Taming the SRU

AUGUST 4, 2024

We discussed some practices to push learners outside of their comfort zone and promote learning, based on their level as well as their goals for the shift.

Dislocations 85

Dislocations Emergency Department Documentation/Coding Burns 85

ACEP Now

AUGUST 29, 2023

Our program pairs training at one of the busiest emergency departments in the country at a nationally recognized county, safety-net, Level I Trauma and Regional Burn Center (MetroHealth) with a world-renowned quaternary academic referral center (Cleveland Clinic). How should potential applicants learn more about your program?

Academics 52

Academics Burns Emergency Department Ultrasounds 52

Sensible Medicine

JULY 24, 2023

A later re-analysis increased the time to 21 seconds, which was still well below statistical significance. Using an echocardiogram (ultrasound), they found that muscle downstream from the stented vessel looked a lot better in the treatment arm vs placebo. There were no differences in physical limitation scores.

Academics 98

Academics Documentation/Coding Ultrasounds Wellness 98

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? Academic Pediatrics 2024 24 1 51-58 What’s it about?

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

Sensible Medicine

MAY 31, 2024

Second guessing, also called post-call quarterbacking, is alive and well in medicine and, when done thoughtfully, can be a great way to teach and learn. As part of his evaluation, a doppler ultrasound of his carotid arteries is ordered. At most academic medical centers, doctors are salaried. The patient did well.

Operations 76

Operations Wellness Academics Ultrasounds 76

Taming the SRU

FEBRUARY 24, 2024

Providers should use ultrasound as early as possible to evaluate for cardiac dysfunction, pulmonary edema, and fluid status. Patients will typically present in acute respiratory distress. They tend to be hypertensive, tachycardic, tachypneic, and hypoxic. Do not always appear volume overloaded on exam.

Leadership 93

Leadership EMS Pediatrics Stroke 93

EM Curious

JULY 24, 2015

One of our beloved colleagues from the community has recently declared to us his love of ultrasound guided nerve blocks--a skill that is established in the anesthesia world but is quickly gaining traction in our realm. Academic Emergency Medicine, 20(6), 584–591. Ultrasound-Guided Three-In-One Nerve Block for Femur Fractures.

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

Dr. Smith's ECG Blog

JULY 21, 2024

Distinction of PMVT vs VFib is an academic one in this case ). In this study — Procainamide was superior to Amiodarone for terminating monomorphic VT, as well as having fewer adverse effects than Amiodarone ( Ortiz et al — Eur Heart J 1;38 (17): 1329-1335, 2017 ). The arrhythmia starts with a PVC having a short coupling interval.

EKG/ECG 134

EKG/ECG Shock Hospitals Sepsis 134

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. ” But less than half of the included studies used ultrasound guidance during central line placements.

Ultrasounds 40

Ultrasounds Operations Outcomes Research 40

The Skeptics' Guide to EM

MAY 11, 2019

His practice is in trauma, emergency general surgery, and critical care with an academic interest in ultrasound and medical simulation. His practice is in trauma, emergency general surgery, and critical care with an academic interest in ultrasound and medical simulation.

Documentation/Coding 40

Documentation/Coding Operations Academics Ultrasounds 40

The Skeptics' Guide to EM

SEPTEMBER 18, 2021

His practice is in trauma, emergency general surgery, and critical care with an academic interest in ultrasound and medical simulation. While the presentation of appendicitis can vary from patient to patient, as our emergency medicine colleagues know well, most patients are not diffusely peritonitic or systemically unwell.

Operations 52

Operations Academics Ultrasounds Hospitals 52

Dr. Smith's ECG Blog

MAY 30, 2023

We recorded an ECG in which V1-V3 were put in the position of V4R-V6R, and V4-6 were placed in V7-9 to (academically) confirm posterior OMI. I say academically because the STD in V2 is diagnostic -- posterior leads are NOT necessary. Case continued A bedside ultrasound showed diminished LV EF and of course bradycardia.

Shock 97

Shock EKG/ECG Academics Stroke 97

Dr. Smith's ECG Blog

JANUARY 6, 2023

Smith comment: There is a change in V2 as well, with less normal STE and a smaller T-wave with some inversion. Nevertheless, this suggests that the OMI involves the posterior wall as well. Academic Emergency Medicine 27(S1): S220. A single DES stent was placed, and the patient did well post-procedure. Abstract 556.

EKG/ECG 52

EKG/ECG Wellness Academics Ultrasounds 52

Stop and Think

OCTOBER 2, 2024

Their argument required high levels of trust in measurements from ultrasound images. Well known is the fact that procedures put out a much stronger placebo effect than tablets. Academic Publishing I am now up to a modest 76 peer-reviewed co-authored papers. Aka—”shadows.” Take a look at Cardiology Trials.

Stroke 44

Stroke Academics Shock Ultrasounds 44

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 Radiology Radiology 70

Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

Pads were placed with ultrasound guidance, so they were in the correct position. Definitive diagnosis that ECG #1 is in fact VT is more than academic. No adenosine was given (if you believe it is SVT, this is worth a try). However, this is not SVT. If it is VT, adenosine is safe but not effective. Shocked x 2 without effect.

