PulmCCM

NOVEMBER 17, 2023

shows blood administration with a direct linear relationship between Pra and CO/VR; only Pmsf is varied here. ’ This could be done with the Venous Excess Ultrasound Score [VExUS] [5, 6]. The ultrasound journal 2020, 12(1):1-12. Ultrasound J 2022, 14(1):36. OP is operating point. See text for details.

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

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. In cardiac arrest, a delay in IV access subsequently results in a delay in epinephrine administration. This study also showed the median time for IO placement was only 1.2

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

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? Patients were actively screened for DVT (all received lower extremity ultrasound on or around day 7).

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

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. Peripheral pressors: not only safe, but beneficial? doi: 10.1016/j.chest.2023.08.019.

PPE 96

PPE Ultrasounds Resuscitation Emergency Department 96

Core Ultrasound

MARCH 25, 2024

The IVC is unable to reliably tell you anything about fluid responsiveness but fluid responsiveness is a flawed outcome and we have to start taking a more holistic view on the administration of fluid. There is no one dichotomous test that will tell you whether to give fluid or not. That is a holy grail that we have to stop chasing.

Administration 75

Administration Sepsis Ultrasounds Outcomes 75

RebelEM

JANUARY 29, 2024

PMID: 37188358 Clinical Question: What is the efficacy and safety of low-dose (25mg) prolonged administration (over 6hrs) of alteplase in patients with massive PE? Randomized, Controlled Trial of Ultrasound-Assisted Catheter-Directed Thrombolysis for Acute Intermediate-Risk Pulmonary Embolism. Clin Exp Emerg Med 2023. CHEST 2010.

Stroke 133

Stroke Outcomes Hospitals Administration 133

EMDocs

MARCH 19, 2024

Ultrasound can miss this diagnosis (especially of the vertebral arteries, which are not easily visualized on US). If it’s ischemic, maintain BP < 185/110 mm Hg prior to administration of thrombolytics followed by < 180/105 mm Hg. Management Consult neurology. May need neurosurgery (SAH or LVO present).

Stroke 105

Stroke EMS Administration Ultrasounds 105

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. The Accu-Chek was 214, and there was no response to empiric Narcan administration. Introduction to Bedside Ultrasound, iBook Ch 2, Basic Cardiac, Pg 27. Epub 2022 Jun 30.

Ultrasounds 97

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Shock 97

EMDocs

JANUARY 16, 2024

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. Be careful with excessive medication administration.

Hyperthermia / Hypothermia 104

Hyperthermia / Hypothermia Resuscitation CPR EMS 104

Dr. Smith's ECG Blog

JUNE 28, 2023

He arrived in the ED and had an immediate bedside cardiac ultrasound while this ECG was being recorded. The bedside ultrasound (video not available) reportedly showed only a slightly reduced LV function. The patient was given 6mg, then 12 mg, of adenosine, without a change in the rhythm. Here is the ECG: What do you think?

EKG/ECG 98

EKG/ECG Ultrasounds Administration EMS 98

The Skeptics' Guide to EM

AUGUST 24, 2024

More recently, the April 2024 SGEMHOP reviewed a trial on how effective and safe an ultrasound-guided erector spinae plane block (ESPB) in adult patients with rib fractures is. The block is typically performed under ultrasound guidance, which allows for precise placement of the anesthetic and minimizes the risk of complications.

Fractures 53

Fractures Emergency Department Ultrasounds Radiology 53

EMDocs

NOVEMBER 4, 2023

An ultrasound of the testes reveals the following: What is the diagnosis? He reports approximately one month of dysuria, and around two weeks ago noticed a dull aching sensation in his testicles that has progressively gotten worse. He came to the ED because he now has a fever, chills, and nausea along with his testicular pain.

EMS 87

EMS Ultrasounds Emergency Department Infectious Diseases 87

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? All of which leads to easier image acquisition. Accredited trainers are currently lacking.

