RebelEM

FEBRUARY 24, 2025

Well, the established cutoff for the distensibility index is 18%. Regarding caval indexes, the advent of artificial intelligence and advanced learning has become integrated into many ultrasound machines. Ultrasound Med Biol. Why does it matter? As with most things in medicine, it is important to understand the pitfalls.

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

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

RebelEM

JANUARY 25, 2024

Background: Point-of-care ultrasound (PoCUS) is a valuable clinical tool in the assessment of acute dyspnea. Impact of serial cardiopulmonary point-of-care ultrasound exams in patients with acute dyspnoea: a randomized, controlled trial. PoCUS evaluations included lung ultrasound (LUS) and focused cardiac ultrasound (FoCUS).

Ultrasounds 128

Ultrasounds Outcomes COPD Hospitals 128

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 95

Ultrasounds Documentation/Coding Wellness EMS 95

Dr. Smith's ECG Blog

SEPTEMBER 23, 2024

When EMS found her, she was dyspneic and diaphoretic. Answer : Bedside ultrasound! Smith : RV infarct may also have this appearance on ultrasound. So hypoxia without B lines on lung ultrasound strongly weights toward PE. _ Here are some representative stills with red arrows pointing to the emboli.

EKG/ECG 126

EKG/ECG Ultrasounds Shock EMS 126

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 94

Ultrasounds Emergency Department Pediatrics Radiology 94

Dr. Smith's ECG Blog

OCTOBER 1, 2023

He called EMS who brought him to the ED. I sent this ECG, without any text at all, to Dr. You can see that she is not only "looking" at the ST segment, but the majority of the T wave itself, and factoring in the QRS as well (just like expert humans do). Gallbladder ultrasound was negative for stones. Chest x-ray was normal.

EKG/ECG 126

EKG/ECG EMS Ultrasounds Wellness 126

ACEP Now

MAY 4, 2023

EMS recognized a chest wall deformity with movement of the chest wall, and a splint was devised and taped around his chest for what was suspected to be a flail chest. He is also system-wide clinical ultrasound co-chair at MetroHealth Medical Center in Cleveland, Ohio. The post Case Report: EMS Says Flail Chest, But Is It?

EMS 52

EMS Fractures Operations Radiology 52

Dr. Smith's ECG Blog

APRIL 14, 2024

A bedside cardiac ultrasound performed by a true EM expert (Robert Reardon, who wrote the cardiac ultrasound chapter in Ma and Mateer) showed an inferior wall motion abnormality. But there are also new Q-waves, stronly suggesting new infarction. Overall interpretation: this does not look like OMI to me.

EKG/ECG 118

EKG/ECG Ultrasounds EMS Wellness 118

Emergency Medicine Cases

MARCH 26, 2018

The long wait has been well worth it. The EM Cases POCUS Cases Video Series has officially been launched! POCUS Cases is an original EM Cases video series led by Dr. Robert Simard, an Emergency Physician at North York General Hospital and Sunnybrook Health Sciences Centre in Toronto.

Ultrasounds 52

Ultrasounds EMS Hospitals Wellness 52

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. Not so FAST- Chest ultrasound underdiagnoses traumatic pneumothorax.

Ultrasounds 40

Ultrasounds Emergency Department Wellness EMS 40

EM Curious

MAY 14, 2015

The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest. The breakdown on the evidence @ The SGEM.

Ultrasounds 52

Ultrasounds Poisoning EMS Burns 52

Taming the SRU

NOVEMBER 3, 2023

Ultrasound‐Guided Serratus Anterior Plane Block (SAPB) Improves Pain Control in Patients With Rib Fractures. Ultrasound Med. The thought with introducing the serratus anterior plane block was that regional anesthesia is well within the purview of EM physicians and can offer a safe alternative to systemic pain medications.

