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Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. Casey currently splits his time […] The post SGEM#415: Buckle Down for some Ultrasound to Diagnosis Distal Forearm Fractures first appeared on The Skeptics Guide to Emergency Medicine. Reference: Snelling et al.
She is the cofounder of FOAMcast and a pulmonary embolism and implementation science researcher. Dr. Westafer serves as the Social Media Editor and a research methodology editor for Annals of Emergency Medicine. Chest x-ray shows no pneumonia or pneumothorax and bedside ultrasound reveals no B-lines or effusion.
THE CASE A female in her early 20s, G4P2012, presents to the emergencydepartment (ED) with a 5 day history of left lower quadrant abdominal pain which has been worsening since onset. A bedside ultrasound is completed to assess the location of the pregnancy. She reports that her previous ectopic pregnancy was treated medically.
Background: Point-of-care ultrasound (PoCUS) is a valuable clinical tool in the assessment of acute dyspnea. In many emergencydepartments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. Emerg Med J. 2023;40(10):700-707.
Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergencydepartment: A randomized controlled trial. Background: We have covered rib fractures once before on the Skeptics’ Guide to Emergency Medicine.
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)
2) Management: Confirmed by CT Surgical consult Utility of UltrasoundUltrasound can be helpful in identifying hernias and in assisting in reduction. 8) “Ultrasound may decrease the emergency surgery rate of incarcerated inguinal hernia” by Chen et al. (1) The results revealed a rate of emergency surgery of 9.8%
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].
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 emergencydepartment. 1 To date, there have been three GRACE publications. 1 To date, there have been three GRACE publications.
Should we use ultrasound to diagnose distal forearm fractures in children and adolescents? X-ray (radiography) is the standard imaging technique used in emergencydepartments. However, ultrasound is gaining popularity due to its portability, affordability, and lack of ionising radiation.
7-year-old Tilly is brought to your emergencydepartment at 11 p.m. Abdominal pain in children is common, accounting for over 1 in 20 attendances to paediatric emergencydepartments [1]. Clinical scoring tools have improved diagnostic performance in assessing suspected appendicitis in the emergencydepartment.
Clinical outcomes assessed at 60 days included an unplanned return to the emergencydepartment (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.
Of course, we are (in a convoluted way) referring to ocular ultrasound. Historically a great party trick, can this modality accurately diagnose visual problems in the emergencydepartment? Sit back, relax, and visualize the latest in ocular POCUS research. It's been done before, but it hasn't been done to this degree.
A 46-year-old female with a prior medical history of asthma presented to the emergencydepartment 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.
Sean Baldwin is an Emergency Physician practising in Sydney, Australia in both a large tertiary emergencydepartment and a small regional emergencydepartment. Interests include information systems and digital health, research and education. Reference: Partyka et al.
Talk about your major extra-curricular activities and research in the department. For example, one medical school student I recently interviewed who was applying for internal medicine – primary care spoke about her research with transgender individuals and their perceptions of sexual health. These reasons are TOO common.
Pathway with single-dose long-acting intravenous antibiotic reduces emergencydepartment hospitalizations of patients with skin infections. AEM October 2021 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate.
Ultrasound can be used to identify any large pleural effusions. Five-year-old Ginny presents to the EmergencyDepartment with a syncopal episode. Arguably, more robust research is neither feasible nor ethical to conduct in such a rare and time-critical emergency. – Simple tests (e.g. .
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 EmergencyDepartment faster than sutures, allowing the ED physician to be more efficient.
For those new to the probe, we recommend first reviewing the basics in the incredible FOAMed Introduction to Bedside Ultrasound Book , 5 Minute Sono , and POCUS Atlas. The one absolute contraindication for ocular ultrasound is any suspicion for globe rupture, as placing any pressure on the globe can worsen extrusion of intraocular contents.
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.
Chip is the CEO of an ultrasound education company called Practical POCUS which is based in the United States but is expanding into an international market. Case: A 6-year-old boy comes into your emergencydepartment at around midnight with his parents complaining of abdominal pain.
One of our beloved colleagues from the community has recently declared to us his love of ultrasound guided nerve blocks--a skill that is established in the anesthesia world but is quickly gaining traction in our realm. Do your research, and always be safe. jps Sources Roberts and Hedges Clinical Procedures in Emergency Medicine.
There are greater than 2 million annual emergencydepartment visits for suspected renal colic in the US, and Ct scanning is performed for more than 90% of patients who receive a diagnosis of kidney stone. What Your Gut Says: We need a CT report to diagnose a kidney stone. ” The Journal of Urology 199.4S (2018): e683-e684.
She is interested in social determinants of health in the emergencydepartment and health policy. Dr. Ian Holley is also a PGY-3 resident in Emergency Medicine at Washington University School of Medicine in St. He is interested in ultrasound and international emergency medicine.