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

EMDocs

APRIL 10, 2024

While not specifically reviewed in this post, check out the methemoglobinemia tox card for more information about one of the other known events that can occur with local anesthetic administration. 3] If performing a nerve block with ultrasound guidance, always know where the tip of your needle is. [5]

Advances Cardiac Life Support (ACLS) 109

Advances Cardiac Life Support (ACLS) Seizures EMS Poisoning 109

Northwestern EM Blog

MAY 16, 2022

What is your initial imaging test of choice, ultrasound (US) or non-contrast CT, and why? Would you be confident in a point-of-care-ultrasound evaluation or a formal ultrasound? Many patients in the ultrasound groups did get additional imaging, but this was not the majority. How do you proceed? In this study, 40.7%

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

EM Curious

JULY 22, 2015

ULTRASOUND CASE OF THE WEEK [BLOG]: A 38 year old male presents from jail with the pathology seen below. Find out here at Ultrasound Of The Week. Excellent teaching videos from George Kovacs. Check you his Youtube page for more content. Which nerve block will facilitate drainage?

Infectious Diseases 52

Infectious Diseases EMS Ultrasounds Emergency Department 52

Don't Forget the Bubbles

MAY 17, 2023

Minor head trauma in infants – how accurate is cranial ultrasound performed by trained radiologists? Finding the most suitable puncture site for intraosseous access in term and preterm neonates: an ultrasound-based anatomical pilot study. Hypohydration, functional constipation, and physical activity in elementary school students.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

Dr. Smith's ECG Blog

JULY 5, 2024

A formal ultrasound later showed reasonably good LV function, and so he later received carvedilol and diltiazem, Unfortunately, those led to hypotension at 80/40 with a HR 40. Several hours later, this was the effect: NT pro-BNP elevated to 7000 Furosemide was also given.

EKG/ECG 114

EKG/ECG Stroke Administration Ultrasounds 114

The Skeptics' Guide to EM

JANUARY 25, 2020

His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. Date: January 9th, 2020 Reference: Casey et al. He has worsening work of breathing and a decreasing level of consciousness.

EMS 40

EMS Airway Management Administration Resuscitation 40

Taming the SRU

JUNE 3, 2024

Common venomous snakes in the United States include: Coral Snakes ( Elapidae family) which produces a neurotoxin Rattlesnake, Cottonmouth, Copperhead ( Viperidae family) which produces a hematologic toxin resulting in significant local tissue damage and coagulopathy Field treatment involves splinting the extremity, immobilizing the patient as possible, (..)

Shock 91

Shock Seizures Airway Management Stroke 91

Taming the SRU

MAY 5, 2023

Despite the complexity and heterogeneity of patients with sepsis, there have been few interventions which have been demonstrated to decrease mortality: early antimicrobial and fluid administration (Levy, Evans et al. 2018, Kuttab, Lykins et al. 2019, Evans, Rhodes et al. 2021, Im, Kang et al. vs 33.2%; OR, 0.42; 95% CI 0.32-0.55;

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Don't Forget the Bubbles

DECEMBER 25, 2023

In the BUCKLED trial that looked at whether ultrasound was non-inferior to X-ray in diagnosing forearm fractures, the primary outcome was physical function of the affected arm at four weeks. They found that epinephrine administration was associated with higher survival at 30 days ( 3.2% We love POOs. vs. 2.4% ). vs. 1.9% ).

Research 83

Research Outcomes Fractures Pediatrics 83

PEMBlog

OCTOBER 26, 2023

Ultrasound and CT may not differentiate it from normal bowel. It has a long and non-branching course and ends toward the right lower quadrant.

Radiology 64

Radiology Radiology Administration Resuscitation 64

Pediatric Emergency Playbook

AUGUST 1, 2017

Hypertrophic pyloric stenosis: tips and tricks for ultrasound diagnosis. J Ultrasound. The non-diagnostic ultrasound in appendicitis: is a non-visualized appendix the same as a negative study? Utility of MRI After Inconclusive Ultrasound in Pediatric Patients with Suspected Appendicitis. Semin Pedaitr Surg. Dias SC et al.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Downeast Emergency Medicine

APRIL 26, 2021

2][3] If earlier treatment with TXA is better, would there be benefit in its administration in the prehospital setting? Association between prehospital tranexamic acid administration and outcomes of severe traumatic brain injury. If so, could this be done safely? These questions are asked in the first paper that we reviewed.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