EKG/ECG 141

EKG/ECG Shock Documentation/Coding Academics 141

ALiEM

OCTOBER 28, 2024

She was well during the interval until more recently, the patient began to complain of persistent abdominal pain and would point to the epigastric area. The patient had been tolerating oral intake well, passing adequate urine, having normal bowel movements, and behaving at baseline. HEENT : Normocephalic and atraumatic.

Pediatrics 64

Pediatrics Ultrasounds Academics Wellness 64

Urgent Care Ultrasounds

MAY 15, 2018

The importance of patient positioning, probe position and patience, for the detection of small pneumothoraces Ultrasound to rule out a pneumothorax is easy! Well, maybe. If you are using ultrasound in the primary care setting as a rule out test, you really don’t want to miss any pneumothorax, however small.

Ultrasounds 40

Ultrasounds Academics Fractures Wellness 40

SheMD

APRIL 27, 2023

We are fortunate, however, to practice in an age of advanced technology, particularly in the field of Assisted Reproduction as well as an age that is focused on health and wellness and empowerment of women to take charge of their fertility and child-bearing goals while pursuing their professional and academic goals in unison.

Academics 52

Academics Ultrasounds Wellness 52

Pediatric Emergency Playbook

MARCH 1, 2016

Adults tolerate hypotension relatively well, and is sufficient until we send them to the OR or interventional radiology suite. Fox et al in Academic Emergency Medicine found a sensitivity of 52%; with a 95% confidence interval [CI] = 31% to 73%. To avoid this, we target a MAP of 65 and look for clinical signs of sufficient perfusion.

Resuscitation 40

Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

EB Medicine

JULY 8, 2019

Jeff: Well that’s kind worrisome. Jeff: And while it’s not exactly core EM, we’re going to briefly discuss indications for bariatric surgery, as this is something we don’t often review even in academic training programs. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. A 2011 meta-analysis in the journal of Academic Emergency Medicine found ESR, CRP, and PCT were not acutely useful in the diagnosis of septic arthritis due to wildly varying sensitivities and specificities between studies.

Infectious Diseases 88

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

Don't Forget the Bubbles

OCTOBER 4, 2023

A study in Pediatrics revealed that a breath of fresh air (<10°C) works well while we wait for the steroids to kick in. The utility of point-of-care ultrasound protocol to confirm central venous catheter placement in the preterm infant. The mountain scenery in Geneve gave us an insight into a ’natural therapy’ for croup.

Pediatrics 111

Pediatrics Fractures Outcomes Research 111

SheMD

NOVEMBER 2, 2023

Ultrasound findings confirmed the suspected diagnosis and the placenta biopsy returning 2 days later left zero doubt. A baby that would need constant medical care well beyond that of a healthy baby. Any affluent non government citizens as well. In fact, it would bring us severe distress.

Sexual Assault 52

Sexual Assault Ultrasounds Academics Operations 52

Dr. Smith's ECG Blog

APRIL 8, 2015

Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Academic Emergency Medicine., Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade. orthostatic vitals b.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

EMDocs

NOVEMBER 13, 2023

2019) argue against a minimum NIHSS score to trigger the use of CTA, instead purporting that clinical suspicion of acute ischemic stroke presenting within 24 hours of the last known well was sufficient evidence to order the study. Semin Ultrasound CT MR 2017, 38 (4), 345-356. 8 The data in Mayer et al. positivity rate on CTA for BCVI.

Stroke 98

Stroke Radiology Radiology Emergency Department 98

Sensible Medicine

MARCH 21, 2024

The most formative experience of this longitudinal preceptorship was when my attending (and mentor) paged me at 6pm on a Friday to ask how I wanted to manage an acute DVT that resulted on an outpatient duplex ultrasound late that afternoon. This is what happens when medical education waits and reacts to the forces around it.

Hospitals 109

Hospitals Patient Safety Academics Wellness 109

Don't Forget the Bubbles

JANUARY 6, 2025

Article 1: Is lung ultrasound a viable alternative to chest x-ray in diagnosing community-acquired pneumonia? Diagnostic accuracy of point-of-care lung ultrasound for community-acquired pneumonia in children in ambulatory settings: A systematic review and meta-analysis. Ultrasound. 2024 Oct 29; Whats it about?

Dislocations 59

Dislocations CPR Ultrasounds Resuscitation 59

EMDocs

FEBRUARY 3, 2025

This mortality is multifactorial and thought to be related to more active disease as well as an association with biochemical abnormalities such as hyperglycemia, hypocalcemia, uremia, and elevated liver enzymes (19).Intestinal Protein-losing enteropathy in systemic lupus erythematosus: 12 years experience from a Chinese academic center.

Stroke 58

Stroke EMS Seizures Outcomes 58

Taming the SRU

JULY 24, 2024

Transvaginal ultrasound images can be optimized by obtaining a transvaginal ultrasound first, having the patient empty their bladder, and using gel inside the probe cover as well as on the outside. Included 10 academic hospitals. What is an IUP? Can an airway assessment score predict difficulty at intubation in the ED?

Leadership 52

Leadership Domestic Violence Ultrasounds Academics 52