ALiEM

MAY 13, 2024

Take the ALiEMU PEM POCUS: Soft Tissue Quiz Case Goals List the indications of performing a pediatric soft tissue point-of-care ultrasound (POCUS). Pediatric Soft Tissue POCUS Ultrasound Technique Figure 1. Linear ultrasound transducer Probe Use a linear, high-frequency transducer. Describe the limitations of soft tissue POCUS.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

RebelEM

JANUARY 25, 2024

Background: Point-of-care ultrasound (PoCUS) is a valuable clinical tool in the assessment of acute dyspnea. Impact of serial cardiopulmonary point-of-care ultrasound exams in patients with acute dyspnoea: a randomized, controlled trial. PoCUS evaluations included lung ultrasound (LUS) and focused cardiac ultrasound (FoCUS).

Ultrasounds 129

Ultrasounds Outcomes COPD Hospitals 129

EMDocs

DECEMBER 1, 2024

The RUSH exam: Rapid Ultrasound in SHock in the evaluation of the critically lll. January 2022. Answer : Murine Typhus Epidemiology: Murine typhus is endemic in several parts of the U.S.: Curr Opin Infect Dis. 2016 Oct;29(5):433-9. Perera P, Mailhot T, Riley D, Mandavia D. Emerg Med Clin North Am. 2010 Feb;28(1):29-56, vii.

EMS 105

EMS Infectious Diseases Shock Airway Management 105

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 Radiology Radiology 70

Pediatric EM Morsels

JULY 26, 2024

These females should have imaging with either MRI or CT as well as abdominal or transvaginal ultrasound to assess for ovarian teratoma. 2022 Jul 6;9(5):e200013. Prevalence decreases with decreasing age. Risk of teratoma is higher in African American and Asian women. Moral of the Morsel It’s NOT always psych! doi: 10.1212/NXI.0000000000200013.

Psychiatric 271

Psychiatric Seizures Outcomes Pediatrics 271

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

ALiEM

APRIL 14, 2023

Highlighted Quality Posts: Procedures Site Article Author Date Label Rebel EM Intra Articular Lidocaine vs Sedation in Shoulder Reductions Nordia Matthews, MD 30 Jan 2023 AIR EM Docs Video Laryngoscopy in the ED Cameron Jones, MD 8 Aug 2022 AIR First 10 EM Lacerations: Does closure technique matter?

EMS 98

EMS Ultrasounds Academics Fractures 98

Taming the SRU

JULY 22, 2024

perform arthrocentesis ULTRASOUND-GUIDED PROCEDURE Ultrasound-guided (USG) arthrocentesis may be helpful in instances where there is no obvious effusion that can easily be palpated on physical exam. Studies have shown that effusions of as little as 2 to 4 mL can be identified using ultrasound [6]. 2022, August 29).

Ultrasounds 96

Ultrasounds Emergency Department EMS 96

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

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 154

Soft Tissue Injuries Dehydration Fractures Operations 154

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

OCTOBER 27, 2023

Diagnostic accuracy of point-of-care ultrasound (PoCUS) for shoulder dislocations and reductions in the emergency department: a diagnostic randomised control trial (RCT). 39, 655–661 (2022). The use of ultrasound in the diagnosis and management of musculoskeletal injuries is becoming more common. Jarman, R. & Cardona, T.

Dislocations 95

Dislocations Fractures Ultrasounds Emergency Department 95

PulmCCM

NOVEMBER 17, 2023

’ This could be done with the Venous Excess Ultrasound Score [VExUS] [5, 6]. Beaubien-Souligny W, Rola P, Haycock K, Bouchard J, Lamarche Y, Spiegel R et al : Quantifying systemic congestion with Point-Of-Care ultrasound: development of the venous excess ultrasound grading system. The ultrasound journal 2020, 12(1):1-12.

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

Dr. Smith's ECG Blog

SEPTEMBER 23, 2024

Answer : Bedside ultrasound! Smith : RV infarct may also have this appearance on ultrasound. So hypoxia without B lines on lung ultrasound strongly weights toward PE. What do you do clinically when the ECG looks like this? How do you emergently triage the patient to cath lab or possibly IR suite for thrombectomy?

EKG/ECG 128

EKG/ECG Ultrasounds Shock EMS 128

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) If the ultrasound-guided attempt failed, emergency surgery was scheduled.

Ultrasounds 93

Ultrasounds Emergency Department Pediatrics Radiology 93

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

EMDocs

APRIL 22, 2024

Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. Multiorgan POCUS The diagnostic power of POCUS often resides in combining multiple ultrasound exams. Introduction to Bedside Ultrasound, iBook Ch 2, Basic Cardiac, Pg 27.

Ultrasounds 98

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 98

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. PMID: 34932040.

Ultrasounds 40

Ultrasounds Emergency Department Wellness EMS 40

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). Materials and Methods It was an interventional study at a single tertiary care referral center with a level I trauma designation and an approximate annual ED census of 90,000.

