Taming the SRU

JULY 24, 2023

THE CASE A male in his 60s presented to the emergency department for right upper quadrant abdominal pain. A bedside right upper quadrant ultrasound was performed, and the images are below. Ultrasound is the gold standard for diagnosing cholelithiasis because it is more sensitive for detecting gallstones.

Ultrasounds 79

Ultrasounds Sepsis Radiology Radiology 79

Don't Forget the Bubbles

JANUARY 31, 2024

As a Trauma Unit within the Thames Valley Trauma Network, Wexham Park Hospital hosts trainees from across the spectrum of acute specialties. Article 1: What predicts parental anxiety in the Paediatric Emergency Department? Predictors of parental anxiety in a paediatric emergency department. Martin, S.R.,

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

ACEP Now

JANUARY 4, 2025

Emergency medicine was approved as the 23rd medical specialty in 1979, shortly after a young Elsburgh Clarke, MD, discovered the burgeoning specialty. 1 Just one year prior, Dr. Clarke had begun an emergency medicine residency at what was then known as LA CountyUSC Hospital, Los Angeles. Click to enlarge.) Click to enlarge.)

Forensics 52

Forensics Urgent Care Hospitals Emergency Department 52

ACEP Now

MAY 9, 2024

6 The increasing mortality rate led to an additional emergency regulation in 2022 requiring the consenting physician to perform the critical steps of the case, limiting surgeons to three cases per day, and mandating continuous, recorded ultrasound guidance for gluteal AFT procedures. units per patient.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

The Skeptics' Guide to EM

APRIL 20, 2024

Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergency department: A randomized controlled trial. Background: We have covered rib fractures once before on the Skeptics’ Guide to Emergency Medicine.

Fractures 85

Fractures Ultrasounds Emergency Department CDC 85

Taming the SRU

OCTOBER 14, 2024

THE CASE A female in her 60’s with a remote history of bilateral cataract surgery presented to the emergency department (ED) with a two-week history of right eye swelling. Ocular point-of-care-ultrasound (POCUS) was performed as seen below. Performing an ocular ultrasound requires preparation and caution. Brzycki et al.

Ultrasounds 52

Ultrasounds Urgent Care Emergency Department Documentation/Coding 52

ACEP Now

FEBRUARY 11, 2024

1,2 In the emergency department (ED), the focus of treatment is pain control and immobilization unless there is a clear indication for surgery, such as open fractures, skin tenting, or neurovascular compromise. The ultrasound-guided clavipectoral plane block (CPB) is a newly described technique in the emergency medicine literature.

Ultrasounds 52

Ultrasounds Fractures Emergency Department Hospitals 52

The Skeptics' Guide to EM

JULY 30, 2022

Point-of-Care Ultrasound-First for the Evaluation of Small Bowel Obstruction: National Cost Savings, Length of Stay Reduction, and Preventable Radiation Exposure. AEM July 2022 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. specificity with ultrasound [1].

Ultrasounds 52

Ultrasounds Operations Documentation/Coding Outcomes 52

Greater Sydney Area HEMS

FEBRUARY 20, 2024

The cohort of patients that require this intervention in the pre-hospital setting are likely to be the most critically unwell patients we encounter. The evidence for improved safety and quality with the use of ultrasound for CVC implementation is well established [i]. One approach to obtaining BCV origin access (fig.1)

Ultrasounds 98

Ultrasounds Shock Research Operations 98

Dr. Smith's ECG Blog

JUNE 17, 2024

Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. Cardiac Ultrasound may be a surprisingly easy way to help make the diagnosis Answer: pulmonary embolism.

EKG/ECG 140

EKG/ECG Emergency Department Shock Ultrasounds 140

Taming the SRU

MAY 13, 2024

Acute stump appendicitis without evidence of perforation or abscess (Figure 1) HOSPITAL Course Acute Care Surgery was consulted from the ED and recommended admission for operative resection of a 3 cm remnant of the appendix. The patient was discharged on hospital day 5. The Ultrasound Journal, 11(1). No free intraperitoneal air.

Ultrasounds 98

Ultrasounds Emergency Department Wellness Operations 98

RebelEM

APRIL 29, 2024

Many clinicians don’t consider IO placement while others consider it a last resort or only a pre-hospital procedure. The IO can actually be your “GO-TO” emergency line or your second choice after failed PIV access. World J Emerg Surg 2023 PMID: 36918947 3. Int J Emerg Med 2009 PMID: 20157465 4. minutes CVC group.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

ACEP Now

AUGUST 22, 2023

Regardless of the domain, somewhere an expert panel has convened to issue a pronouncement informing all of the ideal care of patients under their specialty umbrella, indirectly extending to their care in the emergency department. 1 To date, there have been three GRACE publications. 1 To date, there have been three GRACE publications.

