Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

The latter 1950s and 1960s, quested for nerve gas defense studying expired air resuscitation and modern resuscitology; developing intensive care units. To me, it harkens a new scientific renaissance of resuscitation science, emergency care, and creating systems for care. 1950s & 1960s Resuscitation Research. EDNA->ENA.

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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.

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Shock EKG/ECG Resuscitation Ultrasounds 40

Downeast Emergency Medicine

APRIL 26, 2021

Trauma patients between the ages of 18-90 years had to have either had one documented episode of hypotension (defined as a systolic BP <90 mmHg) or tachycardia (>100 beats/minute) to be included in the study. If the trauma center performed screening ultrasounds to evaluate for asymptomatic DVTs, they were not included in this study.

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Head Injuries Administration Outcomes Seizures 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. In fact, bedside ultrasound might even find severe aortic stenosis.

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EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

Dr. Smith's ECG Blog

APRIL 8, 2016

Bedside ultrasound showed no effusion and moderately decreased LV function, with B-lines of pulmonary edema. After resuscitation, he was found to have a 90% thrombotic lesion in the same saphenous vein graft to the right posterior descending artery. He was managed medically with Clopidogrel. He appeared to be in shock.

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Resuscitation EKG/ECG Hospitals Administration 52

EMDocs

JANUARY 11, 2024

Cardiac Management Takeaway : Perform an echo as soon as you can to guide resuscitation. These conversations should occur frequently and be clearly documented for other health care professionals who are not present during the conversations (96%, 22/23). There are no hard MAP recommendations.

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Seizures Shock Infectious Diseases CPR 94

EB Medicine

JUNE 6, 2019

CT is good but you really should learn ultrasound, and lastly, sick patients need prompt consultation and resuscitation, not rapid trips to radiology. Nachi: Diagnosis of appendicitis, in a pregnant patient, ultrasound vs. mri. Jeff: Next we have everybody’s favorite, the ultrasound. Jeff: Indeed. Sounds familiar.

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Ultrasounds Radiology Radiology Sepsis 40

Mind The Bleep

FEBRUARY 29, 2024

It is worth looking through previous documentation to see whether the patient’s team or senior intensivists have set any individual cardiovascular targets. Assessing a patient’s cardiovascular status and whether we need to manipulate any aspects of it is disease process-specific and patient-specific.

Documentation/Coding 52

Documentation/Coding Hospitals Wellness Best Practices 52

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

A bedside cardiac ultrasound was performed with a parasternal long axis view demonstrated below: There is a large pericardial effusion with collapse of the right ventricle during systole. This patient was reported to have distant heart sounds but was not hypotensive and did not have JVD according to documentation.

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EKG/ECG Ultrasounds Documentation/Coding COPD 40

EB Medicine

JULY 8, 2019

Vitamin D, B12, Calcium, foate, iron, and thiamine deficiencies are all well documented complications. Consider performing a RUSH exam (that is rapid ultrasound for shock and hypotension) to identify the cause. Nachi: If possible, obtain a view of the IVC also while doing your ultrasound to assess for volume status.

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Pediatric Emergency Playbook

JUNE 1, 2017

Hemodynamically labile children should be resuscitated and a stat transesophageal echocardiogram obtained. The best documented cormorbidity is sickle cell disease, although other pro-thrombotic conditions also put the child at risk. Cardiovasculr Ultrasound. Circulation. 2004; 110:e511-e513. Tomkewicz-Pajak L et al. 2014; 12:15.

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Pediatrics EKG/ECG Wellness Seizures 52

EB Medicine

OCTOBER 1, 2018

And sepsis-3 redefined septic shock as “hypotension not responsive to fluid resuscitation” with the added requirement of vasopressors to maintain a MAP greater than or equal to 65 and with a lactate > 2. One, lung ultrasound can be really useful to find that occult pneumonia or differentiating pneumonia from CHF. vasopressin.

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Sepsis Shock Fluid Resuscitation Hospitals 40

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

A bedside cardiac ultrasound was normal, with no effusion. A Rising Troponin That afternoon, he complained of increased shortness of breath and was noted to have oxygen saturations in the 70s, prompting a mini code to be called. He had the following EKG recorded: Low voltage, suggests effusion. He was intubated and then went pulseless.

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

EB Medicine

MARCH 1, 2019

Post opiate hypotension in prehospital trauma patients is a rare but documented complication. Jeff: Interestingly, the system I work in has prehospital physicians, who do carry US, but I can’t think of a major trauma where ultrasound changed any of the decisions we made. for pericardial effusion. Let’s move on to treatment.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

EB Medicine

AUGUST 6, 2019

Interestingly, one retrospective study found limited agreement between EMS records and hospital documentation on current DOAC usage. But next we should talk about ultrasound. Jeff: For all agents, regardless of the DOAC, the initial resuscitation follows the standard principles of hemorrhage control and trauma resuscitation.

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Emergency Department Stroke Wellness Administration 40

Thinking Critical Care

AUGUST 3, 2024

This exclusive event, produced in collaboration with Flosonics Medical, will take place on September 28th, 2024 , in Toronto , Ontario, Canada This masterclass is designed for those who seek a deep dive into the cutting-edge techniques of venous congestion, Doppler ultrasound, and fluid resuscitation.

Fluid Resuscitation 52

Fluid Resuscitation Documentation/Coding Resuscitation Ultrasounds 52

EB Medicine

JANUARY 2, 2019

So to get us all on the same page, the discriminatory zone is the b-HCG at which an IUP is expected to be seen on ultrasound. Nachi: Definitely concerning, but this is all the more reason you need to employ our favorite imaging modality… the ultrasound. For a threatened abortion, the os would be closed with an IUP seen on ultrasound.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

ACEP Now

FEBRUARY 11, 2025

2 As the ACEP considers ultrasound guided regional anesthesia a core skill, this leaves a unique opportunity for hospital systems to leverage emergency physicians to provide these services in the inpatient and outpatient setting. Rib fractures are a condition that we commonly treat with ultrasound-guided nerve blocks.

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Emergency Department Fractures Ultrasounds Hospitals 80

Mind The Bleep

DECEMBER 6, 2024

Normally identified on scrotal exploration (being performed for presumed torsion) as ultrasound is not always diagnostic. and (2022), A BURST-BAUS consensus document for best practice in the conduct of scrotal exploration for suspected testicular torsion: the Finding Consensus for Orchidopexy in Torsion (FIX-IT) study. Khadhouri, S.,

Documentation/Coding 52

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