Don't Forget the Bubbles

JUNE 19, 2023

There were no issues during the pregnancy, and estimated fetal growth by ultrasound was constant. Differential diagnosis of small babies The differential diagnosis for SGA and growth-restricted babies is extensive: The diagnosis of growth restriction in utero has improved because of the better use of ultrasound but still remains challenging.

Pediatrics 143

Pediatrics Ultrasounds Hyperthermia / Hypothermia Sepsis 143

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). The primary outcome in this study was a change in pain score at rest 60 minutes after block.

Fractures 98

Fractures Ultrasounds Research Outcomes 98

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 110

Hyperthermia / Hypothermia Resuscitation CPR EMS 110

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 95

Ultrasounds Documentation/Coding Outcomes Emergency Department 95

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. The lack of differences in the observed outcomes do not suggest one EM training length is superior. 1 Curricula with non-EM internships (i.e., 11 What should we take away?

EMS 114

EMS Academics Telemedicine Operations 114

Emergency Medicine Journal

JULY 24, 2023

Ultrasound could be a reliable, cheap and radiation free alternative to diagnose fractures and ligamentous injuries. The purpose of this systematic review was to investigate the accuracy of ultrasound in diagnosing ankle injuries. No restrictions were applied for date and language.

Ultrasounds 40

Ultrasounds Fractures Outcomes 40

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. minutes compared to a mean placement time of 10.7 Healthcare.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

EMDocs

MAY 15, 2024

Ultrasound Sensitivity 88-100%, specificity 68-94% Positive likelihood ratio of 14.6 (95% While chest radiograph is often the first-line imaging modality, lung ultrasound has higher sensitivity and can detect pulmonary abnormalities earlier; CT imaging should be considered if initial imaging is negative or if concern for PE is present.

Blood Transfusions 104

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 104

Dr. Smith's ECG Blog

APRIL 22, 2024

Bedside ultrasound with no apparent wall motion abnormalities, no pericardial effusion, no right heart strain. Available from: [link] In this study, the major outcomes were the same for both groups, but of 70 patients in the delayed group, 4 required emergent intervention for sudden re-occlusion. Eur Heart J [Internet].

EKG/ECG 118

EKG/ECG Outcomes Ultrasounds Hospitals 118

Broome Docs

MARCH 28, 2024

If you want to see Justin in the video format and his new Youtube series then click here: [link] If you would like to check out my current ultrasound training project then click here: WACHS Ultrasound Otherwise – enjoy the show and see you in a few weeks. 2022 Feb;52:85-91. Emerg Med J. 2024 Jan 22;41(2):96-102.

PPE 96

PPE Ultrasounds Resuscitation Emergency Department 96

PulmCCM

JULY 3, 2023

If those grizzled veterans give you a hard time, remember, they’re also the ones who dispensed attaboys in the pre-ultrasound era like “if you’re not cannulating the carotid artery or dropping lungs, you’re not doing enough central lines!”) (Who themselves would be less experienced at video.) (If

Airway Management 105

Airway Management Outcomes Hospitals Emergency Department 105

EMDocs

MAY 28, 2024

Ultrasound Sensitivity 88-100%, specificity 68-94% LR+ of 14.6 (95% While chest radiograph is often the first-line imaging modality, lung ultrasound has higher sensitivity and can detect pulmonary abnormalities earlier; CT imaging should be considered if initial imaging is negative or if concern for PE is present. 2022 Aug;58:235-244.

Blood Transfusions 98

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 98

Don't Forget the Bubbles

MARCH 4, 2024

This was a secondary outcome embedded in the Travel Fever study – a multi-centre, retrospective diagnostic accuracy study for imported malaria. Safety and efficacy of a nitrous oxide procedural sedation programme in a paediatric emergency department: a decade of outcomes. doi: 10.1136/emermed-2022-212931. Emerg Med J.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

ALiEM

OCTOBER 30, 2024

Clinical impact: The patient’s DVT ultrasounds were negative. Drug Checking Quarterly Report (Q3 2022). 2022; 06/26/2023. 2022 May;14(5). Emergency department-initiated buprenorphine for opioid dependence with continuation in primary care: outcomes during and after intervention. 2011 Dec;6:1-4.

Emergency Department 64

Emergency Department Operations Psychiatric EMS 64

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. Outcomes: Primary: Percent change in management decisions after introducing the Radiology Department RUQ US.

Ultrasounds 68

Ultrasounds Radiology Radiology Emergency Department 68

Mount Sinai EM

OCTOBER 11, 2024

2022 Surgical drainage : needle aspiration vs incision and drainage Needle aspiration has long been the preferred initial surgical drainage technique over scalpel incision and drainage Chang et al., There was significant heterogeneity among studies and outcomes were not measured consistently.

Ultrasounds 100

Ultrasounds Wellness Outcomes Hospitals 100

The Skeptics' Guide to EM

DECEMBER 10, 2022

Date: November 30th, 2022 Reference: Johnson et al. One-year outcome of surgery compared with immobilization in a cast for adults with an undisplaced or minimally displaced scaphoid fracture: A meta-analysis of randomized controlled trials. Date: November 30th, 2022 Reference: Johnson et al. 0.23) * Ultrasound 0.27 (0.13–0.56)

Operations 52

Operations Fractures Military Emergency Department 52

Broome Docs

JANUARY 30, 2023

2022 Nov 6. Covered or uncovered: A randomized control trial of Tegaderm versus no Tegaderm for ocular ultrasound. 2022 Nov;61:87-89. Epub 2022 Aug 28. 2022 Nov;29(11):1403-1404. Epub 2022 Aug 17. 2022 Aug 1;5(8):e2226809. 2022 Sep 1;5(9):e2235575. 2022 Nov 29. 2022 Jul;57:76-80.