Emergency Department 98

Emergency Department Academics Critical Access Research 98

ACEP Now

DECEMBER 7, 2024

Ekosonic Endovascular System (EKOS), a form of pharmacomechanical thrombolysis, uses a catheter to deliver thrombolytics directly to the target pulmonary artery in combination with high-frequency ultrasound to enhance lytic penetration and encourage thrombus fragmentation. Catheter Cardiovasc Interv. 2017;89(4):754-760.

Ultrasounds 52

Ultrasounds Radiology Radiology EKG/ECG 52

The Trauma Pro

OCTOBER 4, 2024

Clinical outcomes assessed at 60 days included an unplanned return to the emergency department (ED), re-admission, complications, and development of new bleeding confirmed by surgery, ultrasound, or computed tomography (CT) at 60 days post-injury. ” This means they probably did not.

Pediatrics 113

Pediatrics Operations Outcomes Emergency Department 113

Don't Forget the Bubbles

NOVEMBER 8, 2023

7-year-old Tilly is brought to your emergency department at 11 p.m. Abdominal pain in children is common, accounting for over 1 in 20 attendances to paediatric emergency departments [1]. She had a low-grade fever and an episode of vomiting before coming to the hospital. Hospital Admitted Patient Care Activity.

Emergency Department 105

Emergency Department Ultrasounds Pediatrics Best Practices 105

Don't Forget the Bubbles

NOVEMBER 13, 2023

Should we use ultrasound to diagnose distal forearm fractures in children and adolescents? X-ray (radiography) is the standard imaging technique used in emergency departments. However, ultrasound is gaining popularity due to its portability, affordability, and lack of ionising radiation.

Fractures 64

Fractures Ultrasounds Emergency Department Pediatrics 64

EB Medicine

OCTOBER 21, 2024

Eckler, MD discuss the October 2024 Pediatric Emergency Medicine Practice article, Elder Abuse and Neglect: Making the Diagnosis and Devising a Treatment Plan in the Emergency Departmen t 00:00 Welcome and Introduction 00:13 Free Subscription for Emergency Medicine Residents 01:05 Introduction to Pediatric Emergency Medicine Practice 01:37 Discussion (..)

Pediatrics 59

Pediatrics Elder Abuse Risk Management Emergency Department 59

ACEP Now

OCTOBER 9, 2024

Emergency physicians have long taken pride in delivering care every day of the week, every hour of the day. ACEP’s Emergency Department Accreditation program adds a layer to that, says Marianne Gausche-Hill, MD, FACEP, FAAP, FAEM, Chair of the program’s Board of Governors. There are five sets of domains.

Emergency Department 52

Emergency Department Critical Access Geriatric Emergencies Ultrasounds 52

EMDocs

DECEMBER 4, 2023

Johnson, MD ( Community EM, Salina Regional Health Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra, MD (Cleveland Clinic Foundation, EM-CCM); Brit Long, MD (@long_brit) Case A 40-year-old woman presents to a rural emergency department (ED) with left leg pain and swelling for the past 5 days.

Ultrasounds 90

Ultrasounds Documentation/Coding Wellness EMS 90

ACEP Now

DECEMBER 6, 2024

A 46-year-old female with a prior medical history of asthma presented to the emergency department with shortness of breath and wheezing. Given the persistent symptoms, a cardiac point-of-care ultrasound was obtained. 4 Dr. Ram is clinical research director at The Brooklyn Hospital Center, Brooklyn, N.Y.

Emergency Department 64

Emergency Department Ultrasounds Hospitals Research 64

Taming the SRU

APRIL 5, 2023

THE CASE An elderly female patient presents to the emergency department (ED) with 1 week of generalized weakness leading to numerous falls. Outside hospital records were obtained and upon review, it was noted that the patient had recently been diagnosed with a horseshoe kidney on CT imaging. Images are seen below.

Ultrasounds 52

Ultrasounds Pediatrics Radiology Radiology 52

Dr. Smith's ECG Blog

MARCH 28, 2024

male with pertinent past medical history including Atrial fibrillation, atrial flutter, cardiomyopathy, Pulmonary Embolism, and hypertension presented to the Emergency Department via ambulance for respiratory distress and tachycardia. Bedside ultrasound showed volume depletion and no pulmonary edema.

EKG/ECG 130

EKG/ECG EMS Emergency Department Ultrasounds 130

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. Nebulized ketamine: the solution to a non-existent problem? Age Ageing.

