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Putting Clinical Gestalt to Work in the Emergency Department

ACEP Now

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. 4 However, emergency physicians rely on gestalt to predict outcomes well.

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The Ultrasound-Guided Genicular Nerve Block

ACEP Now

Patients often seek care in the emergency department (ED) setting when flares of pain affect their ability to ambulate, climb stairs, or even stand up from sitting. The innervation of the knee is complex, but much of its sensory innervation is supplied by the genicular nerves, which are easy targets for ultrasound-guided nerve blocks.

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Ultrasound of the Month: Peritonsillar Abscess

Taming the SRU

THE CASE A female in her 20’s presented to the emergency department with concern for oral swelling. She endorsed low grade fevers and chills as well as odynophagia, dysphagia, and some shortness of breath. Patient preparation is one of the most important aspects of successful intraoral ultrasound. There was no trismus.

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Trick of the Trade: Gel-free ultrasound-guided peripheral IV technique

ALiEM

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.

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PEM POCUS Series: Pediatric Lung Ultrasound

ALiEM

Read this tutorial on the use of point of care ultrasonography (POCUS) for pediatric lung ultrasound. Take the ALiEMU PEM POCUS: Pediatric Lung Ultrasound Quiz Module Goals List indications for performing a pediatric lung point-of-care ultrasound (POCUS). Describe the technique for performing lung POCUS.

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SGEM#469: You Take My Breath Away – D-dimer for Ruling out PE in High-Risk Patients

The Skeptics' Guide to EM

Dr. Westafer serves as the Social Media Editor and a research methodology editor for Annals of Emergency Medicine. Case: A 57-year-old woman presents to the emergency department (ED) with pleuritic posterior chest/back pain, shortness of breath, and left leg swelling.

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Diagnostics and Therapeutics: Vascular Access in the Emergency Department

Taming the SRU

Ultrasound Guided Peripheral IV (USGIV) Access anatomy of arm veins when considering USGIV. unported license [link] Ultrasound allows us to visualize deeper, typically larger veins in the forearm and upper arm. Place ultrasound machine on the opposite side of the bed to minimize neck strain. Check for flash in the IV chamber.