Some other different features this year include: Integrated Research Forum: Get ready for an electrifying experience at ACEP’s Research Forum, emergency medicine’s premier research event! Get a personal financial plan, immerse yourself in hands-on training, brush up on your ultrasound and more. 28: 10 a.m.–5
We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. Minor head trauma in infants – how accurate is cranial ultrasound performed by trained radiologists? Dias FC, et al. J Pediatr Gastroenterol Nutr. 2023 Apr 25.
Guest Skeptic: Dr. Melissa Langhan is an Associate Professor of Pediatric Emergency Medicine at Yale University in New Haven, CT. Melissa is passionate about clinical and translational research and focuses most of her work […] The post SGEM#205: Twist & Shout – Testicular Torsion first appeared on The Skeptics Guide to Emergency Medicine.
Written by Colin Jenkins and Nhu-Nguyen Le with edits by Willy Frick and by Smith A 46-year-old male presented to the emergencydepartment with 2 days of heavy substernal chest pain and nausea. The receiving emergency physician consulted with interventional cardiology who stated there was no STEMI. link] Fesmire, F. Wharton, D.
epidemiology of venous thromboembolism in pregnancy VTE is not only important to understand because it is the number one cause of mortality for pregnant patients, but also because it is common and will show up in your EmergencyDepartment likely frequently throughout your career. If you feel the patient is high-risk (ie.
Our program pairs training at one of the busiest emergencydepartments in the country at a nationally recognized county, safety-net, Level I Trauma and Regional Burn Center (MetroHealth) with a world-renowned quaternary academic referral center (Cleveland Clinic). What does your program offer that residents can’t get anywhere else?
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 emergencydepartments in the United States were staffed by a private equity-owned physician group. Center for Economic and Policy Research (CEPR). The New Yorker.
There are many different types of pneumothorax (PTX), and the management paradigm has shifted in recent years as the research has exploded on this topic. This post aims to broadly cover the types of PTX, the diagnostic modalities available, and the ideal management by PTX type in the EmergencyDepartment. Ann Emerg Med.
This time, Doctors from ‘The Bridge ‘ tell us what is new in the world of paediatric literature… The Bridge: Is a Post Graduate Doctor in Training (PGDiT) -led paediatric research forum in Yorkshire and Humber, UK, with the aim of bridging the gap in research access amongst PGDiT. Am J Emerg Med. 2024.04.053.
A retrospective evaluation of phenobarbital versus benzodiazepines for the treatment of alcohol withdrawal in a regional Canadian emergencydepartment Link: [link] Bottom Line: This study in a small regional ED showed a QI project rolling out a Phenobarbital or Diazepam for Alchohol withdrawal syndrome.
Here, then, are some links for Third Trimester Emergencies. Keep your ultrasound handy. Understand the application of the EMTALA law (Emergency Medical Treatment and Active Labor Act [ USA ]) to your situation. Preeclampsia/ Eclampsia - EmergencyDepartment Resources. {3 abstracts} Luckett-Gatopoulos, S.
Kirsty did her residency in North West England and has a PhD in Health Services Research from Sheffield. Case: A 22-year-old patient presents to the emergencydepartment with sudden onset shortness of breath. She did her Medical School at Manchester, with a History of Medicine BSc at the same time.
She was unable to be defibrillated but was cannulated and placed on ECMO in our EmergencyDepartment (ECLS - extracorporeal life support). The ways to tell for certain include intravascular ultrasound (to look for extra-luminal plaque with rupture) or "optical coherence tomography," something I am entirely unfamiliar with.
Ultrasound Not ready for prime time. Discharged on supplemental oxygen from an emergencydepartment in patients with bronchiolitis. Management of bronchiolitis in the emergencydepartment: impact of evidence-based guidelines? Factors that are predictive of a definite infiltrate are: significant hypoxia ( 39°C).
Diarrhea is one of the most common complaints in the pediatric emergencydepartment, especially in the summer and early fall. Timing and utility of ultrasound in diarrhea-associated hemolytic uremic syndrome: 7-year experience of a large tertiary care hospital. References: Glatstein M, Miller E, Garcia-Bournissen F, Scolnik D.
We have teamed up with the team from the EmergencyDepartment at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The children’s Emergencydepartment sees approximately 50,000 presentations per year. Without a clear definition, tailoring research and audit is difficult.
1 The rationale for the shift away from normal saline in 2021 derived from multiple trials, including the Isotonic Solutions and Major Adverse Renal Events Trial (SMART) and Saline Against Lactated Ringer’s or Plasma-Lyte in the EmergencyDepartment (SALT ED). Procalcitonin and sepsis in the EmergencyDepartment: an update.
A 6-year-old male presented to the pediatric emergencydepartment (PED) for scalp lesions. An outpatient ultrasound was performed showing “multiple scalp echogenic nodular lesions measuring from 0.5 A point-of-care ultrasound (POCUS) using a high-frequency, linear transducer was performed during the PED visit (Image 2).
We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. The researchers compared children diagnosed via screening with those diagnosed after clinical symptoms appeared. Akkaya B et al. Eur J Pediatr. 2024 Apr 13.
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