Taming the SRU

NOVEMBER 3, 2023

Ultrasound‐Guided Serratus Anterior Plane Block (SAPB) Improves Pain Control in Patients With Rib Fractures. Ultrasound Med. This topic is important because of the high incidence of rib fractures in trauma patients and their association with increased morbidity and mortality. 41, 2695–2701 (2022). Why do we care?

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Fractures Ultrasounds Outcomes Research 98

Ultrasound Gel

FEBRUARY 26, 2024

What's the deal with using ultrasound for forearm fractures in kids? What's the deal with using ultrasound for forearm fractures in kids? The GEL Jr. team is back and they have a bone to pick. They examine a recent article on this topic from the New England Journal of Medicine. link] [link] The GEL Jr.

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Emergency Medicine Journal

MAY 28, 2024

Hip fractures require prompt, effective analgesia. 3 Preoperative FIB for hip fractures is associated with reduced pain, opioid use, delirium and mortality. 2 3 As FIB can be undertaken safely by generalist clinicians, 4 it is now an established part of ED hip fracture management.

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Emergency Medicine Journal

NOVEMBER 28, 2023

Background There is a high rate of surgical fixation of displaced Colles’ type distal radial wrist fractures despite fracture manipulation in the ED. Point-of-care ultrasound has been used to guide ED manipulations but its effect on the quality of fracture reduction or subsequent need for surgical fixation is unknown.

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Fractures Ultrasounds Outcomes Research 40

Core Ultrasound

FEBRUARY 21, 2023

In this intro video, we demonstrate the use of ultrasound imaging to identify fractures. Ultrasound-guided fracture identification is a minimally invasive technique that allows for quick and accurate diagnosis of fractures, without the need for radiation or contrast agents.

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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).

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Fractures Ultrasounds Emergency Department Operations 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. OMFS was consulted for multiple facial fractures for which patient was set up to follow up in clinic.

Dislocations 52

Dislocations Ultrasounds Fractures Radiology 52

PHEM Cast

JULY 27, 2021

Some useful videos: Hopefully you found the podcast interesting, but since this is quite a visual topic we have put together some videos to demonstrate some of the pathologies discussed and what they look like on ultrasound: How does ultrasound work? Want to know how to use ultrasound? Intensive Care Med 2010; 36: 1475-83.

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Emergency Medicine Journal

SEPTEMBER 27, 2023

Plain radiography of her right clavicle ( figure 1 ) revealed a comminuted right clavicular fracture with a coracoclavicular distance of 7 mm. Thus, the ultrasound machine was brought to the bedside in anticipation of. Given her personal history with opioids, the patient declined narcotics but was in severe acute pain.

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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. Sensation to light touch is intact distally.

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Broome Docs

SEPTEMBER 9, 2023

In this episode we do a deep dive into the BUCKLED trial that looked at the use of bedside ultrasound vs. plain film X-rays for the initial investigation of paediatric forearm fractures. Bottom line: ultrasound appears to be non-inferior to X-ray when used as a first line investigation in terms of functional, patient-oriented outcomes.

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Fractures Ultrasounds Outcomes 114

Emergency Medicine Journal

JULY 24, 2023

Although fractures can be ruled out using the Ottawa Ankle Rules, the specificity is low, which means many patients may still receive unnecessary radiographs. Ultrasound could be a reliable, cheap and radiation free alternative to diagnose fractures and ligamentous injuries. No restrictions were applied for date and language.

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The Skeptics' Guide to EM

DECEMBER 10, 2022

One-year outcome of surgery compared with immobilization in a cast for adults with an undisplaced or minimally displaced scaphoid fracture: A meta-analysis of randomized controlled trials. X-rays demonstrate a minimally displaced midwaist fracture of the scaphoid. The LR- to rule out a scaphoid fracture was 0.15

Operations 52

Operations Fractures Military Emergency Department 52

EB Medicine

NOVEMBER 1, 2021

and get 20% of all orders at [link] Emergency Department Management of Rib Fractures Author: Patrick Maher, MD Episode Outline: Why rib fractures? and get 20% of all orders at [link] Department Management of Rib FracturesAuthor: Patrick Maher, MDEpisode Outline:* Why rib fractures?*

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Fractures Documentation/Coding Operations Emergency Department 52

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.

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Fractures Ultrasounds Emergency Department Pediatrics 64

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Rib fractures account for over 15% of all trauma attendances in the Emergency Department. 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. ED Physicians are already well-versed in the use of ultrasound.

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Fractures Anaphylaxis Emergency Department Ultrasounds 40

Ultrasound Gel

APRIL 15, 2019

Fractures of the distal radius are pretty common among people who choose not to break their fall with their face. Ultrasound is great for finding fractures, but what about being able to guide the reduction? link] Fractures of the distal radius are pretty common among people who choose not to break their fall with their face.

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Fractures Ultrasounds Emergency Department Pediatrics 52

Emergency Medicine Cases

FEBRUARY 25, 2020

Which proximal humerus fractures are likely to require surgical management? When is an ultrasound of the shoulder indicated and how should they be interpreted? What are the surgical indications for clavicle fractures? Which shoulder injuries require a simple sling vs Velpeau sling vs collar and cuff vs sugar tong splint?

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Fractures Dislocations Ultrasounds EMS 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?

