms, with reported cases in the United States increasing from 614 in 2002 to 61,387 by 2021, a nearly 10,000 percent increase. units per patient.

Emergency Department

Emergency Department Operations Ultrasounds Hospitals

Trick of the Trade: Gel-free ultrasound-guided peripheral IV technique

ALiEM

APRIL 12, 2023

You set up everything, have the patient positioned, and then notice there is no sterile ultrasound gel. The trick is to eliminate anything of poor acoustic impedance between the ultrasound probe and the patient’s skin. Note that some ultrasound manufacturers do not recommend the use of isopropyl alcohol on their transducers.

Ultrasounds

Ultrasounds Emergency Department Resuscitation Wellness

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

Taming the SRU

OCTOBER 23, 2023

THE CASE A female in her early 20s, G4P2012, presents to the emergency department (ED) with a 5 day history of left lower quadrant abdominal pain which has been worsening since onset. A bedside ultrasound is completed to assess the location of the pregnancy. She reports that her previous ectopic pregnancy was treated medically.

Ultrasounds

Ultrasounds Operations Radiology Radiology

Traumatic Lens Dislocation Identified on Ocular Ultrasound

Cook County EM Blog

MARCH 28, 2023

On point-of-care ocular ultrasound of the affected eye using the linear probe a round, mobile structure was noted in the posterior chamber with an absence of the lens in its typical position, consistent with posterior lens dislocation. What is the utility of point-of-care ultrasound in identifying lens dislocation?

Dislocations

Dislocations Ultrasounds Fractures Radiology

Ultrasound of the Month: Gallbladder Perforation

Taming the SRU

JULY 24, 2023

THE CASE A male in his 60s presented to the emergency department for right upper quadrant abdominal pain. A bedside right upper quadrant ultrasound was performed, and the images are below. Ultrasound is the gold standard for diagnosing cholelithiasis because it is more sensitive for detecting gallstones. Int J Surg.

Ultrasounds

Ultrasounds Sepsis Radiology Radiology

SGEM#437: Don’t Be Fooled by the Meds I Got, I Still Need an ESP Block – For My Rib Fractures

The Skeptics' Guide to EM

APRIL 20, 2024

Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergency department: A randomized controlled trial. Background: We have covered rib fractures once before on the Skeptics’ Guide to Emergency Medicine.

Fractures

Fractures Ultrasounds Emergency Department CDC

SGEM#451: I’ve Become So Numb – Serratus Anterior Plane Blocks for Rib Fractures

The Skeptics' Guide to EM

AUGUST 24, 2024

Sean Baldwin is an Emergency Physician practising in Sydney, Australia in both a large tertiary emergency department and a small regional emergency department. Case: A 67-year-old male presents to your hospital emergency department (ED) after a fall from his bicycle. Reference: Partyka et al.

Fractures

Fractures Emergency Department Ultrasounds Radiology

Sono Pro Tips and Tricks for Evaluation of Elevated Intracranial Pressure

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

Ultrasounds Emergency Department Academics EMS

Ultrasound of the Month - Not all veggies are good for your health

Downeast Emergency Medicine

DECEMBER 9, 2021

Case presentation A 37-year-old female with a history of mild intermittent asthma, hepatitis C, and opioid abuse disorder (in remission for the past year being maintained on buprenorphine) presents to the emergency department after being called due to positive blood cultures. Arrow highlighting the small pericardial effusion.

Ultrasounds

Ultrasounds Urgent Care Emergency Department Sepsis

Approach to Hernias in the ED

Taming the SRU

APRIL 14, 2024

2) Management: Confirmed by CT Surgical consult Utility of Ultrasound Ultrasound can be helpful in identifying hernias and in assisting in reduction. 8) “Ultrasound may decrease the emergency surgery rate of incarcerated inguinal hernia” by Chen et al. (1) The results revealed a rate of emergency surgery of 9.8%

Ultrasounds

Ultrasounds Emergency Department Pediatrics Radiology

Annals of B Pod: Stump Appendicitis

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. 2021; 9:e04871.

Ultrasounds

Ultrasounds Emergency Department Wellness Operations

Clinical Conundrums: Do We Need to Order a CT for Every Patient with Renal Colic?

RebelEM

FEBRUARY 12, 2024

There are greater than 2 million annual emergency department visits for suspected renal colic in the US, and Ct scanning is performed for more than 90% of patients who receive a diagnosis of kidney stone. Am J Emerg Med. 2021 Sep;47:70-73. Epub 2021 Mar 22. ” The Journal of Urology 199.4S (2018): e683-e684.

