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

ACEP Now

FEBRUARY 13, 2024

See below: Fascia iliaca Serratus anterior Erector spinae The risks of opioid medications, especially in the elderly, has been well described. published a study, “Safety and Pain Reduction in Emergency Practitioner Ultrasound-Guided Nerve Blocks: A One-Year Retrospective Study.” 2023 Sep 2;15(9):e44583. mean) to 2.8

Ultrasounds 52

Ultrasounds Emergency Department Hospitals Wellness 52

Taming the SRU

APRIL 14, 2024

You may place cold packs or ice packs to the hernia site to help reduce inflammation and swelling, as well as to assist in local analgesia. Symptoms include persistent tenderness in the area, as well as symptoms of obstruction including nausea, vomiting, and pain, despite reduction. (2) 1) In a study performed by Chen et al.

Ultrasounds 91

Ultrasounds Emergency Department Pediatrics Radiology 91

EMDocs

DECEMBER 4, 2023

The facility does not have ultrasound (US) availability at the time of the patient’s presentation, as the sonographer comes to the hospital only 2 days a week. First, examine the patient and risk-stratify them for the diagnosis of DVT before deciding on the clinical utility of an ultrasound. What findings make a DVT more likely?

Ultrasounds 71

Ultrasounds Documentation/Coding Wellness EMS 71

ALiEM

OCTOBER 23, 2023

There was a well-healed scar on the bottom eyelid. On ultrasound, it appears as a heterogeneous isoechoic collection that abuts the right globe. The hyperdense foreign body is again seen on CT, as well as a small focus of air within the anterior chamber. The lateral canthus appeared inferiorly displaced.

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

ALiEM

SEPTEMBER 29, 2023

Additional Images Physical Exam General : Well-appearing male in no distress Neck : Hemostatic wound to his left neck. Copyright Images and cases from the Society of Academic Emergency Medicine (SAEM) Clinical Images Exhibit at the 2023 SAEM Annual Meeting | Copyrighted by SAEM 2023 – all rights reserved.

Radiology 70

Radiology Radiology Academics Ultrasounds 70

EMDocs

AUGUST 12, 2023

He presented to the emergency department because he is having numbness distal to the site of injury, as well as constant bleeding and some difficulty with flexing his finger. Accessed June 24, 2023. Treasure Island (FL): StatPearls Publishing; February 5, 2023. Accessed June 10, 2023. The Atlas of Emergency Medicine, 5e.

EMS 69

EMS Fractures Operations Ultrasounds 69

Medagadget

JUNE 8, 2023

However, the esophagus lies pretty close as well, often just a couple of millimeters away. How to safely protect the esophagus has been a well-recognized problem for at least 15 years,” said Daoud. See a video about the technology: The study was presented at the Heart Rhythm Society’s 2023 meeting.

Research 73

Research Patient Safety Ultrasounds Wellness 73

PulmCCM

APRIL 1, 2024

That could (and should) change if improved functional outcomes, persisting for months after hospital discharge, are ever confirmed in large, well-conducted trials. Authors included 130 studies published 2015-2023, “to ensure that included studies were representative of current medical practices, including ultrasonography guidance.”

Ultrasounds 40

Ultrasounds Operations Outcomes Research 40

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 55

Ultrasounds Outcomes Wellness Research 55

RebelEM

APRIL 29, 2024

CVC vs PIV The critically ill patient is often associated with pathology that makes IV access difficult such as shock state, hypovolemia, obesity, IV drug abuse, end-stage renal disease, cardiac arrest, as well as other conditions. World J Emerg Surg 2023 PMID: 36918947 3. 2023 PMID: 37502742 11 Schwalbach KT et al. Healthcare.

Resuscitation 102

Resuscitation Administration Emergency Department Hospitals 102

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 Emergency Department Radiology 70

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. Rosh Review Website Link References Park CW, Juliano ML, Woodhall D. Tendon Lacerations. In: Knoop KJ, Stack LB, Storrow AB, Thurman R. Dec 21, 2022.

EMS 78

EMS Fractures Soft Tissue Injuries Ultrasounds 78

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. 1-3 As many as 25% of acute PE cases present as sudden cardiac death.

