The Skeptics' Guide to EM

DECEMBER 10, 2022

Date: November 30th, 2022 Reference: Johnson et al. Date: November 30th, 2022 Reference: Johnson et al. Bone Joint J 2022 Guest Skeptic: Dr.Matt Schmitz is an Orthopaedic Surgeon specializing in Adolescent Sports Medicine and Young Adult Hip Preservation. 0.23) * Ultrasound 0.27 (0.13–0.56) Initial X-ray 0.24 (0.07–0.79)

Operations 52

Operations Fractures Military Emergency Department 52

The Skeptics' Guide to EM

JULY 30, 2022

Date: July 28th, 2022 Reference: Brower et al. Point-of-Care Ultrasound-First for the Evaluation of Small Bowel Obstruction: National Cost Savings, Length of Stay Reduction, and Preventable Radiation Exposure. AEM July 2022 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals.

Ultrasounds 52

Ultrasounds Operations Documentation/Coding Outcomes 52

Pediatric EM Morsels

JUNE 16, 2023

2022) Morel-lavallee lesions – diagnosis and practical management of these troublesome injuries! Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Arch Gen Med. and Taylor, B.

Soft Tissue Injuries 152

Soft Tissue Injuries Dehydration Fractures Operations 152

Taming the SRU

APRIL 5, 2023

Given her age, history of nephrolithiasis, and frequent urinary tract infections, a bedside renal ultrasound was performed to assess for hydronephrosis due to concern her generalized weakness may be secondary to an infected stone or obstructive uropathy. 2022 Nov 28. Treasure Island (FL): StatPearls Publishing; 2022 Jan–.

Ultrasounds 52

Ultrasounds Pediatrics Radiology Radiology 52

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. Accessed 2022-03-26. Ann Emerg Med. J Emerg Med.

EMS 114

EMS Academics Telemedicine Operations 114

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. 2022 PMID: 35206981 2. Healthcare 2022 PMID: 35206981 Post Peer Reviewed By: Frank Lodeserto, MD & Salim R. References: 1 Astasio-Picado Á et al. Healthcare.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Taming the SRU

NOVEMBER 3, 2023

Ultrasound‐Guided Serratus Anterior Plane Block (SAPB) Improves Pain Control in Patients With Rib Fractures. Ultrasound Med. 41, 2695–2701 (2022). Results 24 patients were eligible during the study period from January 2019 to June 2020 and 20 patients age 33-95 were ultimately enrolled by the 6 operators. SD 3.28) and 6.5,

Fractures 97

Fractures Ultrasounds Outcomes Research 97

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., The ultrasound journal 2020, 12(1):1-12. Crit Care 2022, 26(1):150.

Ultrasounds 87

Ultrasounds Operations Shock 87

Don't Forget the Bubbles

JANUARY 1, 2024

Data from the Nurse-Family Partnership program involving 60,171 families were analysed across four cohorts, including pre-pandemic and three pandemic cohorts (from July 2022 to October 2023). However, children who had an operation experienced improvements in behaviour, symptoms, and quality of life and had lower blood pressure.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

The Skeptics' Guide to EM

MARCH 25, 2023

Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Trauma Surg Acute Care Open 2022 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. Date: March 22, 2023 Reference: Hilsden et al.

Ultrasounds 52

Ultrasounds Emergency Department Dislocations Radiology 52

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 Hospitals 52

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

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?! 2022 Aug 1;93(2):157-165. J Trauma Acute Care Surg.

Poisoning 70

Poisoning Dislocations Operations Ultrasounds 70

Dr. Smith's ECG Blog

SEPTEMBER 9, 2024

The cut points for what constitute OMI and not OMI as well as confidence levels are calibrated to maximize sensitivity and specificity according to the receiver operating characteristic. In a large proportion of cath labs, the operator would probably have ended the case at this point. The cardiologist called this 20% stenosis.

EKG/ECG 70

EKG/ECG Operations Wellness Ultrasounds 70

Don't Forget the Bubbles

MAY 17, 2023

Post-operative pain in children: Comparison of pain scores between parents and children. Minor head trauma in infants – how accurate is cranial ultrasound performed by trained radiologists? 2023 Apr 20:fetalneonatal-2022-324835. 2023 Apr 4:archdischild-2022-325281. J Pediatr Gastroenterol Nutr. 2023 Apr 24.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

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. and Lee, S.H.,

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

The Skeptics' Guide to EM

DECEMBER 3, 2022

Date: November 16th, 2022 Reference: Lipsett SC, Monuteaux MC, Shanahan KH, et al. Pediatrics 2022 Guest Skeptic: Dr. Angelica DesPain is an Assistant Professor of Pediatrics and a pediatric emergency medicine physician at the Baylor College of Medicine Children’s Hospital of San Antonio in San Antonio, TX.

