Emergency Medicine Journal

MAY 23, 2023

Background Point-of-care (POC) lung ultrasound (LUS) is widely used in the emergency setting and there is an established evidence base across a range of respiratory diseases, including previous viral epidemics. Methods Traditional and grey-literature searches were performed on 1 June 2021.

Ultrasounds 52

Ultrasounds Operations Research Hospitals 52

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. For ultrasound, it is recommended to scan the most tender area using a linear probe. 2021; 9:e04871.

Ultrasounds 96

Ultrasounds Emergency Department Wellness Operations 96

Don't Forget the Bubbles

JANUARY 17, 2024

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. 2021 These beads, once hydrated inside the body, reached considerable sizes. His abdominal X-ray looked a lot like this.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

ACEP Now

JUNE 21, 2023

2,3 In the 2021-2022 academic year, categorical (non-combined) EM residency lengths included 221 (80 percent) PGY 1-3 and 55 (20 percent) PGY 1-4 programs. Therefore, applicant, funding, and operational factors may influence programs to offer a particular curriculum length. 1 Curricula with non-EM internships (i.e., Ann Emerg Med.

EMS 114

EMS Academics Telemedicine Operations 114

PulmCCM

NOVEMBER 11, 2023

Diagnosis because P ra is non-invasively transduced with ultrasound, for instance via the size and collapsibility of the inferior vena cava [1] and/or the Venous Excess Ultrasound Score [VExUS] [2-4]. The dependent variable is the operating point [i.e., Adv Chronic Kidney Dis 2021, 28(3):252-261. Can these data deduce CO?

Ultrasounds 87

Ultrasounds Operations Shock 87

Don't Forget the Bubbles

JANUARY 1, 2024

However, children who had an operation experienced improvements in behaviour, symptoms, and quality of life and had lower blood pressure. Data collected from 2002 to 2021 revealed a 72% decline in IPD incidence among children (<18 years), with continued reductions after the transition from PCV7 to PCV13. Musolino AM, et al.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

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. 2021 PMID: 34273470 12 Petitpas F et al. We were not able to identify a study specifically comparing US-guided CVC compared to IO placement. Resusc Plus. Resuscitation.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

EB Medicine

NOVEMBER 1, 2021

EMplify – November 2021 Announcements: The EB Medicine app is live and available for free in the Apple Store. Coming to Google Play soon. It is in Beta and your feedback is welcome. Also, this month use code ACEP21!

Fractures 52

Fractures Documentation/Coding Operations Emergency Department 52

EMDocs

AUGUST 12, 2023

Management consists of intravenous antibiotics , and hand surgery should be consulted to consider operative debridement. McGraw Hill; 2021. November 9, 2021. Inoculation usually occurs by penetrating injury , which seeds the tendon sheath. Unrecognized or persistent infection can lead to necrosis of the tendon. In: StatPearls.

EMS 70

EMS Fractures Operations Ultrasounds 70

Broome Docs

APRIL 30, 2024

Don’t forget Justin has a stream on his Youtube channel that does include this podcast and his deeper dives into the data – HERE You can also check out some random ultrasound education and other goodies on the Broomedocs Youtube channel Avoiding calls to neurosurgery?! 2021 Oct;38(10):446-448. 2024 Mar 18:e240762.

Poisoning 70

Poisoning Dislocations Operations Ultrasounds 70

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. References Garcia SE. Healing Is No Joke.

Emergency Department 52

Emergency Department Operations Ultrasounds Hospitals 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? Scand J Trauma Resusc Emerg Med 29, 170 (2021) What’s it about? Hetmann, F.,

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

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]. weight-bearing status, operative vs. non-operative) If necessary/helpful to ensure adequate follow-up At time of discharge: Counsel on expected course of injury, supportive care (e.g.,

Fractures 76

Fractures Dislocations Operations Radiology 76

PulmCCM

APRIL 1, 2024

Read in Lancet Respiratory Medicine Higher vs. lower oxygenation targets in Covid-19 (HOT-COVID trial) Published in January 2021, the HOT-ICU trial found no difference in mortality (42.9% ” But less than half of the included studies used ultrasound guidance during central line placements.

Ultrasounds 40

Ultrasounds Operations Outcomes Research 40

EMDocs

JULY 17, 2023

7 While post-operative adhesive disease is also a risk factor, it is far less commonly implicated in LBO compared to SBO. 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. Cancers (Basel ).

Operations 77

Operations EMS Fluid Resuscitation Resuscitation 77

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. McGraw Hill; 2021. Vital signs: HR 118, BP 103/68, RR 20, T 99.8.

EMS 69

EMS Ultrasounds Emergency Department Outcomes 69

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. Disclaimer: This post was written before the COVID-19 pandemic.

Research 98

Research Academics Hospitals Administration 98

EMDocs

SEPTEMBER 9, 2023

McGraw Hill; 2021. The value of ultrasound for detecting hand fractures: A meta-analysis. Results of primary extensor tendon repair in relation to the zone of injury and pre-operative outcome estimation. Tendon Lacerations. In: Knoop KJ, Stack LB, Storrow AB, Thurman R. The Atlas of Emergency Medicine, 5e. 2013;29(2):261-268.