Radiology

Radiology Radiology Emergency Department Ultrasounds

Don’t Forget About the IO in the Critically Ill Patient

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

Resuscitation Administration Emergency Department Hospitals

Episode 63 – Rib Fracture- An Interview with Dr. Patrick Maher

EB Medicine

NOVEMBER 1, 2021

EMplify – November 2021 Announcements: The EB Medicine app is live and available for free in the Apple Store. and get 20% of all orders at [link] Emergency Department Management of Rib Fractures Author: Patrick Maher, MD Episode Outline: Why rib fractures? Coming to Google Play soon. It is in Beta and your feedback is welcome.

Fractures

Fractures Documentation/Coding Emergency Department Operations

Don’t Forget the Orbeez!

Don't Forget the Bubbles

JANUARY 17, 2024

Curious Ken is brought into your emergency department. 2021 A plain abdominal X-ray shows multiple dilated loops of bo wel. Abdominal ultrasound, used in 34 cases, was able to visualize a rounded intraluminal image corresponding to a bead in 28 patients. Journal of The Korean Society of Emergency Medicine , 33 (1), pp.134-138.

Pediatrics

Pediatrics Poisoning Ultrasounds Dehydration

Hypothermic Cardiac Arrest: Pearls and Pitfalls

EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Am J Emerg Med. Accidental Hypothermia: 2021 Update.

Hyperthermia / Hypothermia

Hyperthermia / Hypothermia Resuscitation CPR EMS

Paediatric Neck Lumps

Don't Forget the Bubbles

NOVEMBER 20, 2023

Neck lumps are a common presenting complaint to the paediatric emergency department with many aetiologies, sometimes resulting in a diagnostic conundrum. These may require surgical drainage following confirmation on ultrasound scan. April 2021 Russell F, Lowe D. DOI: 10.1016/j.joms.2006.11.039 Dermatopathology.

Pediatrics

Pediatrics Documentation/Coding Emergency Department Hospitals

PEM POCUS Series: Pediatric Renal and Bladder Ultrasound

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

Ultrasounds Pediatrics Emergency Department Radiology

EM@3AM: Liver Transplant Complications

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? McGraw Hill; 2021. The emergency medicine approach to transplant complications. Am J Emerg Med. LFTs are in the thousands.

EMS

EMS Ultrasounds Emergency Department Outcomes

Trick of Trade: Inflating the Esophageal Balloon of a Blakemore/Minnesota Tube without a Manometer

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]. Accessed December 17, 2021. PulmCrit Wee: Ultrasound-guided blakemore tube placement.

Emergency Department

Emergency Department Ultrasounds Wellness EMS

EM@3AM: Testicular/Scrotal Abscesses

EMDocs

NOVEMBER 4, 2023

An ultrasound of the testes reveals the following: What is the diagnosis? McGraw Hill; 2021. 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.

EMS

EMS Ultrasounds Emergency Department Infectious Diseases

First10EM Journal Club: January 2023

Broome Docs

JANUARY 30, 2023

Covered or uncovered: A randomized control trial of Tegaderm versus no Tegaderm for ocular ultrasound. Am J Emerg Med. Ann Emerg Med. 2021 Aug;78(2):253-266. Epub 2021 Apr 29. Outcomes of patients discharged from the pediatric emergency department with abnormal vital signs. Am J Emerg Med.

Emergency Department

Emergency Department Outcomes Ultrasounds Pediatrics

Four patients with chest pain and ‘normal’ ECG: can you trust the computer interpretation?

Dr. Smith's ECG Blog

OCTOBER 18, 2023

If you were working in a busy emergency department, would you like to be interrupted to interpret these ECGs or can these patients safely wait to be seen because of the normal computer interpretation? Emergent cardiac outcomes in patients with normal electrocardiograms in the emergency department. Am J Emerg Med.

EKG/ECG

EKG/ECG Documentation/Coding Emergency Department Outcomes

SGEM#344: We Will…We Will Cath You – But should We After An OHCA Without ST Elevations?

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Date: September 8th, 2021 Reference: Desch et al. Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. first appeared on The Skeptics Guide to Emergency Medicine. Date: September 8th, 2021 Reference: Desch et al.