PPE 96

PPE Ultrasounds Resuscitation Emergency Department 96

Emergency Medicine Journal

NOVEMBER 28, 2023

Manipulation performed under ultrasound guidance has the potential to decrease the number of reduction attempts. Methods This multicentre randomised controlled trial was undertaken between December 2018 and July 2020 in the ED of four hospitals in the Netherlands.

Fractures 40

Fractures Ultrasounds Emergency Department Operations 40

ALiEM

SEPTEMBER 13, 2024

A 32-year-old male with no significant past medical history presented to the emergency department (ED) from an outside hospital for further management of right eye pain and vision loss sustained after he was struck by a metal wire while at work. An emergent ophthalmology consult is needed to plan for operative repair.

Emergency Department 64

Emergency Department Fractures Academics Hospitals 64

ACEP Now

SEPTEMBER 3, 2024

Hahnemann University Hospital in Philadelphia closed in 2019, a year and a half after it was acquired along with St. Christopher’s Hospital for Children by private equity (PE) firm Paladin Healthcare Capital for 170 million dollars. 14 Dr. Stinson remembers what it was like to work for a PE-owned hospital early in her career. “I

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113

SheMD

APRIL 24, 2023

I break bad news almost every shift in the emergency department. An email with a sad face to a woman jacked up hormones was not the best approach. I waited until my 6 week ultrasound. On my ultrasound day, I had started to feel pregnant. My friend did an ultrasound and we saw free fluid- a lot of it.

Ultrasounds 83

Ultrasounds Radiology Radiology Emergency Department 83

EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). The patient is extubated and decannulated four days later.

Hyperthermia / Hypothermia 104

Hyperthermia / Hypothermia Resuscitation CPR EMS 104

Emergency Medicine Journal

SEPTEMBER 25, 2024

Background Ultrasound-guided (USG) erector-spinae plane block (ESPB) may be better than intravenous opioids in treating acute hepatopancreaticobiliary (HPB) pain in the ED. Methods This open-label randomised controlled trial was conducted in the ED of a tertiary-care hospital between March and August 2023.

Ultrasounds 52

Ultrasounds Emergency Department Hospitals 52

Dr. Smith's ECG Blog

MAY 20, 2024

Diagnosis of Type I vs. Type II Myocardial Infarction in Emergency Department patients with Ischemic Symptoms (abstract 102). Annals of Emergency Medicine 2011; Suppl 58(4): S211. So the patient was admitted to the hospital with no plan for an angiogram. Murakami MM. Smith: What???!!!

EKG/ECG 127

EKG/ECG Hospitals Wellness Emergency Department 127

The Skeptics' Guide to EM

AUGUST 24, 2024

Sean Baldwin is an Emergency Physician practising in Sydney, Australia in both a large tertiary emergency department and a small regional emergency department. Case: A 67-year-old male presents to your hospital emergency department (ED) after a fall from his bicycle. Reference: Partyka et al.

Fractures 53

Fractures Emergency Department Ultrasounds Radiology 53

Don't Forget the Bubbles

NOVEMBER 20, 2023

Neck lumps are a common presenting complaint to the paediatric emergency department with many aetiologies, sometimes resulting in a diagnostic conundrum. These may require surgical drainage following confirmation on ultrasound scan. Royal Children’s Hospital. Royal Children’s Hospital, Melbourne.

Pediatrics 124

Pediatrics Documentation/Coding Emergency Department Ultrasounds 124

EMDocs

NOVEMBER 18, 2023

A point of care ultrasound of the liver reveals the following: Image 1: Ultrasound of the liver showing abnormal hepatic artery flow and resistance index 1 Question: What is the diagnosis? Emergency department visits and unanticipated readmissions after liver transplantation: A retrospective observational study.

EMS 89

EMS Ultrasounds Emergency Department Outcomes 89

Cook County EM Blog

MAY 1, 2023

The Case: A 56-year-old male with no significant past medical history presents to the emergency department with worsening swelling, pain, and erythema of the right elbow. He also states that the erythema of his right elbow has increased in size and tracked proximally since being seen at the outside hospital two days prior.

Ultrasounds 52

Ultrasounds Emergency Department Hospitals Outcomes 52

PulmCCM

JULY 3, 2023

emergency departments and ICUs were randomized to undergo either DL or VL for intubation. More than 90% of the intubations were performed by emergency medicine residents (~70%) or critical care fellows (~23%). Registries like the National Emergency Airway Registry only partially address that important gap in data.

Airway Management 105

Airway Management Outcomes Hospitals Emergency Department 105

The Skeptics' Guide to EM

MARCH 25, 2023

Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Trauma Surg Acute Care Open 2022 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care.

Ultrasounds 52

Ultrasounds Emergency Department Dislocations Radiology 52