Don't Forget the Bubbles

NOVEMBER 13, 2023

Should we use ultrasound to diagnose distal forearm fractures in children and adolescents? Distal forearm fractures are common in children and adolescents, but the best method for diagnosing them is still debatable. However, ultrasound is gaining popularity due to its portability, affordability, and lack of ionising radiation.

Fractures 64

Fractures Ultrasounds Emergency Department Pediatrics 64

Emergency Medicine Journal

NOVEMBER 28, 2023

Background During closed reduction of displaced distal radius fractures, physical examination is used to determine the need for further manipulation before radiographic confirmation and cast application. Manipulation performed under ultrasound guidance has the potential to decrease the number of reduction attempts. to 6.45).

Fractures 40

Fractures Ultrasounds Emergency Department Operations 40

RebelEM

APRIL 29, 2024

Many clinicians don’t consider IO placement while others consider it a last resort or only a pre-hospital procedure. The current standard of practice has moved away from landmark-based central line placement given the efficacy and safety of ultrasound-based techniques. This study also showed the median time for IO placement was only 1.2

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

RebelEM

JANUARY 29, 2024

Randomized, Controlled Trial of Ultrasound-Assisted Catheter-Directed Thrombolysis for Acute Intermediate-Risk Pulmonary Embolism. A prospective, Single-Arm Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism: The SEATTLE II Study. CHEST 2010.

Stroke 133

Stroke Outcomes Hospitals Administration 133

The Skeptics' Guide to EM

NOVEMBER 9, 2019

Guest Skeptic: Chip Lange is an Emergency Medicine Physician Assistant (PA) working primarily in rural Missouri in community hospitals. Guest Skeptic: Chip Lange is an Emergency Medicine Physician Assistant (PA) working primarily in rural Missouri in community hospitals. He also hosts a great #FOAMed blog and podcast called TOTAL EM.

Ultrasounds 52

Ultrasounds Fractures Pediatrics Radiology 52

The Skeptics' Guide to EM

MARCH 15, 2019

Guest Skeptic: Chip Lange is an Emergency Medicine Physician Assistant (PA) working primarily in rural Missouri in community hospitals. Guest Skeptic: Chip Lange is an Emergency Medicine Physician Assistant (PA) working primarily in rural Missouri in community hospitals. Ann Emerg Med 2018. Ann Emerg Med 2018.

Ultrasounds 52

Ultrasounds Fractures EMS Hospitals 52

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. Laboratory Data CT Orbits/Sella w/ IV Contrast : No acute orbital fracture.

Emergency Department 64

Emergency Department Fractures Academics Hospitals 64

Don't Forget the Bubbles

MAY 17, 2023

The Bubble Wrap Plus is a monthly paediatric journal club reading list from Anke Raaijmakers, working with Professor Jaan Toelen and his team at the University Hospitals in Leuven. Minor head trauma in infants – how accurate is cranial ultrasound performed by trained radiologists? Can’t get enough of Bubble Wrap?

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

Taming the SRU

JANUARY 10, 2024

There are 38 states where it currently is a felony of some level to assault a healthcare worker BUT there is currently no federal law that protects hospital employees from assault or intimidation. Current bills in progress: US H.R.2663 2663 & S.1176 1176 focuses on violence prevention (introduced for the 3rd time 4/18/23); US H.R.2584

EKG/ECG 93

EKG/ECG Shock Fractures Dislocations 93

Don't Forget the Bubbles

DECEMBER 25, 2023

In the BUCKLED trial that looked at whether ultrasound was non-inferior to X-ray in diagnosing forearm fractures, the primary outcome was physical function of the affected arm at four weeks. A randomized trial of epinephrine in out-of-hospital cardiac arrest. They are the variables that matter most to the patient. We love POOs.

Research 83

Research Outcomes Fractures Pediatrics 83

Taming the SRU

OCTOBER 1, 2023

Blunt trauma can cause rib fracture or dislocation that may injure the visceral pleura. PPV, rib fractures, and decreased GCS were predictive of conservative management failure [23]. Carries the advantage of being able to detect displaced rib fractures, foreign bodies, mediastinal or diaphragmatic changes [17].

Fractures 96

Fractures COPD Hospitals Emergency Department 96

The Skeptics' Guide to EM

DECEMBER 17, 2022

AEM December 2022 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. EMS have already splinted an obvious mid-shaft femoral fracture, but he continues to be tachycardic and hypotensive.

Blood Transfusions 52

Blood Transfusions Fractures EMS Emergency Department 52

The Skeptics' Guide to EM

MARCH 25, 2023

Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Ultrasound is usually the first line imaging modality for diagnosing acute biliary disease.

