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. Indian J Surg.

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Ultrasounds Sepsis Radiology Radiology 78

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.

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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.

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Ultrasounds Emergency Department EMS 96

ACEP Now

MAY 9, 2024

6 The increasing mortality rate led to an additional emergency regulation in 2022 requiring the consenting physician to perform the critical steps of the case, limiting surgeons to three cases per day, and mandating continuous, recorded ultrasound guidance for gluteal AFT procedures. units per patient.

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Emergency Department Operations Ultrasounds Shock 52

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. Emerg Med J. doi: 10.1136/emermed-2023-213285. Ann Emerg Med.

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PPE Ultrasounds Resuscitation Administration 96

ALiEM

APRIL 14, 2023

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Social Media Index, the ALiEM AIR Team is proud to present the highest quality online content related to related to procedures in the Emergency Department. More specifically, we identified 2 AIR and 4 Honorable Mentions.

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EMS Ultrasounds Academics Fractures 98

ACEP Now

FEBRUARY 11, 2024

1,2 In the emergency department (ED), the focus of treatment is pain control and immobilization unless there is a clear indication for surgery, such as open fractures, skin tenting, or neurovascular compromise. The ultrasound-guided clavipectoral plane block (CPB) is a newly described technique in the emergency medicine literature.

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Ultrasounds Fractures Emergency Department Hospitals 52

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%

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Ultrasounds Emergency Department Pediatrics Radiology 93

ACEP Now

AUGUST 22, 2023

Regardless of the domain, somewhere an expert panel has convened to issue a pronouncement informing all of the ideal care of patients under their specialty umbrella, indirectly extending to their care in the emergency department. 2-4 A fourth is planned for publication in late 2023, and will address non-opioid substance dependence.

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Emergency Department Academics Critical Access Research 98

Broome Docs

APRIL 6, 2023

2023 Jan 21. Clinical risk factors for testicular torsion and a warning against falsely reassuring ultrasound scans: a 10-year single-centre experience. Am J Emerg Med. 2023 Feb;64:206.e1-206.e3. 2023 Jan 30. A prospective cluster-randomized trial to implement the Canadian CT Head Rule in emergency departments.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

Don't Forget the Bubbles

NOVEMBER 13, 2023

Should we use ultrasound to diagnose distal forearm fractures in children and adolescents? X-ray (radiography) is the standard imaging technique used in emergency departments. However, ultrasound is gaining popularity due to its portability, affordability, and lack of ionising radiation. 2023 Jun 1;388(22):2049-2057.

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Fractures Ultrasounds Emergency Department Pediatrics 64

ALiEM

OCTOBER 23, 2023

A 32-year-old man with a history of traumatic globe rupture from a stab wound two months ago, status post repair, presented to the emergency department for worsening right eye pain and green malodorous drainage for the past three days. On ultrasound, it appears as a heterogeneous isoechoic collection that abuts the right globe.

Academics 111

Academics Emergency Department Ultrasounds Wellness 111

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]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Accessed April 6, 2023.

Emergency Department 98

Emergency Department Ultrasounds Wellness EMS 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. 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.

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Resuscitation Administration Emergency Department Ultrasounds 105

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.

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EKG/ECG Documentation/Coding Emergency Department Outcomes 122

ALiEM

AUGUST 26, 2024

A 27-year-old male with no past medical history presents to the Emergency Department with right eye pain. A vitreous hemorrhage OD was also identified on bedside ultrasound. Iridodialysis Traumatic iridodialysis is an uncommon ocular emergency with very distinct findings that we can encounter in the Emergency Department.

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Emergency Department Academics Ultrasounds 70

Emergency Medicine Journal

SEPTEMBER 25, 2024

Background Ultrasound-guided (USG) erector-spinae plane block (ESPB) may be better than intravenous opioids in treating acute hepatopancreaticobiliary (HPB) pain in the ED. Methods This open-label randomised controlled trial was conducted in the ED of a tertiary-care hospital between March and August 2023.

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Ultrasounds Emergency Department Hospitals 52

ALiEM

SEPTEMBER 13, 2024

A 32-year-old male with no significant past medical history presented to the emergency department (ED) from an outside hospital for further management of right eye pain and vision loss sustained after he was struck by a metal wire while at work. An emergent ophthalmology consult is needed to plan for operative repair.

Emergency Department 64

Emergency Department Academics Fractures Hospitals 64

ALiEM

FEBRUARY 2, 2024

Laboratory Data Ultrasound reveals a 1.7 Because of the concern for malignancy, a biopsy was performed in the emergency department after the ultrasound and CT scan confirmed there was no extension into the thorax. It is soft with some slight nodularity on palpation, and only mild tenderness noted. There is no fluctuance.

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Ultrasounds Academics Emergency Department 67

The Skeptics' Guide to EM

MARCH 25, 2023

Date: March 22, 2023 Reference: Hilsden et al. Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Casey […] The post SGEM#398: Another Ab Gets BUSED – POCUS in the ED for Biliary Disease first appeared on The Skeptics Guide to Emergency Medicine.

Ultrasounds 52

Ultrasounds Emergency Department Dislocations Radiology 52

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 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

ALiEM

AUGUST 30, 2024

A 5-year-old female presented to the emergency department (ED) with a one-year history of gradually increasing anterior neck swelling. NG/DL) Ultrasound of the neck revealed an enlarged thyroid gland with lobular contours and diffuse hypoechoic echogenicity, without noticeable nodules, fluid collection, or lymphadenopathy.

Pediatrics 64

Pediatrics Ultrasounds Academics Emergency Department 64

ACEP Now

FEBRUARY 13, 2024

A 77-year-old man presented to the emergency department (ED) with hip pain following a fall. In the January issue of Annals of Emergency Medicine , Merz-Herrara, et al., published a study, “Safety and Pain Reduction in Emergency Practitioner Ultrasound-Guided Nerve Blocks: A One-Year Retrospective Study.”

