PulmCCM

NOVEMBER 17, 2023

Kenny MD [ @heart_lung ] In part 1 , right atrial pressure [P ra ] and cardiac output/venous return [CO/VR] were considered as two hemodynamic measures bound at the operating point [OP] of the circulatory system. OP is operating point. Shows what happens when Ppc, Pmsf, Rcardiac and Rvr all vary [grey operating points].

Operations 129

Operations Ultrasounds Resuscitation Blood Transfusions 129

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 130

Ultrasounds Outcomes COPD Hospitals 130

Pediatric EM Morsels

JUNE 30, 2023

I know we already know this, but it especially true when you are talking about trying to obtain images on a wiggling fetus somewhere around the size of a banana.

Ultrasounds 281

Ultrasounds Pediatrics Operations EMS 281

Greater Sydney Area HEMS

FEBRUARY 20, 2024

The evidence for improved safety and quality with the use of ultrasound for CVC implementation is well established [i]. How can this situation be rectified or has the use of ultrasound rendered this blind subclavian “trauma line” a thing of the past? One approach to obtaining BCV origin access (fig.1)

Ultrasounds 98

Ultrasounds Shock Research Operations 98

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

ALiEM

SEPTEMBER 13, 2024

Tonometry and ocular ultrasound (US) are generally not recommended as you could squeeze more liquid out of the eye or increase the intraocular pressure even more, pushing the iris further out. An emergent ophthalmology consult is needed to plan for operative repair. 2023, March 23). Consult ophthalmology emergently. Eye (Lond).

Emergency Department 64

Emergency Department Academics Hospitals Fractures 64

ALiEM

NOVEMBER 27, 2023

g/dL BMP, lipase, Alk phos/Bili/ALT/AST, PT/PTT, and lactate : Unremarkable Serum HCG : Negative Urinalysis (UA) : Unremarkable COVID : Negative Case Question: Can you identify the abnormalities on the right upper quadrant (RUQ) ultrasound image? Diagnosis of Fitz-Hugh-Curtis syndrome by ultrasound. k/uL Hgb : 10.5 PMID: 8405645.

Ultrasounds 64

Ultrasounds Academics Operations OB/GYN 64

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. Date: March 22, 2023 Reference: Hilsden et al. Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions.

Ultrasounds 52

Ultrasounds Emergency Department Dislocations Radiology 52

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?! 2023 Feb 8:S0735-6757(23)00066-9. Epub 2023 Aug 12.

Poisoning 70

Poisoning Dislocations Operations Ultrasounds 70

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., Crit Care 2023, 27(1):205. The ultrasound journal 2020, 12(1):1-12.

Ultrasounds 87

Ultrasounds Operations Shock 87

Pediatric EM Morsels

JUNE 16, 2023

Available at: [link] (Accessed: 12 June 2023). Available at: [link] (Accessed: 12 June 2023). 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

PulmCCM

APRIL 1, 2024

Authors included 130 studies published 2015-2023, “to ensure that included studies were representative of current medical practices, including ultrasonography guidance.” ” But less than half of the included studies used ultrasound guidance during central line placements.

Ultrasounds 40

Ultrasounds Operations Outcomes Research 40

EMDocs

AUGUST 12, 2023

Management consists of intravenous antibiotics , and hand surgery should be consulted to consider operative debridement. Accessed June 24, 2023. Treasure Island (FL): StatPearls Publishing; February 5, 2023. Accessed June 10, 2023. Inoculation usually occurs by penetrating injury , which seeds the tendon sheath.

EMS 69

EMS Fractures Operations Ultrasounds 69

ACEP Now

JUNE 21, 2023

For example, applicant interest in EM significantly declined after the EM workforce report was published resulting in a final count of 132 unfilled programs in 2023. Therefore, applicant, funding, and operational factors may influence programs to offer a particular curriculum length. Advanced Data Tables 2023 Main Residency Match.

EMS 114

EMS Academics Telemedicine Operations 114

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 77

Fractures Dislocations Operations Radiology 77

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. 2023 PMID: 37502742 11 Schwalbach KT et al. Healthcare. 2022 PMID: 35206981 2. Ngo AS, Oh JJ, Chen Y, Yong D, Ong MEH. Resusc Plus.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

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? Article 1: What predicts parental anxiety in the Paediatric Emergency Department?

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

ACEP Now

JULY 7, 2024

2,3 In this case, aortic dissection was visualized neither on initial bedside nor on repeat inpatient TTE, despite operator knowledge of a known lesion and extensive operator training. Her orthopedic injury was managed non-operatively until her aortic repair could be performed. Published 2023 Apr 17. Click to enlarge.)

Operations 59

Operations Hospitals Administration Outcomes 59

Taming the SRU

NOVEMBER 3, 2023

Ultrasound‐Guided Serratus Anterior Plane Block (SAPB) Improves Pain Control in Patients With Rib Fractures. Ultrasound Med. 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. 11/3/2023 41, 2695–2701 (2022).

