EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. Jeff: Even more shockingly, some series showed a 52% repeat operation rate. These patients often require emergent operative intervention.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

ALiEM

SEPTEMBER 9, 2024

A 61-year-old female with a past medical history of hypertension, hyperlipidemia, type 2 diabetes, and normal pressure hydrocephalus s/p VP shunt (last revision nine months ago) presented to the Emergency Department (ED) for evaluation after noticing a “string” coming out of her anus today. Interdisciplinary Neurosurgery, 13, 66-70.

Sepsis 60

Sepsis Academics Operations Wellness 60

ACEP Now

MAY 4, 2023

A 58-year-old male with a history of alcohol abuse presented to the emergency department (ED) as a category 2 trauma for a fall with a reported flail chest. On hospital day 2, he was taken to the operating room for surgical rib fixation. Case FIGURE 1: Chest X-ray of multiple rib fractures (arrows). Click to enlarge.)

EMS 52

EMS Fractures Operations Ultrasounds 52

Northwestern EM Blog

MAY 16, 2022

1 Low-dose non-contrast abdominal CT has become the gold standard for diagnosis as it has become readily available in emergency departments nationwide, with some studies touting sensitivity and specificity of 97% and 95%, respectively.2 Follow up CT should depend on the patient and ultrasound operator. vs. In this study, 40.7%

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

Taming the SRU

MAY 22, 2023

weight-bearing status, operative vs. non-operative) If necessary/helpful to ensure adequate follow-up At time of discharge: Counsel on expected course of injury, supportive care (e.g., Most frequent reasons for emergency department visits, 2018. A comparison between pre-operative ultrasonography and surgical findings.

Fractures 76

Fractures Dislocations Operations Radiology 76

RebelEM

NOVEMBER 20, 2023

Patients with torso hemorrhage present a clinical conundrum often requiring interventional radiology or surgery, both of which take time to mobilize. Case volume for operative hemorrhage control is much lower in UK compared to other countries, reflecting better road safety standards and low levels of interpersonal violence.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

EMDocs

MARCH 25, 2024

2, 3 Biliary POCUS can help decrease patient length of stay in the Emergency Department. 1 A biliary point-of-care ultrasound (POCUS) is the fastest and most accurate way to assess for biliary pathology, but it can be difficult to locate the gallbladder, as it is not a fixed organ. 4 Benefits of Biliary POCUS?

Ultrasounds 87

Ultrasounds Radiology Radiology Operations 87

Don't Forget the Bubbles

MAY 22, 2023

You’ve just started working in the Children’s Emergency Department (CED). These can be operated and maintained by patients and their families at home. Robin’s emergency care plan/RESPECT form and ventilator settings should be reviewed and updated while he is in hospital too. You go to see Robin.

Radiology 98

Radiology Radiology Hospitals Wellness 98

ALiEM

MAY 13, 2024

Case Introduction: Child with abdominal pain Wendy is a 7-year-old girl who comes into the emergency department with redness, swelling, and pain on her left calf. 63M with an Erythematous Abdomen Limitations of POCUS As with all ultrasound applications, soft tissue POCUS is operator dependent. Pediatr Emerg Care.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

ACEP Now

MARCH 14, 2024

A 24-year-old male with history of quadriplegia and traumatic brain injury presents to the emergency department with hemorrhage in his oral cavity and blood from his tracheostomy tube. 15,19 Endovascular intervention depends upon the patient’s hemodynamic stability and availability of interventional radiology. 2005;128: 3906-9.

Operations 52

Operations Pediatrics Radiology Radiology 52

EMDocs

JUNE 3, 2023

In fact, the World Society of Emergency Surgery (WSES) classification assigns grades I-III depending on their Young-Burgess classification, but any patient hemodynamically unstable from their pelvic fracture is automatically WSES grade IV regardless of their fracture pattern. Note placement over the greater trochanters.

Fractures 54

Fractures Resuscitation Operations EMS 54

ALiEM

AUGUST 9, 2023

Child with Cough and Fever: Case Introduction A 6-year-old boy presents to the emergency department complaining of cough for 3 days and fever for the last day. The lung POCUS is also operator-dependent, and it has a steep learning curve. His fever was 103°F this morning and he received ibuprofen.

Ultrasounds 98

Ultrasounds Pediatrics Emergency Department Operations 98

ACEP Now

SEPTEMBER 3, 2024

Still, this wave of private equity acquisitions in emergency medicine has come crashing down on the heads of many early-career physicians. As of 2022, 1 in 4 emergency departments in the United States were staffed by a private equity-owned physician group. Radiology Business. Heartland-Charleston of Hanahan SC LLC et al.

Hospitals 69

Hospitals Radiology Radiology Administration 69

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. Operators should take care to obtain clear images of the upper renal poles with the understanding that inferior pole evaluation will be limited from the isthmus. Indian J Radiol Imaging.

Ultrasounds 52

Ultrasounds Pediatrics Radiology Radiology 52

Northwestern EM Blog

DECEMBER 20, 2021

Written by: Tommy Ng, MD (NUEM ‘24) Edited by: Patricia Bigach, MD (NUEM ‘22) Expert review by : Terese Whipple, MD '20 So your kid won’t walk One of the most common complaints in a pediatric Emergency Department is a child refusing or inability to ambulate. Management is orthopedic consultation for operative stabilization [12].