Fractures 99

Fractures Ultrasounds Research Outcomes 99

Dr. Smith's ECG Blog

MAY 20, 2024

He called EMS, who arrived on scene about two hours after the onset of pain to find him hypertensive at 220 systolic. And angiographers tell me that it is sometimes difficult to say for certain based on angiogram alone, without intravascular ultrasound or, better yet, optical coherence tomography. Smith: What???!!!

EKG/ECG 124

EKG/ECG Hospitals Wellness Emergency Department 124

EM Curious

SEPTEMBER 2, 2015

The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world, including interesting and relevant evidence based medicine, that you can fit into your busy weekly schedule. Ultrasound of the Week Procedure Pearl Ear foreign body removal with modified suction setup.

Ultrasounds 52

Ultrasounds EMS Shock Hospitals 52

ALiEM

MAY 19, 2023

A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. Esophageal Balloon Tamponade Devices – Linton-Nachlas, Sengstaken-Blakemore, Minnesota Tubes (image courtesy of Dr. Mark Ramzy at REBEL EM) What are esophageal balloon tamponade devices?

Emergency Department 98

Emergency Department Ultrasounds Wellness EMS 98

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. Studies have compared IO to peripheral intravenous (PIV) and central venous (CVC) access for resuscitation.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

EM Curious

JULY 8, 2015

The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest. Well, this may not be completely true.

Infectious Diseases 52

Infectious Diseases Disaster Management Sepsis Ultrasounds 52

Dr. Smith's ECG Blog

DECEMBER 19, 2023

EMS obtained the following vital signs: pulse 50, respiratory rate 16, blood pressure 96/49. It appears EMS obtained two EKGs, but unfortunately these were not saved in the medical record. The EMS crew was only BLS certified, so EKG interpretation is not within their scope of practice. Fortunately, that is exactly what happened.

EKG/ECG 126

EKG/ECG EMS Wellness Operations 126

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.

Dislocations 86

Dislocations Emergency Department Documentation/Coding Burns 86

Taming the SRU

JUNE 24, 2024

Conduction Abnormalities AV blocks, which can also be seen in patients with MI, may require pacing as well, due to ischemia affecting the electrical pathways of the heart.

Advances Cardiac Life Support (ACLS) 91

Advances Cardiac Life Support (ACLS) CPR Burns Resuscitation 91

EM Curious

JULY 1, 2015

The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest. Should we all be jumping on board?

EMS 52

EMS Ultrasounds EKG/ECG Fractures 52

EM Curious

AUGUST 5, 2015

The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest. You must watch this video here !

Airway Management 52

Airway Management EMS Ultrasounds Pediatrics 52

Dr. Smith's ECG Blog

JUNE 28, 2023

EMS was dispatched for a 30-something male who feels his heart is racing. He arrived in the ED and had an immediate bedside cardiac ultrasound while this ECG was being recorded. The bedside ultrasound (video not available) reportedly showed only a slightly reduced LV function. Sudden onset. Is it definitely VT??

EKG/ECG 98

EKG/ECG Ultrasounds Administration EMS 98

ALiEM

OCTOBER 30, 2024

Case A patient arrives via EMS from the bus station complaining of fever, vomiting, and back pain. Clinical impact: The patient’s DVT ultrasounds were negative. Our experience: It was not long ago that we instructed our staff that: ‘COWS >8, give ’em 8 (mg of buprenorphine).’

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

ACEP Now

JUNE 12, 2024

This growth has allowed us to provide more extensive bedside training, along with an advanced ultrasound and simulation curriculum. Our Wellness Committee is dedicated to the well-being of our team, and they have organized many activities to ensure our residents have fun too! Program Details Location: Poughkeepsie, N.Y.

Wellness 52

Wellness Ultrasounds EMS Hospitals 52

Taming the SRU

AUGUST 7, 2023

The patient needs a transvaginal ultrasound w/ doppler with gynecology consult and possible laparotomy TVUS is not just for torsion, it can also be used for ectopic pregnancies or pregnancy of unknown location Acute Ischemic Stroke Updates WITH Drs.