Ultrasounds 82

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 82

PulmCCM

JUNE 26, 2023

They announced this at the American Thoracic Society meeting in May 2023. Cervical and pancreatic cancer patients often do as well with less invasive surgery, and some patients with rectal cancer or Hodgkin lymphoma can safely get less radiation. An expert panel broadened the definition of acute respiratory distress syndrome (ARDS).

Outcomes 98

Outcomes Ultrasounds Hospitals Wellness 98

Dr. Smith's ECG Blog

JUNE 17, 2024

There are well preserved R-waves in Wellens waves. Cardiac Ultrasound may be a surprisingly easy way to help make the diagnosis Answer: pulmonary embolism. Now another, with ultrasound. I refer to My Comment in the March 4, 2023 post — in which I included a Table with ECG Findings of Acute PE. What is the Diagnosis?

EKG/ECG 139

EKG/ECG Emergency Department Shock Ultrasounds 139

Taming the SRU

MAY 22, 2023

Use your exam to guide your initial management as well as your imaging decisions and differential diagnosis. 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. Updated 2023 Apr 22]. Updated 2023 Feb 26].

Fractures 75

Fractures Dislocations Operations Radiology 75

Dr. Smith's ECG Blog

JANUARY 15, 2024

A bedside ultrasound should be done to assess volume and other etiologies of tachycardia, but if no cause of type 2 MI is found, the cath lab should be activated NOW. While awaiting transfer to the cath lab, STAT echocardiogram was performed and showed LVEF 30-35%, as well as anterior, inferior, and apical hypokinesis, and apical thrombus.

EKG/ECG 67

EKG/ECG Wellness Point-of-Care Testing Shock 67

ACEP Now

AUGUST 22, 2023

2-4 A fourth is planned for publication in late 2023, and will address non-opioid substance dependence. While “low-risk” chest pain is more easily described using scoring systems, undifferentiated abdominal pain is less well-defined. Accessed July 14, 2023. 1 To date, there have been three GRACE publications. About SAEM.

Emergency Department 98

Emergency Department Academics Critical Access Research 98

EMDocs

JULY 29, 2023

Transoral Ultrasound in the Diagnosis of Obstructive Salivary Gland Pathologies. Ultrasound Med Biol. Accessed March 27, 2023. Accessed on April 11, 2023. Other bacterial causes include anaerobic oral flora, Strep viridans, E. Other bacterial causes include anaerobic oral flora, Strep viridans, E. Rev Infect Dis.

EMS 71

EMS Dehydration Ultrasounds Emergency Department 71

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

Dr. Smith's ECG Blog

OCTOBER 1, 2023

You can see that she is not only "looking" at the ST segment, but the majority of the T wave itself, and factoring in the QRS as well (just like expert humans do). Gallbladder ultrasound was negative for stones. Back to the case: Unfortunately, the ECG was not understood by the provider. Chest x-ray was normal.

EKG/ECG 129

EKG/ECG EMS Ultrasounds Wellness 129

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). The patient did well afterward without any recurrence of symptoms. Fortunately, that is exactly what happened.

EKG/ECG 122

EKG/ECG EMS Wellness Operations 122

Dr. Smith's ECG Blog

JANUARY 5, 2024

The proximal LAD has mild disease, but the distal LAD and diagonal branches are not well evaluated in this view. The distal LCx is seen, and the OM is not well visualized here. Smith did not have access to the patient's prior ECG at the time. The LCx has diffuse disease (very lumpy, not smooth) with no severe lesions.

EKG/ECG 109

EKG/ECG Burns Urgent Care Documentation/Coding 109

Dr. Smith's ECG Blog

NOVEMBER 17, 2023

What I had not told him before he made that judgement is that the patient also had ultrasound B-lines of pulmonary edema. link] == MY Comment , by K EN G RAUER, MD ( 11/18 /2023 ): == Today's ECG provides unique insight into a less commonly seen manifestation of RBBB ( R ight B undle B ranch B lock ). What do you think?

EKG/ECG 116

EKG/ECG Hospitals Ultrasounds Wellness 116

SheMD

APRIL 28, 2023

Well, infertility is no exception and recent and current data is clearly showing that this is a growing global health issue that affects men and women regardless of ethnicity, social and economic class and geographic location. This report released on April 4, 2023 stated that approximately 17.5%

Ultrasounds 52

Ultrasounds Research Hospitals Wellness 52

RebelEM

JUNE 19, 2023

Demographics were well balanced in the two groups. Patients were actively screened for DVT (all received lower extremity ultrasound on or around day 7). The PATCH-trauma researchers sought to address this critique. Article: PATCH-Trauma Investigators and ANZICS Clinical Trial Group. Prehospital Tranexamic Acid for Severe Trauma.

