The Skeptics' Guide to EM

SEPTEMBER 9, 2023

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.

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Fractures Ultrasounds Pediatrics Outcomes 122

ALiEM

APRIL 12, 2023

You set up everything, have the patient positioned, and then notice there is no sterile ultrasound gel. The trick is to eliminate anything of poor acoustic impedance between the ultrasound probe and the patient’s skin. Note that some ultrasound manufacturers do not recommend the use of isopropyl alcohol on their transducers.

Ultrasounds 103

Ultrasounds Emergency Department Resuscitation Wellness 103

EMDocs

MARCH 25, 2024

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. 2, 3 Biliary POCUS can help decrease patient length of stay in the Emergency Department. Ultrasound. Acad Emerg Med.

Ultrasounds 87

Ultrasounds Radiology Radiology Operations 87

St. Emlyn

AUGUST 23, 2023

St.Emlyn's - Emergency Medicine #FOAMed Part 1 of an introduction to paediatric ultrasound in the emergency department from Dr Pete Hulme @Dr_Pete_EmMed @stemlyns #FOAMed The post Paediatric Point of care ultrasound: Big Kids playing with toys or the future of Paediatric emergency medicine?

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Ultrasounds Emergency Department 91

Taming the SRU

OCTOBER 23, 2023

THE CASE A female in her early 20s, G4P2012, presents to the emergency department (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.

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

ALiEM

MARCH 7, 2024

Given her pain with a history of intermittent hematuria and dysuria, you perform a renal and bladder point of care ultrasound (POCUS) examination. Pre-warmed ultrasound gel is helpful when available. Then test your skills on the ALiEMU course page to receive your PEM POCUS badge worth 2 hours of ALiEMU course credit.

Ultrasounds 70

Ultrasounds Pediatrics Radiology Radiology 70

ALiEM

MAY 13, 2024

Take the ALiEMU PEM POCUS: Soft Tissue Quiz Case Goals List the indications of performing a pediatric soft tissue point-of-care ultrasound (POCUS). 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.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

RebelEM

JANUARY 25, 2024

Background: Point-of-care ultrasound (PoCUS) is a valuable clinical tool in the assessment of acute dyspnea. In many emergency departments (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.

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Ultrasounds Outcomes COPD Hospitals 129

St. Emlyn

AUGUST 29, 2023

St.Emlyn's - Emergency Medicine #FOAMed Part 2 of our introduction to ultrasound use in the paediatric emergency department with @Dr_Pete_EmMed #USS @FOAMed #paediatrics The post Paediatric Point of care ultrasound: Big Kids playing with toys or the future of Paediatric emergency medicine?

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Ultrasounds Emergency Department 75

Ultrasound Gel

JUNE 18, 2018

Ultrasound can see many causes of chest pain. Sooooo lets use ultrasound in patients with chest pain to help with decision making. This article takes an interesting approach in performing a rather complex "focused" echo in the emergency department and uses it to determine the patient's disposition. Chest pain is common.

Emergency Department 52

Emergency Department Ultrasounds Wellness 52

ACEP Now

OCTOBER 29, 2024

On a busy day shift in the emergency department, our seasoned triage nurse comes to me after I finish caring for a hallway patient, “Hey, can you come see this guy in the triage room? This is the essence of emergency medicine. A testicular ultrasound confirmed restored blood flow. His vitals are fine…”.

Emergency Department 59

Emergency Department Mass Casualty Incidents Documentation/Coding Sepsis 59

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.

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Ultrasounds Sepsis Radiology Radiology 78

Cook County EM Blog

APRIL 11, 2023

So, you reach for your ultrasound… Why It Matters : Shoulder dislocations are a common presentation to the emergency department and account for approximately 200,000 visits annually [1]. Ultrasound was also noted to be 43 minutes faster for diagnosing shoulder dislocations compared to standard radiograph approach.

Dislocations 52

Dislocations Ultrasounds Emergency Department Radiology 52

EB Medicine

OCTOBER 8, 2020

EMplify October 2020 Management of Deep Vein Thrombosis in the Emergency Department Authors: Shane R. EMplify October 2020 Management of Deep Vein Thrombosis in the Emergency Department Authors: Shane R.

Emergency Department 52

Emergency Department Ultrasounds 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. References Garcia SE.

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Emergency Department Operations Ultrasounds Hospitals 52

ALiEM

OCTOBER 23, 2024

Ultrasound-guided procedures are difficult enough just identifying the anatomy. Performing a nerve block with the ultrasound in one hand and the needle in the other hand adds extra challenges. The simplest 1-person approach involves attaching a syringe with local anesthetic directly to the end of the procedural needle.

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Ultrasounds Emergency Department 56

ACEP Now

OCTOBER 30, 2023

We are the first community emergency medicine program in the country. Residents train at an academic Level I trauma center and several freestanding emergency departments (EDs). We offer innovative ultrasound training, which includes nerve blocks in the ED, and annually participate in SAEM Sonograms.

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Ultrasounds Academics Emergency Department 111

University of Maryland Department of Emergency Med

JUNE 4, 2023

Pt presents to the emergency department with knee pain. You decide to ultrasound the proximal knee. You place your ultrasound probe. Click to view the rest

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Ultrasounds Emergency Department 90

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

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.