Fractures 98

Fractures Ultrasounds Outcomes Research 98

EMDocs

MARCH 4, 2024

12 Ultrasound and computed tomography (CT) can both identify CBD and are available in most emergency departments. Ultrasound is cost-effective and radiation-sparing. Ultrasound has approximately 90% sensitivity for detecting common bile duct dilation. 13 CT is also superior to ultrasound in its ability to detect malignancy.

Emergency Department 105

Emergency Department Ultrasounds EMS Radiology 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 103

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 103

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

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

Bedside cardiac ultrasound with no obvious wall motion abnormalities. Review of the 2 ECGs in today's case is insightful ( Figure-1 ): The initial ECG shows sinus rhythm, LAHB and meets Peguero Criteria for LVH ( See My Comment in the August 15, 2022 post of Dr. Smith's ECG Blog for more on LVH criteria ). He was started on nitro gtt.

EKG/ECG 122

EKG/ECG Ultrasounds Documentation/Coding Wellness 122

EMDocs

AUGUST 8, 2023

2022 meta-analysis 0-2 as low risk and ≥5 or higher as high risk = AUC of 0.924. 2022 meta-analysis 0-2 as low risk and ≥5 or higher as high risk = AUC of 0.924. Keys: Order the ultrasound in a patient with testicular pain, especially with any TWIST score >0. Minimal if any harm to patients by obtaining ultrasound.

Ultrasounds 94

Ultrasounds Documentation/Coding Outcomes Emergency Department 94

EMDocs

JANUARY 16, 2024

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. Published 2022 Jan 3. doi.org/10.1016/j.resuscitation.2018.11.004

Hyperthermia / Hypothermia 109

Hyperthermia / Hypothermia Resuscitation CPR EMS 109

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 97

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 97

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

Dr. Smith's ECG Blog

JUNE 28, 2023

He arrived in the ED and had an immediate bedside cardiac ultrasound while this ECG was being recorded. The bedside ultrasound (video not available) reportedly showed only a slightly reduced LV function. The patient was given 6mg, then 12 mg, of adenosine, without a change in the rhythm. Here is the ECG: What do you think?

EKG/ECG 98

EKG/ECG Ultrasounds Administration EMS 98

Don't Forget the Bubbles

OCTOBER 18, 2024

Ultrasound-guided insertion is by far the ideal method of venous catheterisation, especially in Paediatrics. 2022 Oct 31;12(4):814-823. What are the methods for cannulation? References Villalba-Nicolau M, Chover-Sierra E, Saus-Ortega C, Ballestar-Tarín ML, Chover-Sierra P, Martínez-Sabater A. doi: 10.3390/nursrep12040079.

Administration 89

Administration Pediatrics Ultrasounds Burns 89

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). Evaluation for nephrotic syndrome due to viral hepatitis, endocarditis, venous thromboembolism or other cause of chronic lymphedema is reasonable. 2011 Dec;6:1-4.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

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. Am J Emerg Med. doi: 10.1016/j.ajem.2021.11.030.

PPE 96

PPE Ultrasounds Resuscitation Emergency Department 96

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. ultrasound and resuscitation procedures) may become a new standard for programs and require a longer training period. Accessed 2022-03-26. Ann Emerg Med. J Emerg Med.

EMS 114

EMS Academics Telemedicine Operations 114

Mind The Bleep

AUGUST 18, 2024

Ultrasound scans are the gold standard to look at the gland itself and show any dilation in the ducts. Imaging A plain x-ray film can be used to locate possible salivary stones. However, it is important to remember that some may be radiolucent and not show up in traditional films. References Payne, K.F., Goodson, A.M., Tahim, A.S.,

Emergency Department 90

Emergency Department Ultrasounds 90

Dr. Smith's ECG Blog

APRIL 22, 2024

Bedside ultrasound with no apparent wall motion abnormalities, no pericardial effusion, no right heart strain. Despite description of Wellens’ Syndrome over 40 years ago — this syndrome remains misunderstood by all-to-many clinicians ( See My Comment at the bottom of the page in the August 12, 2022 post in Dr. Smith’s ECG Blog ).

EKG/ECG 118

EKG/ECG Outcomes Ultrasounds Hospitals 118

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., Hennepin Ultrasound has a blog post on how to perform this both statically and dynamically–visualizing the needle as it aspirates the PTA.

Ultrasounds 100

Ultrasounds Wellness Outcomes Hospitals 100

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

EMDocs

JULY 29, 2023

Transoral Ultrasound in the Diagnosis of Obstructive Salivary Gland Pathologies. Ultrasound Med Biol. Emergency Medicine Residents’ Association; 2022. Other bacterial causes include anaerobic oral flora, Strep viridans, E. Rosh Review Website Link Further FOAMed: [link] [link] References: 1. Wilson M, Pandey S. 2004;97(11):1139.

EMS 96

EMS Dehydration Ultrasounds Emergency Department 96