Outcomes 102

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 102

ACEP Now

FEBRUARY 11, 2024

The ultrasound-guided clavipectoral plane block (CPB) is a newly described technique in the emergency medicine literature. Ultrasound Survey Scan FIGURE 1A: Ultrasound probe should be placed at the clavicle with the probe marker facing cephalad (toward the head). FIGURE 1B: Ultrasound image with labeled relevant anatomy.

Ultrasounds 52

Ultrasounds Fractures Emergency Department Hospitals 52

Taming the SRU

DECEMBER 18, 2023

7) While standard technique for either male or female foley placement is well-known and straightforward, there are several measures that can be taken to ensure the highest likelihood of first-pass success. Treasure Island, FL: StatPearls Publishing; 2023. 7,13) Any signs of urethral injury after attempts at catheterization.

Emergency Nursing 75

Emergency Nursing EMS Emergency Department Ultrasounds 75

Dr. Smith's ECG Blog

SEPTEMBER 3, 2023

Arrival at time 0 ECG 7 min Roomed in hallway at 17 min Moved to room with monitor at 37 min The patient was seen briefly by the physician, who then went to get an ultrasound machine. 3-vessel disease can make resuscitation very difficult, since CPR does not perfuse diseased vessels as well as one would like.

EKG/ECG 133

EKG/ECG Resuscitation CPR Emergency Department 133

Pediatric Education

NOVEMBER 19, 2023

They felt he was breastfeeding well and had only mild jaundice. His examination was normal and the diagnosis of a well newborn infant was made. mg/dL which was well below treatment threshold. Some infants may need car seat tolerance screening as well. Accessed August 29, 2023. BMC Pediatr. 2021;21(Suppl 1):350.

Infectious Diseases 40

Infectious Diseases Administration Pediatrics Wellness 40

EMDocs

JUNE 6, 2023

2023 Feb;64:113-120. Consider fungal coverage for soil involvement or cases of IOFB. References: Pelletier J, Koyfman A, Long B. High risk and low prevalence diseases: Open globe injury. Am J Emerg Med. doi: 10.1016/j.ajem.2022.11.036. 2022.11.036. Epub 2022 Dec 5. PMID: 36516669.

Fractures 75

Fractures Documentation/Coding Ultrasounds Wellness 75

Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

Pads were placed with ultrasound guidance, so they were in the correct position. Procamio randomized trial. == MY Comment , by K EN G RAUER, MD ( 9/20 /2023 ): == Assessment of the regular WCT ( = W ide- C omplex T achycardia ) patient — is one of the most challenging problems in emergency medicine. However, this is not SVT.

EKG/ECG 138

EKG/ECG Shock Documentation/Coding Academics 138

Dr. Smith's ECG Blog

OCTOBER 18, 2023

A majority (62.5%) of those presenting with ‘normal’ ECGs had the cath lab activated without any ECG being labeled ‘STEMI’ by automated interpretation – based on signs of Occlusion MI including ECG changes, regional wall motion abnormality on bedside ultrasound, or refractory ischemia.

EKG/ECG 121

EKG/ECG Documentation/Coding Emergency Department Outcomes 121

Pediatric EM Morsels

AUGUST 4, 2023

Oka, 2023) Female to male predominance with a ratio of 3:2. Oka, 2023) It has various other names but one is Cast Syndrome due to a slight increased risk with patients in hip spica casts. Oka, 2023) Always consider SMA syndrome in patients with eating disorders who present with nausea and bilious vomiting. Record, 2015).

Pediatrics 246

Pediatrics Burns Operations Ultrasounds 246

Taming the SRU

OCTOBER 1, 2023

This topic is additionally complicated by the development of multiple diagnostic tools now available for diagnosis as well as variable sizing algorithms used around the world. Accuracy of Ultrasound in Diagnosis of Pneumothorax: A Comparison between Neonates and Adults-A Systematic Review and Meta-Analysis. 10/2/2023

Fractures 94

Fractures COPD Hospitals Emergency Department 94