He is interested and experienced in healthcare informatics, previously worked with ED-directed EMR design, and is involved in the New York City Health and Hospitals Healthcare Administration Scholars Program (HASP). Five Rules of the SGEM Journal Club Case: A 70-year-old woman is found unresponsive and apneic at home by her partner.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

ACEP Now

SEPTEMBER 3, 2024

The AMA found that administrative burden of reimbursement and low rates were the most frequent factors in physicians’ decisions to sell their practices. Her primary interests are in ultrasound, machine learning, and health justice. References Pomorski C. The death of Hahnemann Hospital. The New Yorker. Published May 31, 2021.

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113

Dr. Smith's ECG Blog

JULY 21, 2024

Another approach is sympathetic chain (stellate ganglion) blockade if you have the skills to do it: it requires some expertise and ultrasound guidance. Administration of Procainamide is 10-17 mg/kg at 20 mg/min. A 1000 mg dose will take 50 minutes.)

EKG/ECG 132

EKG/ECG Shock Hospitals Sepsis 132

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 94

Leadership EMS Pediatrics Stroke 94

Dr. Smith's ECG Blog

AUGUST 9, 2024

However the patient continued to have chest pain and bedside ultrasound showed hypokinesis of the septum with significantly reduced LVEF. Although recognition of OMI was not affected by administration of morphine in this case, use caution with analgesia in ongoing ACS without a definitive plan for angiography.

EKG/ECG 108

EKG/ECG EMS Emergency Department Wellness 108

Taming the SRU

MAY 30, 2023

hours earlier and went to OR 3.5 hours earlier and went to OR 3.5 mg/mL) single-dose 2*-mL ampule or equivalent, 2 Lidocaine injection, 20-mg/mL single-dose 5-mL ampule or equivalent, 2 Nitroglycerin, 0.4-mg

OB/GYN 52

OB/GYN Ultrasounds Pediatrics Resuscitation 52

Emergency Medicine Ireland

JANUARY 22, 2024

This is of course hardly surprising as it is hopefully clear by now on this podcast that I am not especially good at what i do and continue to put my appointment to my current job down as some kind of administrative error that is yet to be detected. Firstly do a bit of resuscitation. Firstly do a bit of resuscitation.

Sepsis 52

Sepsis Resuscitation Wellness Administration 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Four Components to Successful Pain Management and Intranasal Medication Administration Right drug, right dose, right patient, right timing Right Drug – Not every medication is easily amenable to intranasal administration. This is mostly from an old culture of misunderstanding or fear of overdose.

Administration 40

Administration Seizures Emergency Department Ultrasounds 40

Broome Docs

APRIL 6, 2023

Clinical risk factors for testicular torsion and a warning against falsely reassuring ultrasound scans: a 10-year single-centre experience. Renal outcomes following intravenous contrast administration in patients with acute kidney injury: a multi-site retrospective propensity-adjusted analysis. Emerg Med J. Epub ahead of print.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

SheMD

JULY 23, 2023

Another emergency medicine colleague I knew did a 2-week rotation in South America to teach ultrasound to physicians. Therefore, he worked with the primary care innovation department and learned hospital administration and clinical operations during his residency. Common Question #3: Where do you see yourself in 10 years?

Research 98

Research Academics Hospitals Operations 98

Don't Forget the Bubbles

SEPTEMBER 5, 2024

Children with complex medical conditions are at higher risk of morbidity and mortality, and this may be compounded by inaccurate weight estimation and leading to inaccurate medication dose administration. Point-of-care ultrasound for monitoring catheter tip location during umbilical vein catheterization in neonates: a prospective study.

Ultrasounds 52

Ultrasounds Research Emergency Department Outcomes 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2019

On arrival, the patient was in shock, was intubated, and had an immediate cardiac ultrasound. What does a heart look like on ultrasound when the EKG looks like that? Here you go: It's not the world's greatest cardiac ultrasound video, but it does appear to show poor function and low volume. They transported to the ED.

Shock 40

Shock EKG/ECG Resuscitation Ultrasounds 40