Pediatrics 40

Pediatrics Operations Ultrasounds Emergency Department 40

EMDocs

AUGUST 12, 2023

Management consists of intravenous antibiotics , and hand surgery should be consulted to consider operative debridement. The value of ultrasound for detecting hand fractures: A meta-analysis. Emergency Medicine Residents’ Association; 2022:10-11. Inoculation usually occurs by penetrating injury , which seeds the tendon sheath.

EMS 70

EMS Fractures Operations Ultrasounds 70

EMDocs

SEPTEMBER 9, 2023

Treasure Island (FL): StatPearls Publishing; November 15, 2022. Dec 21, 2022. The value of ultrasound for detecting hand fractures: A meta-analysis. Emergency Medicine Residents’ Association; 2022:10-11. Results of primary extensor tendon repair in relation to the zone of injury and pre-operative outcome estimation.

EMS 78

EMS Fractures Soft Tissue Injuries Ultrasounds 78

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

ACEP Now

MAY 4, 2023

On hospital day 2, he was taken to the operating room for surgical rib fixation. The direct movement of air into the chest wall was improved with the placement of a pigtail catheter and ultimately treated with operative repair. He is also system-wide clinical ultrasound co-chair at MetroHealth Medical Center in Cleveland, Ohio.

EMS 52

EMS Fractures Operations Radiology 52

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

ACEP Now

SEPTEMBER 3, 2024

As of 2022, 1 in 4 emergency departments in the United States were staffed by a private equity-owned physician group. 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. 2022:3(9):e222886.

Hospitals 113

Hospitals Radiology Radiology Administration 113

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. 2022 Mar;14(3):e23201.

Operations 52

Operations Emergency Department Ultrasounds 52

RebelEM

AUGUST 31, 2023

CVC placement under ultrasound guidance has decreased overall complication rates and there is increased awareness of transfusion reactions, alloimmunization, acute lung injury, circulatory overload, as well as infection. Despite being common practice, the necessity of routine prophylactic transfusions is now being called into question.

Ultrasounds 58

Ultrasounds Outcomes Wellness Research 58

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. 2022 Jul;45(7):1183-1192. Epub 2022 Mar 25. Sci Rep 12, 8825 (2022). Cite As: Snyder, B. Broadstock, A.

Shock 59

Shock Resuscitation Ultrasounds Research 59

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

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

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 18, 2022

It was notable for a normal cardiac ultrasound with no pericardial fluid, normal LV and RV function (though the quality was not sufficient to evaluate for wall motion abnormalities) and normal IVC dynamics. Bedside ultrasound is another very important piece. Ultrasound can be very helpful to distinguish causes of hypotension.

Ultrasounds 40

Ultrasounds EKG/ECG EMS Radiology 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

Taming the SRU

AUGUST 30, 2023

A larger 2022 meta-analysis in the journal of Clinical Microbiology and Infection examined different test modalities for diagnosing pneumonia in the setting of clinical suspicion for acute community-acquired lower RTI in outpatient clinics, LTACs, and the emergency department. 2022 Jul 11;11(14):2163. 2022 Jan;28(1):13-22.

Infectious Diseases 87

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

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. World FGM Map.

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

MARCH 4, 2024

doi: 10.1136/emermed-2022-212931. Reviewed by: Kieran McDonnell Article 4: Diagnosing Paediatric Distal Forearm Fractures with Ultrasound Snelling PJ, Jones P, Bade D, Bindra R, Davison M, Gillespie A, et al. This was an RCT comparing the accuracy of point-of-care ultrasound to x-ray in diagnosing non-deformed distal forearm fractures.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

RebelEM

SEPTEMBER 11, 2023

Background: Point of care ultrasound (POCUS) has a demonstrated sensitivity of 89.8% Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Published 2022 Sep 2. and specificity of 88.0% Article: Hilsden R, Mitrou N, Hawel J, Leeper R, Thompson D, Myslik F.

Ultrasounds 68

Ultrasounds Radiology Radiology Emergency Department 68

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. Drug Checking Quarterly Report (Q3 2022). 2022; 06/26/2023. 2022 May;14(5). Xylazine (veterinary sedative) use in Puerto Rico. 2011 Dec;6:1-4.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64