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 71

Ultrasounds Documentation/Coding Wellness EMS 71

ACEP Now

MAY 9, 2024

It has been well over a year since the controversial publication of the Agency for Healthcare Research and Quality (AHRQ) report on diagnostic errors in the emergency department (ED). Active extravasation of blood into the hematoma was identified, and the patient was referred to interventional radiology. Ann Emerg Med.

Research 52

Research Emergency Department Infectious Diseases Hospitals 52

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: Well that’s kind worrisome. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

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. They may be well-circumscribed or may have irregular borders. Well-circumscribed abscess with heterogeneous debris C. 97.4%) 85.4% (78.9-90.2%)

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

SheMD

APRIL 24, 2023

Well there were two other ones that were in morula phase but needed to progress to blastocyst. 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. Well that night, I had the residency over for a wellness Thanksgiving dinner.

Ultrasounds 83

Ultrasounds Radiology Radiology Emergency Department 83

Taming the SRU

SEPTEMBER 15, 2023

ultrasound grand rounds: bedside dvt studies - family presence in the ed/icu - r1 clinical knowledge: aicd - r3 small groups: difficult airway management Ultrasound grand rounds: DVT studies WITH Dr. minges Why should we perform bedside DVT studies in the ED?

CPR 88

CPR Burns Airway Management Wellness 88

Don't Forget the Bubbles

MAY 22, 2023

You’ve just started working in the Children’s Emergency Department (CED). Gemma tells you that as well as the physio, Robin’s LTV Consultant has also prescribed some oral antibiotics. Since then, he has been well in himself. The triage nurse comes to let you know about Robin. He’s been taking them for the past few days.

Radiology 98

Radiology Radiology Hospitals Wellness 98

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. Case FIGURE 1: Chest X-ray of multiple rib fractures (arrows). Click to enlarge.) Trauma imaging was performed including bedside X-rays of the chest and pelvis.

EMS 52

EMS Fractures Operations Ultrasounds 52

ALiEM

APRIL 12, 2023

The thin alcohol layer serves to eliminate any air bubbles under the adhesive cover as well as minimizes residual adhesive material sticking to the probe when removing the cover. emDOCs.net – Emergency Medicine Education. The adhesive cover itself serves as a sterile barrier and a slick surface to improve probe maneuverability.

Ultrasounds 103

Ultrasounds Emergency Department Resuscitation Wellness 103

Taming the SRU

JULY 24, 2023

THE CASE A male in his 60s presented to the emergency department for right upper quadrant abdominal pain. The following day, Interventional Radiology placed a percutaneous cholecystostomy tube. The most well-accepted classification of acute perforated cholecystitis is the Niemeier classification which is outlined as below (3,6).

Ultrasounds 76

Ultrasounds Sepsis Radiology Radiology 76

Taming the SRU

OCTOBER 1, 2023

This topic is additionally complicated by the development of multiple diagnostic tools now available for diagnosis as well as variable sizing algorithms used around the world. This post aims to broadly cover the types of PTX, the diagnostic modalities available, and the ideal management by PTX type in the Emergency Department.

Fractures 94

Fractures COPD Hospitals Emergency Department 94

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. F Heart Rate 138 bpm Blood Pressure 102/61 Respiratory Rate 32 Oxygen Saturation (room air) 100% He is well appearing but has increased work of breathing.

Ultrasounds 98

Ultrasounds Pediatrics Emergency Department Operations 98

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. The kidney will have a different axis as well as level of lie, so care should be taken to scan broadly if the renal cortex is not immediately apparent. Indian J Radiol Imaging.

Ultrasounds 52

Ultrasounds Pediatrics Radiology Radiology 52

Taming the SRU

MAY 22, 2023

Use your exam to guide your initial management as well as your imaging decisions and differential diagnosis. Fracture incidence in adults in relation to age and gender: A study of 27,169 fractures in the Swedish Fracture Register in a well-defined catchment area. Most frequent reasons for emergency department visits, 2018.

Fractures 75

Fractures Dislocations Operations Radiology 75

PEMBlog

SEPTEMBER 13, 2023

This harm can manifest through the discomfort of blood draws and urine catheterizations, as well as the radiation exposure involved in head CT scans. Fever First, is there a fever in a previously well child between the ages of 6 months and 5 years? Occult trauma Any trauma that is not seen on your physical (e.g.

Seizures 52

Seizures Pediatrics Point-of-Care Testing Wellness 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. Affects ages 3-8, males to females 2:1 [3].

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

ALiEM

MARCH 7, 2024

It is usually large, nodular, well-defined, homogeneous, and slightly hypoechoic (Figure 13) [6]. Bladder rhabdomyosarcoma tumor without (left) and with (right) color Doppler flow (Images courtesy of Dr. Renal cysts can be confused for hydronephrosis, and both warrant further imaging by Radiology. Dessie et al., and specificity=59.4%.