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

PEMBlog

JUNE 5, 2024

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

EMDocs

NOVEMBER 16, 2024

4 Pain is the most common reason for presentation in the early post operative period. 5 Highest risk of dislocation early in the post operative course due to laxity of the soft tissue after surgery. 6 Hip flexion or adduction in the early post-operative period can cause atraumatic dislocations (typically avoided for 6 weeks post-op).

EMS 75

EMS Dislocations Fractures Operations 75

Pediatric Emergency Playbook

FEBRUARY 1, 2016

REBOA If you have access to resuscitative endovascular balloon occlusion of the aorta or REBOA, this may be an option to temporize the child to get him to the relative control of the operating room. After balloon occlusion, blood pressure improved sufficiently to take the patient either to interventional radiology or to the OR.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

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. Unstable patients do not belong in a radiology suite - they belong in the ED resus bay to be resuscitated first. Nachi: All valid points, but let’s dive in too some actual detail.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

RebelEM

SEPTEMBER 11, 2023

1 It is a quickly deployable and easily interpreted study that can be done in real time to guide decisions in the Emergency Department. Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. and specificity of 88.0% Trauma Surg Acute Care Open.

Ultrasounds 69

Ultrasounds Radiology Radiology Emergency Department 69

Don't Forget the Bubbles

MARCH 4, 2024

We have teamed up with the team from the Emergency Department at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The children’s Emergency department sees approximately 50,000 presentations per year. Emerg Med J. Paediatr Int Child Health. 2024 Jan 11:1-7.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

ACEP Now

JULY 7, 2023

Case A 50-year-old woman presents to the emergency department (ED) complaining of epigastric pain and nausea for 36 hours. Will this be enough for the general surgeon, or will they want an US performed by the radiology department to make their surgical decision? Click to enlarge. Reference: Hilsden, et al.

Ultrasounds 52

Ultrasounds Radiology Radiology Emergency Department 52

EMDocs

OCTOBER 17, 2023

World Society of Emergency Surgery guidelines (2020) “What is the best way to make a diagnosis of ALCD? In patients with suspected ALCD, we suggest a complete assessment of the patients using clinical history, signs, laboratorial inflammation markers, and radiological findings (weak recommendation based on very low-quality evidence, 2D).” “In

Radiology 67

Radiology Radiology Operations Best Practices 67

Don't Forget the Bubbles

FEBRUARY 7, 2024

My first real encounter with the healthcare system took place when I was about seven years old and had to go into hospital for an orchidopexy, so I can empathize with all the young people who come through our emergency department with acute testicular pain. Urgent senior review, decision making and operation 31.3%

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111

Don't Forget the Bubbles

OCTOBER 28, 2024

doi: 10.1136/archdischild-2024-327224 Six-year-old Rhaenyra is brought into the emergency department after being hit by a car. As this is being given and definitive treatment is planned (either surgery or interventional radiology), you consider what adjunctive treatments are needed. Published Online First: 24 June 2024.

Blood Transfusions 72

Blood Transfusions Hyperthermia / Hypothermia Shock Pediatrics 72

Pediatric Emergency Playbook

APRIL 1, 2017

Steady the operating hand by placing your hypothenar eminence on the child’s zygoma or temporal scalp, to avoid jutting the instrument into the ear canal with sudden movement. A commonly available suction catheter is the Frazier suction tip ( right ), a single-use device used in the operating room. Am J Emerg Med. 2008.01.013.

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52

Don't Forget the Bubbles

SEPTEMBER 23, 2024

You are working in the paediatric emergency department of a busy District General Hospital. These centres have a close relationship with their patients, but this does not mean they may not turn up at your emergency department! Look for scars indicating previous central lines, peritoneal dialysis catheters or operations.

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

Don't Forget the Bubbles

AUGUST 10, 2023

We will focus on the most important structures when assessing paediatric hands in the emergency department. Finger injuries caused by fingers being caught in closing doors are extremely common presentations to the paediatric emergency department. It additionally has an intricate blood and nerve supply.

Fractures 52

Fractures Soft Tissue Injuries Emergency Department Operations 52

EMDocs

NOVEMBER 13, 2023

The use of CTA (computed tomography angiography) in the emergency department (ED) has increased dramatically in the past 20 years. Pearls and Pitfalls CT Angiography has become a more readily available tool for diagnosis in the emergency department though requires an understanding of its specific uses and indications.

Stroke 86

Stroke Radiology Radiology Emergency Department 86

Advanced Emergency Nursing from AENJ

MAY 27, 2015

An ambulance pulls up, in haste, to the Receiving door of the Emergency Department with a last squeal of the siren. September 2005) Terrorism and Other Public Health Emergencies Reference Guide for Media. [ Emergency Preparedness. 2008) Mumbai Combined Arms Operation November 26-28, 2008.

Federal Emergency Management Agency 40

Federal Emergency Management Agency Military Hospitals Administration 40