Fractures 98

Fractures Ultrasounds Outcomes Research 98

Taming the SRU

MAY 27, 2024

Ultrasound in recent years has become a very helpful tool in diagnosing smaller effusions, and is noted to be almost 100% sensitive for effusions > 100 mL (2). This often is seen in trauma, cancer, post-operatively, and end-stage metabolic conditions with excessive colloid or protein leak.

Emergency Department 86

Emergency Department Ultrasounds Radiology Radiology 86

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. Accessed April 21, 2023. UpToDate; 2023. Pediatr Radiol.

EMS 69

EMS Ultrasounds Emergency Department Outcomes 69

Dr. Smith's ECG Blog

NOVEMBER 17, 2024

The operator performed intravascular ultrasound and visualized acute plaque rupture with thrombus formation and placed a stent. As per My Comment in the June 30, 2023 post ( in which I review the 9 Criteria derived over the years by Drs. (It's the opposite of this case.) Fortunately, the patient underwent immediate angiography.

EKG/ECG 72

EKG/ECG Operations Ultrasounds Wellness 72

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. Community Eye Health.

Operations 52

Operations Emergency Department Ultrasounds 52

Don't Forget the Bubbles

OCTOBER 14, 2024

Nearly 50,000 undocumented migrants and asylum seekers have arrived in Greece by land or sea since September 2023 , mainly across the Evros land border and the Greek islands. In 2023, MVI conducted 2994 consultations, of which 16% were children. In 2023, 67,337 applications for asylum were recorded in the UK.

Documentation/Coding 59

Documentation/Coding Hospitals Wellness Operations 59

EMDocs

SEPTEMBER 9, 2023

Accessed June 24, 2023. Accessed June 8, 2023. Accessed June 6, 2023. The value of ultrasound for detecting hand fractures: A meta-analysis. Accessed June 7, 2023. Results of primary extensor tendon repair in relation to the zone of injury and pre-operative outcome estimation. Accessed June 9, 2023.

EMS 78

EMS Fractures Soft Tissue Injuries Ultrasounds 78

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 59

Ultrasounds Outcomes Wellness Research 59

RebelEM

JUNE 19, 2023

Patients were actively screened for DVT (all received lower extremity ultrasound on or around day 7). We should expect TXA to help in immediate stabilization and allow trauma teams the time to intervene (whether that be continued resuscitation, interventional or operative procedures). Prehospital Tranexamic Acid for Severe Trauma.

Outcomes 105

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 105

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. Kim, Y.B.,

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

ACEP Now

OCTOBER 15, 2023

Flexible laryngoscopy, CT scan, direct laryngoscopy under general anesthesia, esophagoscopy, ultrasound, or chest X-ray may all be requested by the surgical consultant. She was transported to the operating suite where a tracheostomy was performed. Treasure Island, FL: StatPearls Publishing 2023. Accessed September 16, 2023.

Fractures 52

Fractures Dislocations Airway Management Operations 52

ACEP Now

SEPTEMBER 3, 2024

6,17-18 In a 2023 systematic review, no studies showed decreased costs to patients or payors, and the effect of PE ownership on quality of care measures was “mixed to harmful,” a pattern that has continued in subsequent studies. While secrecy surrounds the operations of many PE-owned groups, Envision serves as a case study.

Hospitals 69

Hospitals Radiology Radiology Administration 69

Mind The Bleep

JANUARY 19, 2024

due to haemorrhage/ dense cataract), then a B scan (ultrasound of the eye) will be performed for better visualisation of the retina. Patients will be advised to posture in a particular position pre-operatively to reduce the risk further progression. (1) If there is a poor view to the retina (i.e Ninth Edition. Elsevier Limited ; 2020.

Operations 52

Operations Ultrasounds 52

ACEP Now

NOVEMBER 16, 2023

Therefore, applicant, funding, and operational factors may influence programs to offer a particular curriculum length. ultrasound and resuscitation procedures) may become a new standard for programs and require a longer training period. Accessed October 9, 2023. government. Association of American Medical Colleges website.

Academics 52

Academics EMS Telemedicine Research 52

Taming the SRU

AUGUST 30, 2023

Specific Evidence: Septic arthritis: According to the European Journal of Bone and Joint Infection’s 2023 guidelines for septic arthritis of native joints (SANJO), no blood tests have adequate sensitivity or specificity to either diagnose or exclude SANJO. 2023 Feb 2;388(5):439-452. Updated 2023 Apr 24]. 2023 Jul 10.

Infectious Diseases 88

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 88

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). A DDENDUM ( 12/19/2023 ) : By way of review — I've excerpted the following material regarding T-QRS-D and MINOCA.

EKG/ECG 118

EKG/ECG EMS Wellness Operations 118

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. 2/19/2023 REFERENCES Sharman, J.E., 2/19/2023 REFERENCES Sharman, J.E., J Hum Hypertens 37, 93–100 (2023).

Shock 59

Shock Resuscitation Ultrasounds Research 59

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. 2023 Jan 1;53(1):140-2. 2022; 06/26/2023. 2023 Jun 1;36:89-91. This month in JAAD Case Reports: August 2023: Xylazine and skin necrosis.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64