Emergency Department 52

Emergency Department Outcomes Ultrasounds Pediatrics 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

ACEP Now

SEPTEMBER 3, 2024

These stakeholders are similarly shielded in court when adverse patient outcomes, such as negligent deaths, occur under their management or when the bought-out companies are challenged for anticompetitive business practices overseen by the PE firm. Her primary interests are in ultrasound, machine learning, and health justice.

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113

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. 2022 ; 51 : 384 - 387 3. 2022 ; 55 : 180 - 182 6. Acad Emerg Med.

EKG/ECG 119

EKG/ECG Documentation/Coding Emergency Department Outcomes 119

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. Published May 11, 2022. Published online August 11, 2022:sjac224.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

Taming the SRU

JANUARY 10, 2024

R4 Case Follow-up: SCAD WITH dr. Martella Spontaneous Coronary Artery Dissection (SCAD) is a diagnosis confirmed via imaging: Coronary Angiography, Optical Coherence Tomography, Intravascular Ultrasound Therefore, treatment in the ED is the same as atherosclerotic ACS: ASA, heparin gtt and possible statin.

EKG/ECG 93

EKG/ECG Shock Fractures Dislocations 93

Don't Forget the Bubbles

MAY 17, 2023

Minor head trauma in infants – how accurate is cranial ultrasound performed by trained radiologists? 2023 Apr 20:fetalneonatal-2022-324835. Finding the most suitable puncture site for intraosseous access in term and preterm neonates: an ultrasound-based anatomical pilot study. 2023 Apr 4:archdischild-2022-325281.

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 17, 2022

Date: December 16th, 2022 Reference: Hohle et al. AEM December 2022 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Date: December 16th, 2022 Reference: Hohle et al. Massive Blood Transfusion Following Older Adult Trauma: the Effect of Blood Ratios on Mortality.

Blood Transfusions 52

Blood Transfusions Fractures EMS Emergency Department 52

Broome Docs

APRIL 6, 2023

Clinical risk factors for testicular torsion and a warning against falsely reassuring ultrasound scans: a 10-year single-centre experience. 2022 Dec 16:emermed-2021-211946. Epub 2022 Nov 21. 2022 Jul 2;400(10345):39-47. 2022 Oct;51(10):595-604. 2022 Dec 20;328(23):2296. Epub 2022 Dec 7. Emerg Med J.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 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. Primary Outcome – Bleeding (Grade 2 to 4) Transfusion 4.8% Non-inferiority margin was set at 2.5% g/dl vs 8.5

Ultrasounds 58

Ultrasounds Outcomes Wellness Research 58

Taming the SRU

FEBRUARY 24, 2024

Providers should use ultrasound as early as possible to evaluate for cardiac dysfunction, pulmonary edema, and fluid status. They tend to be hypertensive, tachycardic, tachypneic, and hypoxic. Do not always appear volume overloaded on exam. Early recognition and prompt treatment is key.

Leadership 94

Leadership EMS Pediatrics Stroke 94

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. June 26, 2022. Reference article, Radiopaedia.org (Accessed on 28 Aug 2023) [link] Ortiz de Mendivil A, Alcalá-Galiano A, et al. doi: 10.1053/j.sult.2013.01.004.

Stroke 111

Stroke EMS EKG/ECG Radiology 111

JournalFeed

MAY 7, 2022

The JournalFeed podcast for the week of May 2-6th,2022. Airway POCUS Spoon Feed: Upper airway ultrasound (UA-US) may eventually help us predict if a patient will have a difficult laryngoscopy ahead of time. These are summaries from just 2 of the 5 article we cover every week!

Advances Cardiac Life Support (ACLS) 40

Advances Cardiac Life Support (ACLS) Resuscitation Ultrasounds Outcomes 40

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]. Treasure Island (FL): StatPearls Publishing; November 28, 2022. The "lung point": an ultrasound sign specific to pneumothorax. 2013;17(2):247-252.

Fractures 96

Fractures COPD Hospitals Emergency Department 96

Dr. Smith's ECG Blog

MAY 30, 2023

Case continued A bedside ultrasound showed diminished LV EF and of course bradycardia. The primary outcomes were sensitivity/specificity of 1) STD in lead I ≥ 0.5 mm and 2) STE in lead V1 ≥ 0.5 mm, stratified by presence or absence of posterior (inferobasal) MI, as determined by ≥0.5 mm STD in lead V2, for differentiating RVMI from non-RVMI.

Shock 97

Shock EKG/ECG Academics Stroke 97

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

Taming the SRU

MAY 5, 2023

2022), ideally with antibiotics administered within one hour of sepsis recognition by the treating provider (Evans, Rhodes et al. In 2022, the CLASSIC trial was published which provided one investigational angle to this important question. Sixty centers participated during the years 2018-2022. 2018, Kuttab, Lykins et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Mind The Bleep

AUGUST 5, 2023

Example of pneumoperitoneum following perforated NEC Other Investigations Blood tests and abdominal ultrasound. Abdominal ultrasound may show bowel wall thickening, altered vascular state and free fluid. Updated 2022 Aug 8]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Necrotizing Enterocolitis. Lakhoo, K. &

Sepsis 52

Sepsis Ultrasounds Radiology Radiology 52

ACEP Now

OCTOBER 9, 2024

In the emergency department (ED), physicians face the challenge of making rapid decisions that can significantly impact patient outcomes. Collaborating with one of my ultrasound faculty, we conducted a bedside echocardiogram to explore potential cardiac anomalies. Our workup started with an ultrasound and EKG. Published 2022.

EKG/ECG 52

EKG/ECG Fluid Resuscitation Ultrasounds Burns 52