The Skeptics' Guide to EM

DECEMBER 10, 2022

Bone Joint J 2022 Guest Skeptic: Dr.Matt Schmitz is an Orthopaedic Surgeon specializing in Adolescent Sports Medicine and Young Adult Hip Preservation. […] The post SGEM#385: If the Bones are Good, the Rest Don’t Matter – Operative vs Non-Operative Management of Scaphoid Fractures first appeared on The Skeptics Guide to Emergency Medicine.

Operations 52

Operations Fractures Military Emergency Department 52

Greater Sydney Area HEMS

FEBRUARY 20, 2024

The evidence for improved safety and quality with the use of ultrasound for CVC implementation is well established [i]. In fact, it’s use is so ubiquitous that the newer generation of emergency physicians are largely inexperienced in the insertion of central lines as a blind technique. One approach to obtaining BCV origin access (fig.1)

Ultrasounds 98

Ultrasounds Shock Research Operations 98

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

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

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

Downeast Emergency Medicine

FEBRUARY 9, 2022

Bedside musculoskeletal ultrasound of his knees was performed. Credits: Andrew fried, md His left (normal) knee is shown below: Labeled combined still frames of the above ultrasound pointing out landmarks That should BE noted on every knee ultrasound. Want to learn more about diagnosing tendon injuries with bedside ultrasound?

Ultrasounds 52

Ultrasounds Fractures Operations Emergency Department 52

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

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. For ultrasound, it is recommended to scan the most tender area using a linear probe. Clin Case Rep. Nelson, B.

Ultrasounds 96

Ultrasounds Emergency Department Wellness Operations 96

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 Outcomes Operations Emergency Department 113

Emergency Medicine Journal

NOVEMBER 28, 2023

Manipulation performed under ultrasound guidance has the potential to decrease the number of reduction attempts. Patients aged ≥16 years presenting to the ED with a distal radius fracture requiring closed reduction were randomised to either point-of-care ultrasound (PoCUS)-guided or standard reduction.

Fractures 40

Fractures Ultrasounds Emergency Department Operations 40

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. World J Emerg Surg 2023 PMID: 36918947 3. Intraosseous vascular access in adults using the EZ-IO in an emergency department. Int J Emerg Med 2009 PMID: 20157465 4.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

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. IMAGING WITH ULTRASOUND In patients with a horseshoe kidney, there are several differences that make point-of-care ultrasound (POCUS) evaluation difficult. Images are seen below.

Ultrasounds 52

Ultrasounds Pediatrics Radiology Radiology 52

Dr. Smith's ECG Blog

DECEMBER 16, 2024

And almost all of them could be detected by bedside ultrasound. Conclusion: you may take a few moments to look for dissection with your bedside ultrasound, but when it is a clear STEMI, do NOT waste time with a CT scan. It is not a waste of time to use bedside ultrasound to look for dissection 3. Ultrasound Med.

Ultrasounds 87

Ultrasounds EKG/ECG Operations Emergency Department 87

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

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

Resus Review

APRIL 10, 2015

The ECMO ultrasound flow sensors require a conductive interface between the sensor and the circuit. While it is useful to use for ultrasound exams, when exposed to air it dries out quickly which interferes with the flow sensor operation. This is usually a gel or paste. A better product to use is Em-tec Ultrasonic Coupling Paste.

Ultrasounds 52

Ultrasounds Operations Emergency Department EMS 52

Don't Forget the Bubbles

JANUARY 31, 2024

Article 1: What predicts parental anxiety in the Paediatric Emergency Department? Predictors of parental anxiety in a paediatric emergency department. Emergency Medicine Journal. The authors compared 100 POCUS (Point-Of-Care-UltraSound ) images captured by trained physicians (in FUSIC/CACTUS). Martin, S.R.,

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

EB Medicine

NOVEMBER 1, 2021

and get 20% of all orders at [link] Emergency Department Management of Rib Fractures Author: Patrick Maher, MD Episode Outline: Why rib fractures? It is in Beta and your feedback is welcome. Also, this month use code ACEP21! Coming to Google Play soon. It is in Beta and your feedback is welcome. ,* Also, this month use code ACEP21!

Fractures 52

Fractures Documentation/Coding Operations Emergency Department 52

EB Medicine

MARCH 1, 2019

This month, after a few months of primarily medical topics, we’re talking trauma, specifically Blunt Cardiac Injury: Emergency Department Diagnosis and Management. Nachi: Which is why you’ll have to turn to our good friend the ultrasound, for more useful data. I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

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

EMDocs

AUGUST 12, 2023

He presented to the emergency department because he is having numbness distal to the site of injury, as well as constant bleeding and some difficulty with flexing his finger. Management consists of intravenous antibiotics , and hand surgery should be consulted to consider operative debridement.

EMS 69

EMS Fractures Operations Ultrasounds 69

Taming the SRU

AUGUST 4, 2024

to teach you and your learner something new on shift skin adhesives WITH dr. hill Dermabond is a polymer (octyl cyanoacrylate) that can be used to repair lacerations in the Emergency Department faster than sutures, allowing the ED physician to be more efficient. The largest retrospective cohort study to date (Beyde et al.)