EKG/ECG

EKG/ECG Academics EMS CPR

EM@3AM: Flexor Tendon Laceration

EMDocs

AUGUST 12, 2023

He presented to the emergency department because he is having numbness distal to the site of injury, as well as constant bleeding and some difficulty with flexing his finger. The Atlas of Emergency Medicine, 5e. McGraw Hill; 2021. November 9, 2021. Examination reveals the following: What is the diagnosis?

EMS

EMS Fractures Operations Ultrasounds

Looking At the First 10 Years of Emirates Society of Emergency Medicine

ACEP Now

OCTOBER 30, 2023

A notable achievement was ESEM’s co-organization of the International Federation of Emergency Medicine Trauma Update Symposium in 2015. These initiatives aim to equip physicians with an evidence-based approach and effective management strategies for common emergency-department scenarios.

Leadership

Leadership Emergency Department Ultrasounds CPR

POCUS findings of hemodynamically unstable PE with cardiac arrest

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. 2021 Apr;40(2):100852.

Ultrasounds

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

SGEM#381: Put Your Hand on My Shoulder and Reduce It

The Skeptics' Guide to EM

NOVEMBER 1, 2022

AEM October 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called First10EM.com Case: A 19-year-old man presents to the emergency department (ED) with his first time anterior should dislocation after trying to recreate one of his favourite scenes in the movie Lethal Weapon.

Dislocations

Dislocations Ultrasounds Emergency Department

The CLOVERS Trial

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. 2021, Jarczak, Kluge et al. 2021, Im, Kang et al. N Engl J Med. 2023;388(6):499-510. 2019, Bauer, Gerlach et al.

Sepsis

Sepsis Shock Administration Resuscitation

EM@3AM: Extensor Tendon Laceration

EMDocs

SEPTEMBER 9, 2023

The Atlas of Emergency Medicine, 5e. McGraw Hill; 2021. 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. J Ultrason.

EMS

EMS Fractures Soft Tissue Injuries Ultrasounds

SGEM#318: Why Am I Throwing Up – Because You Got High

The Skeptics' Guide to EM

FEBRUARY 6, 2021

Date: January 20th, 2021 Guest Skeptics: Dr. Thorben Doll and Dr. Johannes Pott. They are both fourth year resident doctors in anesthesiology, intensive care and emergency care in St. The post SGEM#318: Why Am I Throwing Up – Because You Got High first appeared on The Skeptics Guide to Emergency Medicine. Annals of EM 2020.

Hospitals

Hospitals Emergency Department Ultrasounds EMS

EM@3AM: Brainstem Strokes

EMDocs

MAY 11, 2024

Semin Ultrasound CT MR. 2013 Apr;34(2):131-41. Available from: [link] American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Use of Intravenous tPA for Ischemic Stroke:; Brown MD, Burton JH, Nazarian DJ, Promes SB. Ann Emerg Med. Erratum in: Ann Emerg Med. 2021 Sep 10;12:727962.

Stroke

Stroke EMS EKG/ECG Radiology

Hip Pain in Pediatrics

Northwestern EM Blog

DECEMBER 20, 2021

Written by: Tommy Ng, MD (NUEM ‘24) Edited by: Patricia Bigach, MD (NUEM ‘22) Expert review by : Terese Whipple, MD '20 So your kid won’t walk One of the most common complaints in a pediatric Emergency Department is a child refusing or inability to ambulate. 2021, Dec 20). Hip Pain in Pediatrics.

Pediatrics

Pediatrics Ultrasounds Emergency Department Radiology

Diagnostics and Therapeutics: Managing Pneumothorax

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. Ann Emerg Med. Can Respir J.

Fractures

Fractures COPD Hospitals Emergency Department

Interview Series: Tips to Answer Five Common Medical School and Residency Interview Questions

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

Research Academics Hospitals Administration

Mastering Minor Care: Knee Arthrocentesis

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

Ultrasounds Emergency Department EMS

Large bowel obstruction: ED presentation, evaluation, and management

EMDocs

JULY 17, 2023

3 Point of care ultrasound (POCUS) can be highly sensitive for free fluid and pneumoperitoneum when used by a trained physician in the appropriate patient population. Published 2021 Apr 22. 2017 WSES guidelines on colon and rectal cancer emergencies: obstruction and perforation. World J Emerg Surg. Am J Emerg Med.

Operations

Operations EMS Fluid Resuscitation Resuscitation

Twisting and Turning - Ankle Injuries in the ED

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. MRI can be used in place of CT.

