Don't Forget the Bubbles

MAY 17, 2023

2023 Apr 17. 2023 Apr 25;329(16):1386-1398. 2023 Apr 29. 2023 Apr 24. 2023 Apr 12. 2023 Apr 28. 2023 Apr 25. 2023 Apr 25. 2023 Apr 25. Minor head trauma in infants – how accurate is cranial ultrasound performed by trained radiologists? 2023 Apr 24. 2023 Apr 24.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

PulmCCM

SEPTEMBER 4, 2024

Kenny MD [ @heart_lung ] Since its first description [1], the Venous Excess Ultrasound Score [VExUS] has received much research attention. Subsequently in the late 1970s, Sivaciyan and Ranganathan [9] confirmed these findings with Doppler ultrasound of the IJV. The ultrasound journal 12: 1-12 2. Jon-Emile S. Echocardiography 7.

Ultrasounds 84

Ultrasounds Operations Research Outcomes 84

RebelEM

JUNE 26, 2023

Interventions such as early application of hemorrhage control, tranexamic acid, reduction of crystalloid fluid administration and balanced ratio blood product transfusion have improved many patients’ outcomes. However, mortality still remains high due to trauma-induced coagulopathy. Severe acute traumatic coagulopathy = PT >1.5

Administration 145

Administration Outcomes Resuscitation Radiology 145

RebelEM

JANUARY 29, 2024

Clin Exp Emerg Med 2023. REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE? Click here for Direct Download of the Podcast Paper: Aykan AC et al. Reduced-Dose Systemic Fibrinolysis in Massive Pulmonary Embolism: A Pilot Study. in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7%

Stroke 136

Stroke Outcomes Hospitals Administration 136

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. 2023 Feb;64:206.e1-206.e3. 2023 Jan 30. Clinical Outcomes After Intensifying Antihypertensive Medication Regimens Among Older Adults at Hospital Discharge.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 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. doi: 10.1136/emermed-2023-213285. 2023 Sep 21:ciad571.

PPE 96

PPE Ultrasounds Resuscitation Emergency Department 96

ALiEM

OCTOBER 30, 2024

Clinical impact: The patient’s DVT ultrasounds were negative. 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. 2023 Aug 1;89(2):231. 2023 [book]. 2023 Jun 1;36:113-5. 2023 Aug 1;89(2):e99-102.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

The Skeptics' Guide to EM

JULY 22, 2023

Date: July 21, 2023 Reference: Prekker et al. NEJM 2023 Guest Skeptic: Dr. Jeff Jarvis is the Chief Medical Officer and System Medical Director for the Metropolitan Area EMS Authority in Fort Worth, Texas, also known as MedStar. Date: July 21, 2023 Reference: Prekker et al.

EMS 98

EMS CPR Ultrasounds Research 98

ACEP Now

JUNE 21, 2023

The lack of differences in the observed outcomes do not suggest one EM training length is superior. The additional year may improve career trajectory or longevity, entrance into fellowship or academic practice, or other longer-term outcomes including successful development of a niche in the specialty. 11 What should we take away?

EMS 114

EMS Academics Telemedicine Operations 114

Broome Docs

JANUARY 30, 2023

Covered or uncovered: A randomized control trial of Tegaderm versus no Tegaderm for ocular ultrasound. Association of Chest Pain Protocol-Discordant Discharge With Outcomes Among Emergency Department Patients With Modest Elevations of High-Sensitivity Troponin. Does wound eversion improve cosmetic outcome?: Am J Emerg Med.

Emergency Department 52

Emergency Department Outcomes Ultrasounds Pediatrics 52

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 109

Hyperthermia / Hypothermia Resuscitation CPR EMS 109

RebelEM

JUNE 19, 2023

PMID: 37314244 Clinical Question: In advanced trauma systems, does prehospital administration of TXA increase the rate of survival with a favorable neurologic outcome in patients at risk for trauma-induced coagulopathy? 1.00 (0.9 – 1.12) Secondary Outcome Mortality 24h 9.7% Prehospital Tranexamic Acid for Severe Trauma.

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

EMDocs

MAY 11, 2024

Reference article, Radiopaedia.org (Accessed on 28 Aug 2023) [link] Ortiz de Mendivil A, Alcalá-Galiano A, et al. Semin Ultrasound CT MR. 2013 Apr;34(2):131-41. Updated 2023 Jun 24]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Updated November 9, 2023. Accessed November 19, 2023. 2013.01.004.

Stroke 110

Stroke EMS EKG/ECG Radiology 110

Taming the SRU

NOVEMBER 3, 2023

Ultrasound‐Guided Serratus Anterior Plane Block (SAPB) Improves Pain Control in Patients With Rib Fractures. Ultrasound Med. The primary outcome in this study was a change in pain score at rest 60 minutes after block. 11/3/2023 41, 2695–2701 (2022). Serratus Anterior Plane Blocks for Rib Fractures in the ED.

Fractures 98

Fractures Ultrasounds Research Outcomes 98

Don't Forget the Bubbles

NOVEMBER 13, 2023

Should we use ultrasound to diagnose distal forearm fractures in children and adolescents? However, ultrasound is gaining popularity due to its portability, affordability, and lack of ionising radiation. However, ultrasound is gaining popularity due to its portability, affordability, and lack of ionising radiation. N Engl J Med.