Ultrasounds 52

Ultrasounds Emergency Department Hospitals Wellness 52

EMDocs

NOVEMBER 4, 2023

An ultrasound of the testes reveals the following: What is the diagnosis? Accessed April 26, 2023. aureus infections among patients in the emergency department. Skin and Soft Tissue Infections in the Emergency Department. Emerg Med Clin North Am. Accessed May 2, 2023. Ann Emerg Med.

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EMS Ultrasounds Emergency Department Infectious Diseases 80

Dr. Smith's ECG Blog

SEPTEMBER 3, 2023

This was sent by anonymous The patient is a 55-year-old male who presented to the emergency department after approximately 3 to 4 days of intermittent central boring chest pain initially responsive to nitroglycerin, but is now more constant and not responsive to nitroglycerin. It is unknown when this pain recurred and became constant.

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EKG/ECG Resuscitation CPR Emergency Department 138

EMDocs

JULY 29, 2023

A 75-year-old male with past history of HTN, CVA, DM II presents to the emergency department with right facial swelling since last night. Transoral Ultrasound in the Diagnosis of Obstructive Salivary Gland Pathologies. Ultrasound Med Biol. WikEM, The Global Emergency Medicine Wiki. Accessed March 27, 2023.

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Taming the SRU

JANUARY 10, 2024

89% agree that violence in the emergency department has harmed patient care. None of the physicians in the study believe that the rate of violence has decreased at all. Current bills in progress: US H.R.2663 2663 & S.1176 1176 focuses on violence prevention (introduced for the 3rd time 4/18/23); US H.R.2584 2584 & S.2768

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EKG/ECG Shock Fractures Emergency Department 93

PulmCCM

JULY 3, 2023

emergency departments and ICUs were randomized to undergo either DL or VL for intubation. More than 90% of the intubations were performed by emergency medicine residents (~70%) or critical care fellows (~23%). (Who Most studies have been small, single center, and only some have favored video.

Airway Management 105

Airway Management Outcomes Hospitals Emergency Department 105

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. Accessed March 5, 2023.

Fractures 77

Fractures Dislocations Operations Radiology 77

The Skeptics' Guide to EM

JANUARY 14, 2023

Date: January 13, 2023 Reference: Razi et al. first appeared on The Skeptics Guide to Emergency Medicine. Date: January 13, 2023 Reference: Razi et al. Case: A 38-year-old female presents to the emergency department (ED) with a five-hour history of acute onset left flank pain.

Emergency Department 52

Emergency Department Ultrasounds 52

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Rib fractures account for over 15% of all trauma attendances in the Emergency Department. ED Physicians are already well-versed in the use of ultrasound. Our study demonstrates that ED Physicians can safely administer early SAPB and ESP to patients with multiple rib fractures within the Emergency Department.

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Fractures Anaphylaxis Emergency Department Ultrasounds 40

Don't Forget the Bubbles

SEPTEMBER 5, 2024

Am J Emerg Med. In the emergency department resuscitation room, weight is usually estimated using an age-based formula until the child is stabilised and can be safely weighed. doi: 10.1136/archdischild-2023-326407. 2023 Aug 23;11:1225087. 2023 Aug;108(8):632-639. doi: 10.1136/archdischild-2023-325343.

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Ultrasounds Research Emergency Department Outcomes 52

ACEP Now

SEPTEMBER 13, 2023

But what if we could measure a patient’s spleen via ultrasound in the emergency department (ED) to guide specific patient care? Practitioners have looked at splenic size on ultrasound and its association with splenic dysfunction. Acad Emerg Med. US Department of Health and Human Services. Am J Roentgenol.

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Pediatrics Ultrasounds Emergency Department Poisoning 40

Taming the SRU

DECEMBER 18, 2023

In the setting of a patient with acute urinary retention and inability to pass a transurethral catheter at an institution without urology or IR, the EM physician can perform this procedure, preferably under ultrasound guidance. (14) Treasure Island, FL: StatPearls Publishing; 2023. The western journal of emergency medicine.

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Emergency Nursing EMS Emergency Department Ultrasounds 77

Don't Forget the Bubbles

FEBRUARY 5, 2024

2024 Jan 12:archdischild-2023-326225. 2024 Jan 23:archdischild-2023-325984. 2024 Jan 11:fetalneonatal-2023-325829. 2024 Jan 11:fetalneonatal-2023-326383. Assessing fluid responsiveness with ultrasound in the neonatal intensive care setting: the mini-fluid challenge. 2024 Jan 17:fetalneonatal-2023-326099.

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Pediatrics Research Resuscitation Psychiatric 52

EMDocs

FEBRUARY 26, 2024

Case study, Radiopaedia.org (Accessed on 07 Dec 2023) [link] Laboratory Tests Cultures are infrequently employed in the diagnosis of PJP due to the challenges associated with growing the fungus. Lung Ultrasound Effectively Detects HIV-Associated Interstitial Pulmonary Disease. Image credit: Amini B, Pneumocystis carinii pneumonia.

Radiology 100

Radiology Radiology Outcomes Ultrasounds 100

Dr. Smith's ECG Blog

JANUARY 15, 2024

Colin is an emergency medicine resident beginning his critical care fellowship in the summer with a strong interest in the role of ECG in critical care and OMI. A patient in their 40s with type 1 diabetes mellitus and hyperlipidemia presented to the emergency department with 5 days of “flu-like” illness. Edits by Willy Frick.

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EKG/ECG Wellness Point-of-Care Testing Shock 66