EMS 78

EMS Fractures Soft Tissue Injuries Ultrasounds 78

ACEP Now

NOVEMBER 16, 2023

2,3 In the 2021-2022 academic year, categorical (non-combined) EM residency lengths included 221 (80 percent) PGY 1-3 and 55 (20 percent) PGY 1-4 programs. Therefore, applicant, funding, and operational factors may influence programs to offer a particular curriculum length. 1 Curricula with non-EM internships (i.e., government.

Academics 52

Academics EMS Telemedicine Research 52

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

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). Fortunately, that is exactly what happened. The patient did well afterward without any recurrence of symptoms.

EKG/ECG 115

EKG/ECG EMS Wellness Operations 115

Taming the SRU

AUGUST 30, 2023

Notably, lung ultrasound for the diagnosis of bacterial CAP demonstrated exceptional stand-alone diagnostic accuracy in 33 studies including 4,901 adults and children in the emergency department, with a pooled sensitivity of 92% and specificity of 90%. 2021; 93: 4358–4369. 2021 Jan;25(1):466-479. Epub 2021 Oct 1.

Infectious Diseases 87

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 87

Taming the SRU

FEBRUARY 19, 2024

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. They also found that when femoral lines did fail, they did so later in the patient’s clinical course. (12) Cite As: Snyder, B.

Shock 59

Shock Resuscitation Ultrasounds Research 59

Northwestern EM Blog

DECEMBER 20, 2021

Management includes imaging studies, typical ultrasound to assess for a joint effusion, then a diagnostic arthrocentesis & antibiotics. Management is orthopedic consultation for operative stabilization [12]. Ultrasound can be useful when evaluating for septic arthritis and transient synovitis and can be performed at the bedside.

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

ACEP Now

SEPTEMBER 3, 2024

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 May 31, 2021. Stinson said, “There have been [PE] facilities where I worked where a third to a half of the staff are all new residents.

Hospitals 113

Hospitals Radiology Radiology Administration 113

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

Don't Forget the Bubbles

OCTOBER 14, 2024

MVI offers essential outreach services to refugee camps as well as operating a central clinic in Athens, providing undocumented migrants, refused asylum seekers, and the homeless with regular medical care. Nationalities of sea arrivals in Greece 2024. In 2023, MVI conducted 2994 consultations, of which 16% were children. Refugees News.

Documentation/Coding 59

Documentation/Coding Hospitals Wellness Operations 59

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

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. This study strengthens the recommendation in a 2021 Cochrane review casting doubt on the effectiveness of IV Mg in severe asthma exacerbations. Picard C, Abbo O, Munzer C, et al.

Emergency Department 140

Emergency Department Hospitals Resuscitation Administration 140

ALiEM

OCTOBER 30, 2024

Clinical impact: The patient’s DVT ultrasounds were negative. Your patient ultimately is diagnosed with a spinal epidural abscess requiring operative care. 2021 Aug 1;94:103086. Evaluation for nephrotic syndrome due to viral hepatitis, endocarditis, venous thromboembolism or other cause of chronic lymphedema is reasonable.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

EMDocs

DECEMBER 18, 2023

The most recent surviving sepsis campaign (SSC) guidelines were released in 2021, which provided 93 recommendations for evidence-based sepsis management. 1 Since 2021, attempts to identify a single screening tool with optimal sensitivity and specificity to predict which patients will develop sepsis or septic shock have been ongoing.

Sepsis 65

Sepsis Fluid Resuscitation Resuscitation Shock 65

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

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

ACEP Now

APRIL 4, 2024

The diagnosis is confirmed with bedside ultrasound (US) or CT. Other exceptions are patient refusal, patient death or immediate transfer to the operating room. Ultrasound of the aorta is a core competency of emergency physicians, but resources such as Sonoguide are available for a refresher at acep.org/sonoguide. J Vasc Surg.

Operations 40

Operations Ultrasounds Emergency Department 40

EMDocs

NOVEMBER 4, 2024

2021 Apr;28(4):444-454. Epub 2021 Jan 2. Evaluation by ultrasound of traumatic rib fractures missed by radiography. 2021 Feb;60(2):165-174. 2021 Feb;60(2):165-174. Pharmacologic therapy should only be utilized for chronic low back pain for patients who have not responded adequately to the aforementioned options.

Emergency Department 99

Emergency Department Fractures Burns EMS 99

EMDocs

NOVEMBER 13, 2023

2021) found that the top 5 reasons for ordering a CTA head/neck were suspected stroke, neurologic problem, dizziness, headache with new/concerning symptoms, and altered mental status. Semin Ultrasound CT MR 2017, 38 (4), 345-356. RadioGraphics 2021, 41 (3), E81-E89. Aging Dis 2021, 12 (4), 1000-1009. 4) Madhuripan, N.;

Stroke 87

Stroke Radiology Radiology Emergency Department 87

ALiEM

FEBRUARY 12, 2024

At the time her beta-hCG was 7225 mlU/mL with no intrauterine pregnancy demonstrated on transvaginal ultrasound. Three days later, the patient had declining b-hCG and transvaginal ultrasound again with no intrauterine pregnancy. Case Question: How would you describe the uterine cavity from the ultrasound images? 2, 2021, pp.

Ultrasounds 64

Ultrasounds Emergency Department Academics Operations 64