Stroke 94

Stroke Outcomes EKG/ECG Research 94

RebelEM

AUGUST 31, 2023

CVC placement under ultrasound guidance has decreased overall complication rates and there is increased awareness of transfusion reactions, alloimmunization, acute lung injury, circulatory overload, as well as infection. Despite being common practice, the necessity of routine prophylactic transfusions is now being called into question.

Ultrasounds 58

Ultrasounds Outcomes Wellness Research 58

EM Curious

JULY 24, 2015

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. EMS appears with a patient who just wiped out big time on the ice. Sorry we've been out of the loop lately.

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

Taming the SRU

DECEMBER 18, 2023

7) While standard technique for either male or female foley placement is well-known and straightforward, there are several measures that can be taken to ensure the highest likelihood of first-pass success. In most male patients, starting with a 16 to 18-Fr Foley catheter is an ideal choice.(7)

Emergency Nursing 78

Emergency Nursing EMS Emergency Department Ultrasounds 78

RebelEM

FEBRUARY 12, 2024

Research from our very own SIUH department of radiology recommended that contrast-enhanced CT scans can safely exclude obstructive urolithiasis just as well as noncontrast CTs. appeared first on REBEL EM - Emergency Medicine Blog. When you are using CT imaging, a CT with IV contrast is preferred. 2002; 225(2):441-449.

Radiology 73

Radiology Radiology Emergency Department Ultrasounds 73

ACEP Now

AUGUST 22, 2023

While “low-risk” chest pain is more easily described using scoring systems, undifferentiated abdominal pain is less well-defined. Therefore, the authors of GRACE-3 call for wide training of the EM workforce in the use of HINTS. The implication of such a call is magnified by the scope of the training.

Emergency Department 98

Emergency Department Academics Critical Access Research 98

Don't Forget the Bubbles

AUGUST 28, 2023

Ultrasound can be used to identify any large pleural effusions. Management must be multidisciplinary involving anaesthetics, paediatric retrieval service/paediatric intensive care, ENT and oncology teams (as well as the cardiothoracic surgery team – not always available). The median age at diagnosis was 47 months (range 1-173 months).

Pediatrics 97

Pediatrics Research Emergency Department Ultrasounds 97

Taming the SRU

OCTOBER 16, 2024

Pregnant patients are inherently higher risk for VTE, and because of this are excluded from normal clinical decision tools like Wells Criteria that would normally be able to help guidance our clinical decisions. Amputations Distal to DIP may require revision amputation, which is in the purview of EM physicians.

Airway Management 75

Airway Management Fractures CDC Pediatrics 75

Dr. Smith's ECG Blog

SEPTEMBER 9, 2024

She took an oxycodone and called EMS. The cut points for what constitute OMI and not OMI as well as confidence levels are calibrated to maximize sensitivity and specificity according to the receiver operating characteristic. The diagonal branches are overlapping one another and not well visualized in this view.

EKG/ECG 65

EKG/ECG Operations Wellness Ultrasounds 65

ACEP Now

AUGUST 29, 2023

We have an Addiction Medicine fellowship, and the sponsoring institution (MetroHealth) has a fellowship in Clinical Informatics; these are in addition to our current, long-standing ultrasound and EMS fellowships. Once per year, we also guarantee a night off together for each class, as well as guy’s night and girl’s night.

Academics 52

Academics Burns Emergency Department Ultrasounds 52

The Skeptics' Guide to EM

SEPTEMBER 14, 2019

He is interested in ultrasound and international emergency medicine. Case: It’s a busy night in the emergency department, your next patient is a well appearing 70-year-old man, presenting after a mechanical fall from standing with loss of consciousness. We also discussed three studies that compared CCHR to the NOC.

Head Injuries 52

Head Injuries Emergency Department Seizures EMS 52