Ultrasounds 70

Ultrasounds Pediatrics Emergency Department Radiology 70

EMDocs

JULY 3, 2023

Louis); Alex Koyfman, MD (@EMHighAK); Marina Boushra, MD (EM-CCM Attending, Cleveland Clinic Foundation) Case A 62-year-old male with past medical history of hypertension (HTN), hyperlipidemia (HLD), and prior cerebrovascular accident (CVA) presents to the emergency department (ED) via ambulance.

Seizures 85

Seizures Stroke Outcomes EMS 85

Don't Forget the Bubbles

SEPTEMBER 20, 2023

Do not obtain abdominal radiographs for suspected constipation The parents of 4-year-old Matthew bring him into the Emergency Department with abdominal pain. Functional constipation and nonspecific, generalized abdominal pain are common presenting complaints for children in emergency departments. of cases.

Pediatrics 133

Pediatrics Emergency Department Radiology Radiology 133

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. For example, patients with misdiagnosed disease has less RLQ pain and tenderness as well as diminished anorexia, nausea, and vomiting.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

EMDocs

OCTOBER 30, 2023

2 In response to the constrained availability of contrast media, emergency medicine (EM) and radiology departments were compelled to enact modifications in their imaging techniques. In most cases, the radiology team functioned as the main decision-maker playing a key role in drafting institutional protocols. 11 Table 1.

Radiology 73

Radiology Radiology Emergency Department Hospitals 73

Pediatric Emergency Playbook

FEBRUARY 1, 2016

Protocols work well for adults, but trauma in children requires that we exercise our clinical muscles just a bit more. After balloon occlusion, blood pressure improved sufficiently to take the patient either to interventional radiology or to the OR. Pediatric emergency department thoracotomy: A 40-year review.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

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]. Tilly is normally fit and well, with no significant past medical history. by her father. She is obviously uncomfortable.

Emergency Department 104

Emergency Department Ultrasounds Pediatrics Best Practices 104

Don't Forget the Bubbles

JANUARY 22, 2024

Choosing Wisely in Paediatric Car e A trainee-led project in a UK tertiary paediatric emergency department looked at the usefulness of blood tests in 101 children. You receive a referral for a 7-year-old Josh, who presented to the emergency department (ED) with a 5-day history of fever, cough, and borderline oxygen saturation.

Emergency Department 90

Emergency Department Best Practices Radiology Radiology 90

EMDocs

APRIL 27, 2024

A 67-year-old man with a history of hypertension and diabetes presents to the emergency department with right ear pain for 2 weeks. The changing face of malignant (necrotising) external otitis: clinical, radiological, and anatomic correlations. and Staphylococcus spp. His vital signs are normal except for a temperature of 38.2°C

EMS 83

EMS Infectious Diseases Radiology Radiology 83

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 The estimated incidence over the past two decades is up to 340 visits per 100,000 individuals.1

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

EB Medicine

FEBRUARY 1, 2019

This month, we’re tackling an incredibly important topic - evaluation and management of life threatening headaches in the Emergency Department. Jeff: Interestingly, there may be a unique role for a d-dimer here as well. Let’s talk radiology. Seizures are very common as well. Avoid opioids and nsaids.

Emergency Department 40

Emergency Department Stroke Outcomes Wellness 40

ACEP Now

NOVEMBER 14, 2023

One of the most hair-raising presentations to the emergency department (ED) can be massive hemoptysis with respiratory failure. True hemoptysis is usually bright red and/or foamy blood, and is associated with respiratory symptoms as well as a sensation of warmth in the chest. Am J Emerg Med. Life-threatening hemoptysis.

Radiology 52

Radiology Radiology Emergency Department Airway Management 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

JUNE 3, 2023

23 Pelvic binding remains a critical resuscitation step well within the purview of the ED physician, and can be reviewed here: [link]. Her initial vital signs are blood pressure 76/54 mmHg, heart rate 128 bpm, temperature 37.0˚ C, respiratory rate 20 breaths per minute, and oxygen saturation 95% on room air.

Fractures 54

Fractures Resuscitation Operations EMS 54

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 63

Documentation/Coding Seizures Wellness Psychiatric 63

EMDocs

NOVEMBER 13, 2023

The use of CTA (computed tomography angiography) in the emergency department (ED) has increased dramatically in the past 20 years. 10 This is addressed in a prior emDOCs article: [link] Figure 1: Vision, aphasia, neglect emergent large vessel occlusion screening tool. vs. 38.1%) with a good functional outcome.

Stroke 87

Stroke Radiology Radiology Emergency Department 87

Pediatric Emergency Playbook

APRIL 1, 2017

Look for a small tip diameter (to fit in the ear canal as well as the nose) and a strong “hold” (at least a 3-lb hold). Am J Emerg Med. Emergency department management of foreign bodies of the external ear canal in children. Radiologic Cases in Pediatric Emergency Medicine; University of Hawaii. 2008.01.013.

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52

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. Thereafter, “siege warfare” conditions prevail, and no one does very well with that, as in Mumbai, Waco , etc. July, 2002) Managing the Emergency Consequences of Terrorist Incidents.

Federal Emergency Management Agency 40

Federal Emergency Management Agency Military Hospitals Administration 40