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

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). 2023 Dec 22. Lung ultrasound for the sick child: less harm and more information than a radiograph. 2023 Dec 21. 2023 Dec 19.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 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

Don't Forget the Bubbles

SEPTEMBER 16, 2023

2023 Aug 23:e2023062806. 2023 Aug 23. 2023 Aug 16. 2023 Aug 2. 2023 Aug 10:e2023062307 Rosacea in children: a review. 2023 Aug 9. 2023 Aug 2. 2023 Aug 30:archdischild-2023-325441. 2023 Aug 21. 2023 Aug 25:e2022057627. 2023 Aug 21:113679. 2023 Aug 24:e2022058674.

Pediatrics 75

Pediatrics Ultrasounds Outcomes Hospitals 75

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 72

EMS CPR Ultrasounds Research 72

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.

Outcomes 102

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 102

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 Research 114

PulmCCM

APRIL 1, 2024

Physical therapy is probably under-provided to critically ill patients, and improving this might improve outcomes for many. That could (and should) change if improved functional outcomes, persisting for months after hospital discharge, are ever confirmed in large, well-conducted trials.

Ultrasounds 40

Ultrasounds Operations Outcomes Research 40

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 84

Hyperthermia / Hypothermia Resuscitation CPR EMS 84

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 89

Stroke EMS EKG/ECG Radiology 89

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 55

Ultrasounds Outcomes Wellness Research 55

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 69

EMS Ultrasounds Emergency Department Outcomes 69

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

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 102

Resuscitation Administration Emergency Department Hospitals 102

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

ACEP Now

MAY 9, 2024

These questionable practices led to a rash of bad outcomes. 6 Theoretically, ultrasound guidance should decrease this risk, which formed the basis for the 2022 Florida Medical Board regulation. 7 The impact of this latest set of regulations on the complication rate has yet to be reported. References Garcia SE. Butt Lifts Are Booming.

Emergency Department 52

Emergency Department Operations Ultrasounds Hospitals 52

Don't Forget the Bubbles

FEBRUARY 5, 2024

Their main outcome measure was the proportion of pictures inconsistent with current safety recommendations. 2024 Jan 12:archdischild-2023-326225. 2024 Jan 23:archdischild-2023-325984. Are sucking patterns and early spontaneous movements related to later developmental functioning outcomes? Anagnostou A, et al. 2024 Jan 13.

Pediatrics 52

Pediatrics Research Resuscitation Outcomes 52

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

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

Taming the SRU

MAY 22, 2023

Certain injuries carry risks of further injury, injury-related complications, and poor outcomes which are exacerbated if they are inappropriately managed in the ED. Point-of-care ultrasound (POCUS) can evaluate for Achilles tendon rupture with a high sensitivity (96-100%) and specificity (83-100%) [8,9]. Accessed March 5, 2023.

Fractures 75

Fractures Dislocations Operations Radiology 75

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

SEPTEMBER 8, 2023

Updated 2023 Apr 7]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Prognosis of acute severe autoimmune hepatitis (as-AIH): The role of corticosteroids in modifying outcome.” Diagnostic accuracy of Doppler ultrasound, CT and MRI in Budd Chiari Syndrome: Systematic Review and meta-analysis.” “Acute liver failure.”

Radiology 59

Radiology Radiology Ultrasounds EMS 59

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 89

Shock Seizures Airway Management Documentation/Coding 89

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 121

EKG/ECG Documentation/Coding Emergency Department Outcomes 121

ACEP Now

NOVEMBER 16, 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. Accessed October 9, 2023.

Academics 52

Academics EMS Research Telemedicine 52

Stop and Think

MARCH 1, 2023

Then, in residency, in our outpatient clinics, consensus held that we should use hormone replacement therapy in post-menopausal women to reduce cardiac outcomes. The core problem we have in 2023 is that we have made so many gains that true progress is quite hard. The number needed to kill patients with this practice was 29.

Ultrasounds 52

Ultrasounds Outcomes 52

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 133

EKG/ECG Resuscitation CPR Emergency Department 133

ACEP Now

JULY 7, 2024

1,3 Temporizing measures are not always possible for critically ill Grade IV patients, and outcomes are usually much worse. Published 2023 Apr 17. Diltiazem, nicardipine, and nitroprusside should be considered as adjuncts. Endovascular therapy for patients with heritable thoracic aortic disease. Ann Cardiothorac Surg. 2022;11(1):31-36.

Operations 59

Operations Hospitals Administration Outcomes 59

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 94

Fractures COPD Hospitals Emergency Department 94

Taming the SRU

FEBRUARY 19, 2024

This has been the central question of many research projects with variable outcomes. 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.,

Shock 59

Shock Resuscitation Ultrasounds Research 59

Taming the SRU

MAY 5, 2023

The CLASSIC trial is a randomized controlled trial conducted in the ICU setting which compared restrictive versus standard fluid strategies with a primary outcome of death by 90 days in patients with septic shock. Safety outcomes Serious adverse event occurrences were similar in both groups. versus 59.2%). versus 14.9% Jarczak, D.,

Sepsis 52

Sepsis Shock Administration Resuscitation 52

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 Outcomes 52

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 122

Ultrasounds Outcomes COPD Hospitals 122

Don't Forget the Bubbles

JULY 17, 2023

Reviews and opinion articles Point-of-care ultrasound in pediatric nephrology. 2023 Jun;38(6):1733-1751. 2023 May 16;28(3):172-183. 2023 Jun 6;28(4):205-251. 2023 Jun 6;28(4):252-266. 2023 Jun 1;177(6):559-560. 2023 Jun;182(6):2785-2792. 2023 May 16;28(3):184-202. 2023 Jun 15.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

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 107

PPE Ultrasounds Resuscitation Administration 107

Dr. Smith's ECG Blog

NOVEMBER 15, 2023

The problem is difficult to study because angiographic visualization of arteries is not perfect, and not all angiograms employ intravascular ultrasound (IVUS) to assess for unseen plaque or for plaque whose rupture and ulceration cannot be seen on angiogram. Thus, intracoronary imaging modalities are crucial in this setting. References: 1.

EKG/ECG 103

EKG/ECG Ultrasounds Wellness Stroke 103

EMDocs

JANUARY 11, 2024

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association (AHA) and Neurocritical Care Society (NCS) released their 2023 Scientific Statement on the critical care management of post ROSC patients. 2023 Dec 1. Neurocrit Care. doi: 10.1007/s12028-023-01871-6. Epub ahead of print.

Seizures 75

Seizures Shock Infectious Diseases CPR 75