Ultrasounds 52

Ultrasounds Emergency Department Dislocations Radiology 52

Taming the SRU

SEPTEMBER 15, 2023

ultrasound grand rounds: bedside dvt studies - family presence in the ed/icu - r1 clinical knowledge: aicd - r3 small groups: difficult airway management Ultrasound grand rounds: DVT studies WITH Dr. minges Why should we perform bedside DVT studies in the ED? ETT onto a fiberoptic scope.

CPR 90

CPR Burns Airway Management Wellness 90

ACEP Now

MARCH 15, 2024

3 Tenderness over the distal radial metaphysis after wrist injury is strongly suggestive of a distal radius fracture despite normal plain radiographs and fluoroscopic images. Children and older adults have weaker long bones than young adults and are more likely to sustain a distal radius fracture after a FOOSH than a carpal bone injury.

Fractures 52

Fractures Dislocations EMS Emergency Department 52

ACEP Now

MAY 4, 2023

Case FIGURE 1: Chest X-ray of multiple rib fractures (arrows). The chest X-ray showed multiple displaced right rib fractures and chest wall subcutaneous emphysema without definitive evidence of a pneumothorax, as well as right lower lobe atelectasis versus contusion (Figure 1). Click to enlarge.) Click to enlarge.) Click to enlarge.)

EMS 52

EMS Fractures Operations 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. References Garcia SE. Butt Lifts Are Booming.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

ACEP Now

OCTOBER 15, 2023

Laryngotracheal trauma has been cited as accounting for less than one in 100,000 hospital admissions. Fracturing the larynx requires considerable force, and the great majority of fractures are from blunt high-velocity trauma. Is there an open neck wound or palpable cartilage fracture?

Fractures 52

Fractures Dislocations Airway Management Operations 52

Mind The Bleep

OCTOBER 17, 2024

What my elective entailed I undertook a four-week Pre-Hospital Emergency Medicine (PHEM) elective with the Midlands Air Ambulance Charity. There were however some investigations used that you would not typically see in a ward A-E, such as thoracic ultrasound to rule out traumatic injuries. Pre-hospital medicine is not always glamorous!

Ambulance Services 52

Ambulance Services Anaphylaxis Hospitals Airway Management 52

Broome Docs

APRIL 6, 2023

Clinical risk factors for testicular torsion and a warning against falsely reassuring ultrasound scans: a 10-year single-centre experience. Immobilisation of torus fractures of the wrist in children (FORCE): a randomised controlled equivalence trial in the UK. PMID: 36688507 You can read Justin’s Full write up here. Emerg Med J.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

Taming the SRU

MARCH 17, 2023

mepivacaine (1-3 h) 1% lidocaine +/- epi (2-3h) 0.25% bupivacaine (2-3 h) 0.25-0.5% mg/kg IV Versed: 0.2 mg/kg IM, 0.2 mg/kg IN (may repeat to max of 0.4 mg/kg IN), 0.2

Seizures 40

Seizures Fractures Burns Pediatrics 40

The Skeptics' Guide to EM

JULY 2, 2017

JACC March 2017 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals Trust (North West England). JACC March 2017 Guest Skeptic: Dr. Kirsty Challen ( @KirstyChallen ) is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals Trust (North West England).

Fractures 40

Fractures Emergency Department Ultrasounds Outcomes 40

Northwestern EM Blog

DECEMBER 20, 2021

Physical examination should always include an attempt to ambulate the child unless there is an obvious contraindication noted immediately (eg open fracture). Management includes imaging studies, typical ultrasound to assess for a joint effusion, then a diagnostic arthrocentesis & antibiotics. 2021, Dec 20). Hip Pain in Pediatrics.

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Still, except for the public hospital, other hospitals did little emergency work and would have unattended first aid or treatment room in which one could meet one's physician or have an intern provide care in the meanwhile. Rebuilding of EDs in proximity to Radiology, Blood Bank, OR, and ICU, becoming organic to the hospital.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

Rural Doctors Net

AUGUST 30, 2013

James and Casey are used to this kind of stuff (although Casey’s mostly in-hospital and has even got a CT scanner…James is used to working out of a tent wearing just rabbit skins). Allocate someone to activate ambulance, other clinical personnel, notify local hospital and give retrieval services a head’s up. The CAT will hurt.

