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

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.

Emergency Department 83

Emergency Department Dislocations Documentation/Coding Burns 83

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

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 69

Operations Wellness Academics Ultrasounds 69

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 52

Documentation/Coding Operations Academics Ultrasounds 52

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

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

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 116

EKG/ECG Shock Hospitals Sepsis 116

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 81

Shock EKG/ECG Academics Stroke 81

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 138

EKG/ECG Shock Documentation/Coding Academics 138

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

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

ALiEM

JANUARY 29, 2024

It requires immediate consultation with ophthalmology as well as neurology as it is considered a stroke equivalent. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine vol. 39,1 (2020): 197-202. doi:10.1002/jum.15073

Stroke 64

Stroke Ultrasounds Academics Outcomes 64

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

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 91

Leadership EMS Pediatrics Stroke 91

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

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

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

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.

Documentation/Coding 95

Documentation/Coding Academics Ultrasounds Wellness 95

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

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 86

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 86

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 111

Hospitals Patient Safety Academics Wellness 111

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 87

Stroke Radiology Radiology Emergency Department 87

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