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

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

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

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. The most well-accepted classification of acute perforated cholecystitis is the Niemeier classification which is outlined as below (3,6).

Ultrasounds 78

Ultrasounds Sepsis Radiology Radiology 78

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. Well, wipe the smile from your face validity because it is not that simple. Ultrasound can see many causes of chest pain. Chest pain is common. Chest pain is common.

Emergency Department 52

Emergency Department Ultrasounds Wellness 52

EMDocs

SEPTEMBER 28, 2024

It was ruled out as well with good specificity, with a bubble time < 40 seconds. Ann Emerg Med. 2: Ultrasound + Pediatric Appendicitis Risk Calculator = Rule Out? Source Identification of children with a nondiagnostic ultrasound at a low appendicitis risk using a pediatric Appendicitis Risk Calculator. Acad Emerg Med.

Ultrasounds 78

Ultrasounds Pediatrics Emergency Department Wellness 78

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.

Fractures 83

Fractures Ultrasounds Emergency Department CDC 83

RebelEM

DECEMBER 10, 2023

Background: The use of ultrasound is well established for trauma patients in the emergency department, with almost every patient receiving a FAST (Focused Assessment with Sonography in Trauma) examination as part of the “ABC’s” of trauma. As always, we should consider new data as it emerges.

Ultrasounds 40

Ultrasounds Emergency Department Wellness EMS 40

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.

Ultrasounds 130

Ultrasounds Outcomes COPD Hospitals 130

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.

Ultrasounds 52

Ultrasounds Emergency Department EMS Wellness 52

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

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. i] Leibowitz A, Oren-Grinberg A, Matyal R.

Ultrasounds 98

Ultrasounds Shock Research Operations 98

Taming the SRU

APRIL 14, 2024

You may place cold packs or ice packs to the hernia site to help reduce inflammation and swelling, as well as to assist in local analgesia. Symptoms include persistent tenderness in the area, as well as symptoms of obstruction including nausea, vomiting, and pain, despite reduction. (2) 1) In a study performed by Chen et al.

Ultrasounds 93

Ultrasounds Emergency Department Pediatrics Radiology 93

Taming the SRU

MAY 13, 2024

The patient is a well-appearing male who is awake, alert, and oriented. There is also a well-appearing, healed surgical scar. There is also a well-appearing, healed surgical scar. The skin is warm and well perfused with brisk capillary refill. Respiratory and cardiovascular exams are normal. BMP : Na 136, K 4.3,

Ultrasounds 97

Ultrasounds Emergency Department Wellness Operations 97

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. I am still intrigued by this study!

Pediatrics 147

Pediatrics Outcomes Operations Emergency Department 147

ACEP Now

FEBRUARY 13, 2024

A 77-year-old man presented to the emergency department (ED) with hip pain following a fall. See below: Fascia iliaca Serratus anterior Erector spinae The risks of opioid medications, especially in the elderly, has been well described. In the January issue of Annals of Emergency Medicine , Merz-Herrara, et al.,

Ultrasounds 52

Ultrasounds Emergency Department Hospitals Wellness 52

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

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 Academics Hospitals Fractures 64

Ultrasound Gel

APRIL 26, 2021

We have been ultrasounding hips for a while now. First it asks the question - "Does point-of-care ultrasound (POCUS) in the emergency department lead to a faster diagnosis?". First it asks the question - "Does point-of-care ultrasound (POCUS) in the emergency department lead to a faster diagnosis?".

Ultrasounds 52

Ultrasounds Emergency Department Wellness 52

Cook County EM Blog

MAY 1, 2023

The Case: A 56-year-old male with no significant past medical history presents to the emergency department with worsening swelling, pain, and erythema of the right elbow. Patient Course: In the emergency department, the patient received lab work that was remarkable for WBC 11.8, and ESR 26. emDocs.net. 2009 Jun 25.

Ultrasounds 52

Ultrasounds Emergency Department Hospitals Outcomes 52

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 103

Emergency Department Ultrasounds Pediatrics Best Practices 103

EMDocs

JUNE 1, 2024

Source Ultrasound-guided central venous catheterization around the neck: Systematic review and network meta-analysis. Am J Emerg Med. Source PECARN prediction rules for CT imaging of children presenting to the emergency department with blunt abdominal or minor head trauma: a multicentre prospective validation study.

