ACEP Now

OCTOBER 29, 2024

4 However, emergency physicians rely on gestalt to predict outcomes well. The externally validated Canadian Syncope Risk Score (CSRS) demonstrated no better prediction of 30-day adverse outcomes for “very low” and “low” risk patients than clinical judgment alone of emergency physicians. Mary’s Hospital in Leonardtown, Maryland.

Emergency Department

Critical Care North Hampton

JUNE 26, 2025

Ultrasound Basics and Physics Cardiac Basic Image Acquisition 5 Minute Sono Chest Advanced Scans and Therapeutics Pathologies and Abnormalities Thoracic Basic Image Acquisition CUSIC Images Abdominal Scans Trauma/Emergency Scans Other Scans Infographs General POCUS’grams Sunny Coast POCUS’grams! Manoj’s Sonobytes! 5 Minute Sono Others!

Ultrasounds

ALiEM

OCTOBER 30, 2024

Clinical impact: The patient’s DVT ultrasounds were negative. Clinical impact: Rather than arguing with the patient about the likelihood of this phenomenon occurring and whether this is a true allergy, the patient is informed that they do not need to immediately start treatment to receive care in the hospital. 2022 May;14(5).

Emergency Department

EMDocs

NOVEMBER 13, 2024

Older age, recurrent episodes of SBP, hepatorenal syndrome, hepatic encephalopathy, acute kidney injury (AKI), concurrent GI bleeding, and higher MELD scores are predictors of worse outcomes. Ultrasound can assist: confirm ascites, evaluate for best site, abdominal wall thickness, blood vessels along needle track. 2019 Jan 14;11:13-22.

Hyperthermia / Hypothermia

EMDocs

JULY 21, 2025

Elevations in Cr, LFTs, troponin associated with worse outcomes. Shorter hospital LOS, lower intubation, lower MACE in high-dose group (Siddiqua). Current literature suggests morphine may worsen outcomes in AHFS. 2022 meta-analysis (6 observational studies) found higher in-hospital mortality with morphine (OR 2.39, 95% CI 1.13-5.08),

Emergency Department

PulmCCM

JUNE 5, 2025

.” In acute pulmonary embolism, they advised fluids might be harmful in patients with right heart congestion as detected by elevated jugular venous pressure, venous excess ultrasound (VEXUS) testing, echocardiography (e.g., to 1.08, P  = 0.30)—the primary outcome.

Sepsis

The Bottom Line

JUNE 27, 2025

Skip to content Twitter Google+ Facebook Reddit RSS The Bottom Line A compendium of critical appraisals in Intensive Care Medicine research and related specialties Home About Us Summaries Intensive Care Medicine Emergency Medicine Peri-operative Medicine Blog News EBM Editorial Submit a review Wessex ICS You are here: Home Blog Critical Care Evidence (..)

Stroke

Cook County EM Blog

JUNE 29, 2025

ULTRASOUND So we think it’s an abscess, but remember, always consider the probe. Using ultrasound has been shown to significantly decrease rates of treatment failure for I&Ds.1 Using ultrasound has been shown to significantly decrease rates of treatment failure for I&Ds.1

Pediatrics

ACEP Now

DECEMBER 7, 2024

3,4 In addition, for patients with contraindications or those who have failed thrombolysis, catheter-directed thrombolysis and surgical thrombectomy are useful treatment modalities that are associated with low major complication rates and improved patient outcomes. 6 The second common catheter-directed approach is mechanical thrombectomy.

Ultrasounds

Mind The Bleep

FEBRUARY 2, 2025

Ensure you management plan includes how you plan to rule out any immediate concerns and what the outcome is likely to be if normal. Document main findings from any imaging including if normal Differential Diagnoses You can use the surgical sieve approach to identify appropriate differential diagnoses.

Documentation/Coding

Dr. Smith's ECG Blog

MAY 31, 2014

A bedside echo done by an ultrasound-fellowship-trained EP was recorded as normal. She was admitted to the hospital. And clot burden does not correlate with outcome, hemodynamic compromise, or lack thereof, is what we base therapy on. A 60 yo with no cardiopulmonary history, felt dizzy, cold and clammy, and then had syncope.