Dislocations 84

Dislocations Emergency Department Documentation/Coding Burns 84

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

This case was provided by Spencer Schwartz, an outstanding paramedic at Hennepin EMS who is on Hennepin EMS's specialized "P3" team, a team that receives extra training in advanced procedures such as RSI, thoracostomy, vasopressors, and prehospital ultrasound. Takotsubo is a sudden event, not one with crescendo angina.

EKG/ECG 52

EKG/ECG Emergency Department Ultrasounds Hospitals 52

Don't Forget the Bubbles

JANUARY 17, 2024

Curious Ken is brought into your emergency department. Abdominal ultrasound, used in 34 cases, was able to visualize a rounded intraluminal image corresponding to a bead in 28 patients. They passed away a few days after a second operation. Journal of The Korean Society of Emergency Medicine , 33 (1), pp.134-138.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

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

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? Liver Transplantation: Operative Techniques and Medical Management. Vital signs: HR 118, BP 103/68, RR 20, T 99.8. Pediatr Radiol.

EMS 69

EMS Ultrasounds Emergency Department Outcomes 69

EB Medicine

MARCH 19, 2020

15:38 When did you create dirty and clean zones in the emergency department? 17:03 What is your annual emergency department volume? 18:04 How many treatment rooms are in your emergency department? 24:36 What are your surgeons, who cannot operate, currently doing? 15:21 What PPE do you currently use?

PPE 40

PPE Emergency Department Ultrasounds Operations 40

The Skeptics' Guide to EM

FEBRUARY 16, 2019

Point-of-Care Ocular Ultrasound for the Diagnosis of Retinal Detachment: A Systematic Review and Meta-Analysis. Guest Skeptic: Dr. Daniel Theodoro is an Assistant Professor of Emergency Medicine at Washington University School of Medicine in St. Louis and the Emergency Medicine Point of Care Ultrasound Section Chief.

Ultrasounds 52

Ultrasounds Operations Emergency Department 52

Taming the SRU

MAY 22, 2023

Point-of-care ultrasound (POCUS) can evaluate for Achilles tendon rupture with a high sensitivity (96-100%) and specificity (83-100%) [8,9]. role of consulting services, emergent closed reduction, need for vascular imaging). Most frequent reasons for emergency department visits, 2018. MRI can be used in place of CT.

Fractures 76

Fractures Dislocations Operations Radiology 76

Don't Forget the Bubbles

MAY 17, 2023

Post-operative pain in children: Comparison of pain scores between parents and children. 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.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

The Skeptics' Guide to EM

DECEMBER 3, 2022

Angelica DesPain is an Assistant Professor of Pediatrics and a pediatric emergency medicine physician at the Baylor College of Medicine Children’s Hospital of San Antonio in San Antonio, TX. Case: A 10-year-old boy comes into the emergency department (ED) with right lower quadrant (RLQ) pain for the past two days.

Pediatrics 40

Pediatrics Operations Ultrasounds Emergency Department 40

ACEP Now

JUNE 6, 2023

POCUS: Point-of-care ultrasound for AD is highly specific, but operator-dependent, and lacking in sensitivity—although late–model units can have sensitivity as high as 80-85 percent. Dr. Dajer was emergency department medical director at NY Presbyterian Lower Manhattan Hospital for 13 years.

EKG/ECG 85

EKG/ECG Stroke Documentation/Coding Operations 85

EMDocs

SEPTEMBER 9, 2023

The value of ultrasound for detecting hand fractures: A meta-analysis. 2021.0052 Emergency Department Management of Extensor Tendon Lacerations – Page 3 of 4. Ann Emerg Med. Emergency Medicine Residents’ Association; 2022:10-11. Extensor tendon repair in the emergency department. J Emerg Med.

EMS 78

EMS Fractures Soft Tissue Injuries Ultrasounds 78

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 Radiology 52

The Skeptics' Guide to EM

FEBRUARY 2, 2018

In her spare time, Melissa also enjoys being the fellowship director to an amazing group of PEM trainees. Case: Brian is a 14-year-old male who presents to the emergency department (ED) complaining of acute onset testicular pain. He has vomited twice, but there is no history of any fever or trauma. Time is testis.

Pediatrics 40

Pediatrics Ultrasounds Emergency Department Research 40

Mind The Bleep

JUNE 21, 2024

– B scan (ultrasound of the eye), for visualisation of the retina when there is a poor view (i.e – B scan (ultrasound of the eye), for visualisation of the retina when there is a poor view (i.e This will not be an issue if oil is used, though this will require another operation to be removed and gain full visual potential.

Operations 52

Operations Emergency Department Ultrasounds 52

EMDocs

JULY 17, 2023

7 While post-operative adhesive disease is also a risk factor, it is far less commonly implicated in LBO compared to SBO. 3 Point of care ultrasound (POCUS) can be highly sensitive for free fluid and pneumoperitoneum when used by a trained physician in the appropriate patient population.

Operations 77

Operations EMS Fluid Resuscitation Resuscitation 77