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Dislocations Fractures Ultrasounds Emergency Department 95

Taming the SRU

OCTOBER 1, 2024

Look for the light bulb sign and always evaluate with scapular 'Y' view Lateral ankle fractures are classified by the Weber Classification, which is based on fracture location relative to the tibiotalar joint line A Jones fracture is a fracture at the 4th/5th metatarsal articulation. C above historical average.

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Dislocations Fractures Poisoning Academics 74

The Skeptics' Guide to EM

MAY 7, 2017

Point-of-care ultrasound for non-angulated distal forearm fractures in children: test performance characteristics and patient-centered outcomes. Point-of-care ultrasound for non-angulated distal forearm fractures in children: test performance characteristics and patient-centered outcomes. Acad Emerg Med May 2017.

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Fractures Pediatrics Ultrasounds Academics 40

Emergency Medicine Cases

JULY 17, 2018

In this month's POCUS Cases Dr. Rob Simard explains the role of POCUS in distal radius fracture diagnosis and reduction, how to troubleshoot finding the echogenic line that represents the shaft of the radius, and the limitations of using POCUS for distal radius fractures.

Fractures 52

Fractures Ultrasounds EMS 52

Emergency Medicine Journal

JULY 24, 2023

However, Deutekom et al present a systematic review of studies evaluating the diagnostic accuracy of ultrasound for ankle injuries. First, plain radiographs do not detect all fractures around the ankle. 1 Why should we consider another diagnostic modality for such a straightforward injury? There are three good reasons.

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Fractures Ultrasounds Emergency Department 45

Mount Sinai EM

AUGUST 13, 2023

Background Hip fractures are a very frequent presentation, even in non trauma centers. Adequate pain control, and early surgical treatment and mobilization are the main goals of hip fracture treatment; to reduce complications including infections, DVT and delirium.

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Fractures Dislocations Operations Ultrasounds 100

EMDocs

AUGUST 12, 2023

The value of ultrasound for detecting hand fractures: A meta-analysis. Open Fracture. The athlete’s hand: ligament and tendon injury. Semin Musculoskelet Radiol. 2012;16(4):338-349. doi:10.1055/s-0032-1327007 Zhao W, Wang G, Chen B, et al. Medicine (Baltimore). 2019;98(44):e17823. doi:10.1097/MD.0000000000017823

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EMS Fractures Operations Ultrasounds 69

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.

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Fractures Dislocations EMS Emergency Department 52

ALiEM

APRIL 14, 2023

Justin Morgenstern, MD 28 Nov 2022 HM DFTB Regional nerve blocks module Nicola Mulrooney, MD 7 Dec 2022 HM EM Docs Ultrasound Guided Regional Anesthesia for Hip Fractures Olivia Victoriano, MD and Jacob Avila, MD 5 Dec 2022 HM Core EM Ultrasound Guided Lumbar Punctures Aaron Bola, MD 31 Mar 2022 HM (AIR = Approved Instructional Resource; HM = Honorable (..)

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EMS Ultrasounds Academics Fractures 98

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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EMDocs

SEPTEMBER 9, 2023

The value of ultrasound for detecting hand fractures: A meta-analysis. Open Fracture. Current concepts in the evaluation and treatment of mallet finger injury. Plast Reconstr Surg. 2013;132(4):560e-566e. doi:10.1097/PRS.0b013e3182a0148c 0b013e3182a0148c Zhao W, Wang G, Chen B, et al. Medicine (Baltimore). 2019;98(44):e17823.

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Taming the SRU

MAY 22, 2023

Ankle fractures are the third most common fracture in the ED [2] and more than 20,000 patients are seen in the ED for ankle sprains each day [3]. traumatic axial loading with calcaneal fractures, pilons, and vertebral compression fractures) [5]. Gross deformities often suggest fracture or dislocation [Image 2].

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Fractures Dislocations Operations Radiology 77

Taming the SRU

JANUARY 1, 2024

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.

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Emergency Department Ultrasounds Administration Burns 91

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.

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Ultrasounds Emergency Department Dislocations Radiology 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.)

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EMS Fractures Operations Radiology 52

ALiEM

SEPTEMBER 13, 2024

Laboratory Data CT Orbits/Sella w/ IV Contrast : No acute orbital fracture. Tonometry and ocular ultrasound (US) are generally not recommended as you could squeeze more liquid out of the eye or increase the intraocular pressure even more, pushing the iris further out. Visual acuity: able to count fingers. Extraocular movements intact.

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Emergency Department Academics Hospitals Fractures 64

Ultrasound Gel

JULY 8, 2019

In October 2018, an all-star group met during the Irish Association for Emergency Medicine annual conference to talk about point-of-care ultrasound. In part 1 of 2, the group talks about the landmark original SHoC-ED trial and performing the erector spinae plane block for rib fractures.

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Fractures Ultrasounds 52

ACEP Now

OCTOBER 15, 2023

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? Reconstructive computed tomography can assess the laryngeal framework to avoid missing laryngeal fracture and, hopefully, long-term comorbidities.

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The Skeptics' Guide to EM

NOVEMBER 9, 2019

Chip is the CEO of an ultrasound education company called Practical POCUS which is based in the United States but is expanding into an international market. This has included performing lumbar punctures, diagnosing acute abdominal aneurysms, acute heart failure, pediatric fractures, retinal detachments and endotracheal tube placement.

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Ultrasounds Fractures Pediatrics Radiology 52