EKG/ECG

EMDocs

MAY 27, 2025

5,6 All of these characteristics contribute to worse presentations and outcomes for patients infected with P. Other tests to consider: Point of care ultrasound (POCUS) and CXR to evaluate for pulmonary edema. 11 Children <5 years old have worse outcomes and higher mortality rates compared to adults.

CDC

Cook County EM Blog

MARCH 21, 2025

The development of VT in the setting of OMI increases the patient’s risk of in-hospital mortality, so prompt recognition of OMI and cath lab activation is critical to improving patient outcomes. 12.75, P < 0.001) with an overall survival rate at 5 years of 74.4% (95% CI 72.8-76.0) vs. 3.9%, P < 0.001) (4).

EKG/ECG

Don't Forget the Bubbles

JULY 1, 2025

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). Although the main outcome was unscheduled healthcare visits, they also examined asthma control, symptoms, and management. In a study by Chong et al.,

Pediatrics

EMDocs

MAY 31, 2025

Intravenous steroids and hospital admission should be used in cases of moderate to severe disease. However, patients with bowel obstructions should be admitted to the hospital. Point-of-care Intestinal Ultrasound in IBD Patients: Disease Management and Diagnostic Yield in a Real-world Cohort and Proposal of a Point-of-care Algorithm.

EMS

Critical Care North Hampton

JUNE 14, 2025

Ultrasound Basics and Physics Cardiac Basic Image Acquisition 5 Minute Sono Chest Advanced Scans and Therapeutics Pathologies and Abnormalities Thoracic Basic Image Acquisition CUSIC Images Abdominal Scans Trauma/Emergency Scans Other Scans Infographs General POCUS’grams Sunny Coast POCUS’grams! Manoj’s Sonobytes! 5 Minute Sono Others!

Sepsis

EMDocs

JANUARY 4, 2025

. #1: PARAMEDIC-3 and IVIO RCTs IO vs IV Epinephrine for OHCA Spoon Feed Two large studies randomizing patients with out-of-hospital-cardiac arrest (OHCA) to either an intraosseous (IO) or intravenous (IV) first approach for access had no difference in 30-day survival or neurologically intact survival. N Engl J Med. N Engl J Med.

Ultrasounds

Don't Forget the Bubbles

JUNE 8, 2025

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). Long-term respiratory outcomes in school-aged children born before 32 weeks of gestation. Can’t get enough of Bubble Wrap? 2025 May 8. 2025 May 23.

Pediatrics

Broome Docs

DECEMBER 22, 2024

This month we cover a few out-of-hospital arrest trials. A Randomized Trial of Drug Route in Out-of-Hospital Cardiac Arrest. Intraosseous or Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest. Which is better in out of hospital cardiac arrest: IV or IO? Favourable neurologic outcomes were seen in 2.7%

Blood Transfusions

Mount Sinai EM

AUGUST 7, 2024

Ultrasound during cardiac arrest has quickly become standard. Initially, data suggested that the use of ultrasound during arrest increased pauses between compressions which worsens outcomes. Rapidly intervened-upon cardiac tamponade in PEA during cardiac arrest has significantly higher hospital discharge rates.

Ultrasounds

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

Casey currently splits his time […] The post SGEM#415: Buckle Down for some Ultrasound to Diagnosis Distal Forearm Fractures first appeared on The Skeptics Guide to Emergency Medicine. or there is a portable bedside ultrasound machine in the next room ready to go. He is also a fully-fledged ultrasonographer. Reference: Snelling et al.

Fractures

RebelEM

APRIL 17, 2023

Background: The increased utility and accessibility of point-of-care ultrasound (POCUS) has allowed clinicians the freedom to rethink their diagnostic approach for many common diseases, including peritonsillar abscess (PTA). Test characteristics of ultrasound for the diagnosis of peritonsillar abscess: A systematic review and meta-analysis.