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Fractures Ultrasounds Emergency Department CDC 83

Emergency Medicine Journal

JULY 22, 2024

Background and objectives The ability to rule appendicitis in or out using ultrasound is limited by studies where the appendix is not visualised. For those patients who had formal ultrasound, direct and indirect findings of ultrasound were abstracted from the ultrasound report. 95% CI 1.7 95% CI 3.8 95% CI 1.4

Ultrasounds 52

Ultrasounds Radiology Radiology Emergency Department 52

Taming the SRU

OCTOBER 27, 2023

Diagnostic accuracy of point-of-care ultrasound (PoCUS) for shoulder dislocations and reductions in the emergency department: a diagnostic randomised control trial (RCT). Clinical Question: What is the impact of point of care ultrasound in adults with acute traumatic shoulder pain when used as an adjunct to physical examination?

Dislocations 95

Dislocations Fractures Ultrasounds Emergency Department 95

Downeast Emergency Medicine

FEBRUARY 14, 2023

THE CASE A 13-year-old boy is seen in the Emergency Department (ED) for a cough. Credits: Andrew fried, md A point-of-care lung ultrasound is performed, with the following findings on the left lung fields. Point of Care Ultrasound of the Left Lung Fields. Point of Care Ultrasound of the Left Lung Fields.

Ultrasounds 52

Ultrasounds Emergency Department Pediatrics 52

Taming the SRU

JULY 22, 2024

INDICATIONS Arthrocentesis is a common procedure performed in the Emergency Department, in which a needle is inserted into a joint to withdraw fluid from the joint capsule. Studies have shown that effusions of as little as 2 to 4 mL can be identified using ultrasound [6]. ANESTHETIZE THE AREA step 7. Step 1: Prepare STEP 2.

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Ultrasounds Emergency Department EMS 96

Emergency Medicine Journal

SEPTEMBER 27, 2023

Emergency physicians are increasingly familiar with point-of-care ultrasound (POCUS) as an adjunct to clinical examination. Although once the preserve of a small number of enthusiasts, POCUS is now a fundamental part of practising emergency medicine. The Sono Case Series has been a popular feature of the EMJ for several years.

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Ultrasounds Emergency Department 40

Cook County EM Blog

MARCH 28, 2023

On point-of-care ocular ultrasound of the affected eye using the linear probe a round, mobile structure was noted in the posterior chamber with an absence of the lens in its typical position, consistent with posterior lens dislocation. What is the utility of point-of-care ultrasound in identifying lens dislocation?

Dislocations 52

Dislocations Ultrasounds Fractures Radiology 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)

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Ultrasounds Shock Research Operations 98

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?

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Ultrasounds Fractures Operations Emergency Department 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

Taming the SRU

APRIL 14, 2024

2) Management: Confirmed by CT Surgical consult Utility of Ultrasound Ultrasound 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%

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Ultrasounds Emergency Department Pediatrics Radiology 93

EM Curious

JULY 10, 2015

By Michael Macias Welcome to the Ultrasound Leadership Academy (ULA) summary blog series. This week, we discuss the basics of shoulder ultrasound. If you want to learn more about the program you can visit Ultrasound Leadership Academy or Ultrasound Podcast to see more from the hosts of this awesome program.

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Leadership Ultrasounds Dislocations Fractures 52

Canadian EM

OCTOBER 24, 2023

A 72-year-old male presents to the emergency department (ED) with severe chest pain and difficulty breathing after an MVC. The post Clinical Question: Which ultrasound-guided nerve block is best for acute pain management of rib fractures in the ED? first appeared on CanadiEM.

Fractures 52

Fractures Ultrasounds Emergency Department 52

Downeast Emergency Medicine

NOVEMBER 5, 2021

male with history of diastolic heart failure, type II DM, HTN, and peripheral vascular disease presented to the emergency department via EMS for evaluation of abnormal vital signs. Upon arrival to the emergency department he remained hypoxic, with an SpO2 of 79% on room air. CASE PRESENTATION A 73 y.o.

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Ultrasounds Emergency Department EMS Wellness 52

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.

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EKG/ECG Emergency Department Shock Ultrasounds 141

Taming the SRU

MAY 13, 2024

Discussion Acute appendicitis is one of the most common causes of acute abdomen that present to the Emergency Department requiring surgical intervention. [1] A clinical suspicion of stump appendicitis may be confirmed with various imaging modalities, abdominal ultrasound or CT imaging being most common. Clin Case Rep.

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Ultrasounds Emergency Department Wellness Operations 97

EMDocs

SEPTEMBER 28, 2024

2: Ultrasound + Pediatric Appendicitis Risk Calculator = Rule Out? The authors found that combining a low pediatric Appendicitis Risk Calculator (pARC) result with a nondiagnostic ultrasound results in a high negative predictive value for appendicitis. Acad Emerg Med. Acad Emerg Med. PMID: 38597847. #2: doi: 10.1111/acem.14893.

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Ultrasounds Pediatrics Emergency Department Wellness 78