Fractures 64

Fractures Ultrasounds Emergency Department Pediatrics 64

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? Accessed April 21, 2023. UpToDate; 2023. Accessed May 7, 2023 5) Oh SY, Lee JM, Lee H, et al. LFTs are in the thousands.

EMS 95

EMS Ultrasounds Emergency Department Outcomes 95

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. This study also showed the median time for IO placement was only 1.2 minutes CVC group.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

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. 2023 Nov; doi:10.1016/j.annemergmed.2023.10.008

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

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

PulmCCM

JUNE 26, 2023

They announced this at the American Thoracic Society meeting in May 2023. No outcomes regarding the delirium itself were reported (i.e., Private equity-backed firms are buying and expanding physician practices and squeezing them for profit, with little regard for patient outcomes, professional standards, or ethics.

Outcomes 98

Outcomes Ultrasounds Hospitals Wellness 98

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

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. Outcomes: Primary: Percent change in management decisions after introducing the Radiology Department RUQ US. 2022;7(1):e000944.

Ultrasounds 68

Ultrasounds Radiology Radiology Emergency Department 68

ALiEM

JANUARY 29, 2024

Case Question: What treatments can you perform in the ED for this diagnosis and do they improve outcomes? Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine vol. This has the potential to expedite consultations with specialty teams and treatment. 39,1 (2020): 197-202.

Stroke 64

Stroke Ultrasounds Academics Outcomes 64

Mount Sinai EM

OCTOBER 11, 2024

2023) of 17 studies with 812 patients (all cohort studies aside from one small RCT), intraoral US was 91% sensitive and 75% specific for PTA, while transcervical US was 80% sensitive and 81% specific. There was significant heterogeneity among studies and outcomes were not measured consistently.

Ultrasounds 100

Ultrasounds Wellness Outcomes Hospitals 100

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

Dr. Smith's ECG Blog

SEPTEMBER 3, 2023

I sent it to 5 of my OMI friends without any clinical information or outcome and all 5 independently responded with exactly the same diagnosis: "reperfused inferior OMI". That is what Emergency Medicine is all about. == MY Comment , by K EN G RAUER, MD ( 9/3 /2023 ): == I’ve seen a “common theme” with many of the ECGs that Drs.

EKG/ECG 135

EKG/ECG Resuscitation CPR Emergency Department 135

Don't Forget the Bubbles

MAY 8, 2024

An interesting study (JAMA Pediatrics) shows the benefits of newborn screening for spinal muscular atrophy (SMA), as initiating disease-modifying therapy earlier improves clinical outcomes. These findings advocate for expanding newborn screening programs to enhance outcomes for children with SMA. 2024 Apr 25:archdischild-2023-326533.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

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% N Engl J Med. later adjusted to INR > 3.0)

Ultrasounds 58

Ultrasounds Outcomes Wellness Research 58

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. have published a number of warnings about the previous reassuring studies.[4,5]

EKG/ECG 119

EKG/ECG Documentation/Coding Emergency Department Outcomes 119

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

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. 2022 Jul 11;11(14):2163. doi: 10.3390/cells11142163.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

Taming the SRU

JUNE 3, 2024

CESAR Trial Published in 2009 Found that even those who didn’t get ECMO, but were transported to a tertiary care center had better outcomes No matter where you go, critical care transport will be part of your life as a sending physician, receiving physician, or both.

Shock 91

Shock Seizures Airway Management Stroke 91

Don't Forget the Bubbles

SEPTEMBER 5, 2024

doi: 10.1136/archdischild-2023-326407. Obesity is considered a contributing factor for some musculoskeletal outcomes. The main outcome measure was a GP consultation with a recorded musculoskeletal symptom or diagnosis. 2023 Aug 23;11:1225087. 2023 Aug;108(8):632-639. doi: 10.1136/archdischild-2023-325343.

Ultrasounds 52

Ultrasounds Research Emergency Department Outcomes 52

Taming the SRU

JANUARY 10, 2024

2768 aka the SAVE act (introduced for the 3rd time 9/12/2023) which establishes a new criminal offense for knowingly assaulting or intimidating hospital personnel during the performance of their official duties in a manner that interferes with their performance of the duties or limits their ability to perform the duties. 2663 & S.1176

EKG/ECG 93

EKG/ECG Shock Fractures Dislocations 93

EMDocs

FEBRUARY 26, 2024

4 Early diagnosis is key to allow for early treatment to improve outcomes. 15 Diagnostic considerations Timely diagnosis of PJP is absolutely essential for effective management and improved disease outcomes. Lung Ultrasound Effectively Detects HIV-Associated Interstitial Pulmonary Disease. A recent study by Gaborit et al.

Radiology 110

Radiology Radiology Outcomes Ultrasounds 110

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]. Accuracy of Ultrasound in Diagnosis of Pneumothorax: A Comparison between Neonates and Adults-A Systematic Review and Meta-Analysis. Published 2020 Jul 23.

Fractures 96

Fractures COPD Hospitals Emergency Department 96

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. One-year outcomes following surgery for necrotising enterocolitis: a UK-wide cohort study. In: StatPearls [Internet].

Sepsis 52

Sepsis Ultrasounds Radiology Radiology 52