Ultrasounds

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

Taming the SRU

OCTOBER 23, 2023

A bedside ultrasound is completed to assess the location of the pregnancy. A radiology performed ultrasound is ordered and has similar findings– Impression: no definitive IUP with a small amount of free fluid within physiologic limits. Laboratory evaluation reveals a hemoglobin and hematocrit of 12.6/37.1

Ultrasounds

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

Don't Forget the Bubbles

JANUARY 31, 2024

As a Trauma Unit within the Thames Valley Trauma Network, Wexham Park Hospital hosts trainees from across the spectrum of acute specialties. Two really important patient groups were excluded – those who were admitted to hospital and families who were not fluent in English. How sick the child was did not appear to play a role.

Hospitals

The Skeptics' Guide to EM

JULY 30, 2022

Point-of-Care Ultrasound-First for the Evaluation of Small Bowel Obstruction: National Cost Savings, Length of Stay Reduction, and Preventable Radiation Exposure. AEM July 2022 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. specificity with ultrasound [1].

Ultrasounds

Don't Forget the Bubbles

JUNE 19, 2023

There were no issues during the pregnancy, and estimated fetal growth by ultrasound was constant. The centile used to define “small” may differ both by scientific study and by hospital. You could consider a cranial ultrasound, cytomegalovirus PCR, and maternal toxicology screening. Ultrasound Obstet Gynecol 2016;48:333-9.

Pediatrics

ACEP Now

JULY 7, 2023

You perform a biliary ultrasound (US) in the ED (BUSED) which shows a gallbladder (GB) full of stones, some GB wall thickening and a positive Murphy’s sign. Background Ultrasound is typically the first-line imaging modality for the diagnosis of acute biliary disease. Click to enlarge. Reference: Hilsden, et al. 2022;7(1):e000944.

Ultrasounds

Taming the SRU

NOVEMBER 3, 2023

Ultrasound‐Guided Serratus Anterior Plane Block (SAPB) Improves Pain Control in Patients With Rib Fractures. Ultrasound Med. The primary outcome in this study was a change in pain score at rest 60 minutes after block. 41, 2695–2701 (2022). Finally, we discussed whether we would expect this paper to change our practice pattern.

Fractures

The Trauma Pro

OCTOBER 25, 2024

To sum up, both are equally effective in controlling hemorrhage, but the hospital costs for patients undergoing angioembolization are significantly less. The primary outcome was the development of VTE during the hospitalization. DVT was detected using duplex ultrasound, and PE was detected by CT angiography.

Fractures

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. Adherence to guidelines was assessed by a follow-up phone call two months after injury.

Pediatrics

PulmCCM

FEBRUARY 5, 2024

Depends On the Patient, and Who You Ask The Centers for Disease Control and Prevention defines a fever (for general hospitalized patients) as >38°C. Also, many patients with infection won’t have fevers, and those that don’t may be at the highest risk for poor outcomes. You can read the document here.

Best Practices

Sensible Medicine

JUNE 28, 2024

A 76-year-old woman presents to a community hospital after waking with garbled speech and right-sided weakness. There were no personal crises or untoward patient outcomes. Case 1: Excess An elderly woman is admitted to a community hospital with a minor stroke. The hospital does an excellent job. I love my job.

Stroke

Don't Forget the Bubbles

DECEMBER 25, 2023

Interpreting Research Outcomes with a Little Bathroom Humour You have learned a method for how to read a research paper , and now you are faced with a bunch of outcomes. There are primary, secondary, composite , and safety outcomes. What are these outcomes? We know there is a bias towards reporting positive outcomes.

Research

Don't Forget the Bubbles

NOVEMBER 13, 2023

Should we use ultrasound to diagnose distal forearm fractures in children and adolescents? However, ultrasound is gaining popularity due to its portability, affordability, and lack of ionising radiation. However, ultrasound is gaining popularity due to its portability, affordability, and lack of ionising radiation.

Fractures

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. hours increased the NNT for a good outcome to 20. The expanded window of 3-4.5

Stroke