Burns 52

Burns Hospitals Ambulance Services Wellness 52

EB Medicine

JUNE 6, 2019

Taylor and Shaukat of Emory and Coney Island Hospital respectively for their efforts in peer reviewing this huge topic. CT is good but you really should learn ultrasound, and lastly, sick patients need prompt consultation and resuscitation, not rapid trips to radiology. Jeff: Indeed. Sounds familiar. Jeff: We sure did!

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

Taming the SRU

AUGUST 30, 2023

In a small study involving 79 hospitalized children, PCT was found to be elevated in bacterial infections, with a decrease after appropriate antibiotic therapy, and decreased in viral infections [24]. Instead, they strongly advocated for the use of lung ultrasound to diagnose bacterial CAP [45]. days (secondary endpoint) [51].

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

EB Medicine

NOVEMBER 1, 2018

It was peer reviewed by Dr. O’Keefe and Dr. Silverberg from Florida State University College of Medicine and Kings County Hospital, respectively. In at least one study, the incidence of DVT in hospitalized burn patients was as high as 23%. Jeff: Real quick – in case you missed it – ultrasound sneaks in again. That’s -- high.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

All Ohio EM

JANUARY 14, 2019

By: Zach Hampton, DO EM Resident at Doctors Hospital Ever performed a needle cricothyrotomy? Without palpating, you can already tell that the patient will have many facial fractures. Remember, ultrasound can help you identify the thyroid and cricoid cartilage, ideally enabling you to better identify the membrane connecting the two.

Pediatrics 52

Pediatrics EMS Fractures Ultrasounds 52

Don't Forget the Bubbles

MARCH 4, 2024

We have teamed up with the team from the Emergency Department at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The hospital is the Paediatric Major Trauma Centre for the South-West. It’s a great idea and maybe something for other centres to copy!) in lower-resource settings.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

ALiEM

OCTOBER 30, 2024

Clinical impact: The patient’s DVT ultrasounds were negative. A trans-esophageal echocardiogram showed a normal ejection fracture, normal right ventricular function, and no vegetations. The Necessity of a Trauma-Informed Paradigm in Substance Use Disorder Services. J Am Psychiatr Nurses Assoc. 2023;29(6):470-476.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

Don't Forget the Bubbles

JUNE 21, 2023

This percentile may differ in scientific studies and by hospital. Problems due to obstructed delivery such as shoulder dystocia, associated fractures of the collar bone and femur, among others, and brachial plexus injury. Ultrasound Obstet Gynecol 2019;54:308-18. Ultrasound Obstet Gynecol 2021;58:264-77. Choi SKY et al.

Ultrasounds 119

Ultrasounds Outcomes Fractures Pediatrics 119

EMDocs

OCTOBER 7, 2023

Morbidity and mortality of hospitalized patients after the 1995 Hanshin-Awaji earthquake. The incidence of a similar condition, traumatic rhabdomyolysis, is estimated to be around 0.074%. The incidence of a similar condition, traumatic rhabdomyolysis, is estimated to be around 0.074%. 1997;42(3):470-475; discussion 475-476. Am J Emerg Med.

EMS 92

EMS Fluid Resuscitation Fractures Resuscitation 92

Don't Forget the Bubbles

MAY 8, 2024

The Bubble Wrap Plus is a monthly paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). Use of neonatal lung ultrasound in European neonatal units: a survey by the European Society of Paediatric Research. Shah M, et al. Brooks L, et al.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

Pediatric Emergency Playbook

JANUARY 1, 2017

Some are simple comfort measures such as splinting (fracture or sprain), applying cold (acute soft tissue injury) or heat (non-traumatic, non-specific pain), or other targeted non-pharmacology. Long-bone injuries Fracture pain should be addressed immediately with splinting and analgesia. References American Academy of Pediatrics.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

Don't Forget the Bubbles

JULY 17, 2023

The Bubble Wrap Plus is a monthly paediatric journal club reading list from Anke Raaijmakers, working with Professor Jaan Toelen and his team at the University Hospitals in Leuven. Reviews and opinion articles Point-of-care ultrasound in pediatric nephrology. Can’t get enough of Bubble Wrap? Sethi SK, et al. Pediatr Nephrol.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

EMDocs

NOVEMBER 4, 2024

Bhana, MD (EM Resident Physician, University of Massachusetts/UMass Chan Medical School); Clarence Kong, MD (Pain Fellow, Eastern Virginia Medical School – Virginia Health Sciences at Old Dominion University); Mani Hashemi, MD (EM Attending, HCA Florida Mercy Hospital); S.M. 6 Clinical course can last weeks to months. Epub 2021 Jan 2.

Emergency Department 105

Emergency Department Fractures Burns EMS 105