Emergency Department 65

Emergency Department Ultrasounds Pediatrics Wellness 65

ACEP Now

AUGUST 22, 2023

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 emergency department. 1 To date, there have been three GRACE publications. 1 To date, there have been three GRACE publications.

Emergency Department 98

Emergency Department Academics Critical Access Research 98

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

ACEP Now

AUGUST 12, 2024

Well, it happens that my interest in birding seemed to parallel a simultaneous growth in the practice of mindfulness in medicine. Now let me take it one step further and tell you why emergency physicians in particular make excellent birders. It has brought me a wealth of joy. But, you might be asking, why should you care?

Ultrasounds 115

Ultrasounds Emergency Department Wellness 115

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 70

Hospitals Ultrasounds Emergency Department Pediatrics 70

EMDocs

OCTOBER 8, 2024

Tachycardia may be present both from many medications or drugs, as well as withdrawal. Let’s use the example of the well appearing patient, without significant comorbidities. Disposition of sinus tachycardia depends on many factors, however the well-appearing asymptomatic patient does not require admission for tachycardia alone.

Shock 95

Shock Emergency Department Pediatrics EKG/ECG 95

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. There are well preserved R-waves in Wellens waves. Now another, with ultrasound. What do you think?

EKG/ECG 137

EKG/ECG Emergency Department Shock Ultrasounds 137

ALiEM

OCTOBER 23, 2023

A 32-year-old man with a history of traumatic globe rupture from a stab wound two months ago, status post repair, presented to the emergency department for worsening right eye pain and green malodorous drainage for the past three days. There was a well-healed scar on the bottom eyelid.

Academics 111

Academics Emergency Department Ultrasounds Wellness 111

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Rib fractures account for over 15% of all trauma attendances in the Emergency Department. ED Physicians are already well-versed in the use of ultrasound. Among patients with multiple rib fractures, the mortality rate can reach a staggering 33%, and this risk doubles for individuals above the age of 65.

Fractures 40

Fractures Anaphylaxis Emergency Department Ultrasounds 40

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: This month’s team parsed through roughly 1200 articles as well as guidelines from the eastern association for surgery in trauma also known as EAST.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

RebelEM

FEBRUARY 12, 2024

There are greater than 2 million annual emergency department 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.

Radiology 85

Radiology Radiology Emergency Department Ultrasounds 85

RebelEM

APRIL 29, 2024

CVC vs PIV The critically ill patient is often associated with pathology that makes IV access difficult such as shock state, hypovolemia, obesity, IV drug abuse, end-stage renal disease, cardiac arrest, as well as other conditions. World J Emerg Surg 2023 PMID: 36918947 3. Int J Emerg Med 2009 PMID: 20157465 4. Crit Care Med.

Resuscitation 105

Resuscitation Administration Emergency Department Hospitals 105

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. I waited until my 6 week ultrasound. It was October. It was certain.

Ultrasounds 83

Ultrasounds Radiology Radiology Emergency Department 83

Taming the SRU

AUGUST 4, 2024

We discussed some practices to push learners outside of their comfort zone and promote learning, based on their level as well as their goals for the shift.

Emergency Department 85

Emergency Department Dislocations Documentation/Coding Burns 85

Pediatric Education

JUNE 9, 2024

Patient Presentation An 18-year-old female came to the emergency department with an 18 hour history of sudden onset of right lower quadrant pain. She said she hadn’t felt well for a couple hours before that and had had some nausea and emesis before the pain. On Doppler ultrasound arterial blood flow may or may not be seen.

Pediatrics 52

Pediatrics Ultrasounds Radiology Radiology 52

ACEP Now

SEPTEMBER 13, 2023

But what if we could measure a patient’s spleen via ultrasound in the emergency department (ED) to guide specific patient care? Practitioners have looked at splenic size on ultrasound and its association with splenic dysfunction. Acad Emerg Med. US Department of Health and Human Services. Am J Roentgenol.

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Poisoning 52