Fractures

Fractures Dislocations Operations Radiology

Chest pain, and Cardiology didn't take the hint from the ICD

Dr. Smith's ECG Blog

JANUARY 23, 2023

Submitted and written by Megan Lieb, DO with edits by Bracey, Smith, Meyers, and Grauer A 50-ish year old man with ICD presented to the emergency department with substernal chest pain for 3 hours prior to arrival. 2021 Dec 7;10(23):e022866. Epub 2021 Nov 15. Triage EKG: What do you think? J Am Heart Assoc. 121.022866.

EKG/ECG

EKG/ECG Shock Emergency Department Ultrasounds

What do you think of this ECG?? Is this during pain, or after pain resolution? Also, see the CT image of the heart.

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

EKG/ECG Emergency Department Ultrasounds EMS

Serial PoCUS for ED Patients with Acute Dyspnea: Is More Actually Better?

RebelEM

JANUARY 25, 2024

Background: Point-of-care ultrasound (PoCUS) is a valuable clinical tool in the assessment of acute dyspnea. In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. Emerg Med J. 2023;40(10):700-707.

Ultrasounds

Ultrasounds Outcomes COPD Hospitals

Paediatric Appendicitis

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

Emergency Department Ultrasounds Pediatrics Best Practices

The 78th Bubble Wrap x Wexham Park Hospital

Don't Forget the Bubbles

JANUARY 31, 2024

Article 1: What predicts parental anxiety in the Paediatric Emergency Department? Predictors of parental anxiety in a paediatric emergency department. Emergency Medicine Journal. The authors compared 100 POCUS (Point-Of-Care-UltraSound ) images captured by trained physicians (in FUSIC/CACTUS). Martin, S.R.,

Hospitals

Hospitals Ultrasounds Emergency Department Pediatrics

The Ultrasound-Guided Genicular Nerve Block

Brazilian Butt Lift Procedure Can Result in Emergency Department Visits

Trending Sources

Trick of the Trade: Gel-free ultrasound-guided peripheral IV technique

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

Traumatic Lens Dislocation Identified on Ocular Ultrasound

Ultrasound of the Month: Gallbladder Perforation

SGEM#437: Don’t Be Fooled by the Meds I Got, I Still Need an ESP Block – For My Rib Fractures

SGEM#451: I’ve Become So Numb – Serratus Anterior Plane Blocks for Rib Fractures

Sono Pro Tips and Tricks for Evaluation of Elevated Intracranial Pressure

Ultrasound of the Month - Not all veggies are good for your health

Approach to Hernias in the ED

Annals of B Pod: Stump Appendicitis

Clinical Conundrums: Do We Need to Order a CT for Every Patient with Renal Colic?

Don’t Forget About the IO in the Critically Ill Patient

Episode 63 – Rib Fracture- An Interview with Dr. Patrick Maher

Don’t Forget the Orbeez!

Hypothermic Cardiac Arrest: Pearls and Pitfalls

Paediatric Neck Lumps

PEM POCUS Series: Pediatric Renal and Bladder Ultrasound

EM@3AM: Liver Transplant Complications

Trick of Trade: Inflating the Esophageal Balloon of a Blakemore/Minnesota Tube without a Manometer

EM@3AM: Testicular/Scrotal Abscesses

First10EM Journal Club: January 2023

Four patients with chest pain and ‘normal’ ECG: can you trust the computer interpretation?

SGEM#344: We Will…We Will Cath You – But should We After An OHCA Without ST Elevations?

EM@3AM: Flexor Tendon Laceration

Looking At the First 10 Years of Emirates Society of Emergency Medicine

POCUS findings of hemodynamically unstable PE with cardiac arrest

SGEM#381: Put Your Hand on My Shoulder and Reduce It

The CLOVERS Trial

EM@3AM: Extensor Tendon Laceration

SGEM#318: Why Am I Throwing Up – Because You Got High

EM@3AM: Brainstem Strokes

Hip Pain in Pediatrics

Diagnostics and Therapeutics: Managing Pneumothorax

Interview Series: Tips to Answer Five Common Medical School and Residency Interview Questions

Mastering Minor Care: Knee Arthrocentesis

Large bowel obstruction: ED presentation, evaluation, and management

Twisting and Turning - Ankle Injuries in the ED

Chest pain, and Cardiology didn't take the hint from the ICD

What do you think of this ECG?? Is this during pain, or after pain resolution? Also, see the CT image of the heart.

Serial PoCUS for ED Patients with Acute Dyspnea: Is More Actually Better?

Paediatric Appendicitis

The 78th Bubble Wrap x Wexham Park Hospital

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