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

The Skeptics' Guide to EM

OCTOBER 21, 2023

Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Implementation of a Clinical Management Tool for Spinal Epidural Abscess Early Diagnosis. AEM October 2023.

Emergency Department 135

Emergency Department Radiology Radiology Hospitals 135

The Trauma Pro

DECEMBER 12, 2023

This necessitates an inter-hospital transfer that is subject to scrutiny by the trauma performance improvement program of both trauma centers. The work-up from the referring hospital can be re-evaluated. In some hospitals, orthopedics may choose to place a traction pin to provide initial fracture management.

Emergency Department 124

Emergency Department Operations Hospitals Radiology 124

ACEP Now

JANUARY 4, 2025

1 Just one year prior, Dr. Clarke had begun an emergency medicine residency at what was then known as LA CountyUSC Hospital, Los Angeles. Firsthand Account An ambulance bay at the LA County-USC Hospital in 1978. Dr. Clarke was then hired as assistant director in the emergency department (ED) at Pomona Valley Hospital, Pomona, Calif.

Forensics 52

Forensics Urgent Care Hospitals Emergency Department 52

The Trauma Pro

APRIL 30, 2024

Angioembolization requires the presence of a special interventional radiology team and a reasonably stable patient. They performed a systematic search of the literature, analyzing the impact of each procedure on in-hospital mortality. The use of both is becoming more widespread, and each has its pros and cons.

Radiology 113

Radiology Radiology Research Fractures 113

Emergency Medicine Ireland

JUNE 14, 2021

There is an image of this in the show notes but to run through it verbally, remembering that these are all meant to be performed pre hospital. this is likely to remove 80% of decontamination * early toxidrome recognition eg if its organophopshates * early antidotes * extensive decontamination * transport to hospital.

Radiology 52

Radiology Radiology Hospitals Wellness 52

Sensible Medicine

APRIL 12, 2024

Most of my undergraduate medical education took place at New York Hospital, where a medical error occasioned the first calls for duty hour reform. I was responsible for staying at the bedside of (or at least in the hospital with) my patients until they were stable. PR was admitted to my service at a hospital where I briefly attended.

Radiology 83

Radiology Radiology Hospitals Documentation/Coding 83

Sensible Medicine

NOVEMBER 30, 2023

At 50% of GDP on health care, we will give everyone a weekly pass to get unlimited, unnecessary radiologic imaging, and if two doctors on Twitter think you should get a solid organ transplant, insurers have to pay. They say that when Rome fell half the days in the capital were holidays.

Research 145

Research Radiology Radiology Administration 145

RebelEM

APRIL 17, 2023

33 studies selected for full review Of those 33 studies, 17 of those met criteria for inclusion Of the 18 studies, 1 was an RCT, 14 were prospective cohort studies, and 3 were retrospective cohort studies Total of 812 patients of whom 541 had PTA from 17 studies.

Ultrasounds 129

Ultrasounds Radiology Radiology Operations 129

The Skeptics' Guide to EM

FEBRUARY 3, 2024

March 2023 Date: January 30, 2024 Guest Skeptic: Dr. Alexandra (Ali) Espinel is an Associate professor of pediatrics and otolaryngology at Children’s National Hospital and George Washington University. She is also the director of the Pediatric Otolaryngology Fellowship at Children’s National Hospital. Laryngoscope. I’m the Problem.

Pediatrics 69

Pediatrics Radiology Radiology Head Injuries 69

EMDocs

NOVEMBER 20, 2023

Key Concept: For patients with LGIB on cardiac aspirin for secondary prevention, aspirin should be continued during hospitalization if possible. Resumption of antiplatelet medications and risk of recurrence Recommendation: We recommend discontinuing nonaspirin NSAIDs after hospitalization for diverticular hemorrhage.

Resuscitation 103

Resuscitation Fluid Resuscitation Hospitals Research 103

ALiEM

FEBRUARY 16, 2024

This patient was admitted to the hospital’s general surgical service and treated with IV broad-spectrum antibiotics and a percutaneous cholecystostomy tube placed by interventional radiology. doi: 10.1148/radiology.148.1.6856839. Hole sign” of the gallbladder. Indian J Gastroenterol 36, 66–67 (2017). 148.1.6856839.

Radiology 64

Radiology Radiology Ultrasounds COPD 64

ACEP Now

JULY 7, 2023

Will this be enough for the general surgeon, or will they want an US performed by the radiology department to make their surgical decision? Clinical Question What is the value of radiology-performed US (RUS) compared to BUSED in terms of the surgical decision-making in acute biliary disease? Click to enlarge. Reference: Hilsden, et al.

Ultrasounds 52

Ultrasounds Radiology Radiology Emergency Department 52

EMDocs

NOVEMBER 1, 2023

Authors: Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA), Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp!

Operations 92

Operations Radiology Radiology Fluid Resuscitation 92

Don't Forget the Bubbles

SEPTEMBER 13, 2023

The American College of Radiology guidelines provide further detail on imaging recommendations based on different age and seizure type variants. 2006;67(9):1542-1550 Royal Children’s Hospital Melbourne. What is the evidence for avoiding laboratory testing? Afebrile Seizures. Accessed online at [link] Sawires R, Buttery J, Fahey M.

Seizures 131

Seizures Pediatrics Emergency Department Radiology 131

Advanced Medical Reviews

APRIL 17, 2019

percent rise in hospital spending and a growth of 5.4 Protect the nation from the health effects of emerging and pandemic infectious diseases and chemical, biological, radiological and nuclear (CBRN) threats. In addition, higher fee-for-service payment updates are expected to result in faster Medicare spending growth.

Infectious Diseases 66

Infectious Diseases Radiology Radiology Administration 66

RebelEM

SEPTEMBER 11, 2023

Outcomes: Primary: Percent change in management decisions after introducing the Radiology Department RUQ US. A change in clinical course resulting from a discrepancy between POCUS and radiology department imaging only occurred in 2% of patients (not 10%). appeared first on REBEL EM - Emergency Medicine Blog.

Ultrasounds 68

Ultrasounds Radiology Radiology Emergency Department 68

SheMD

JUNE 8, 2023

July 1st is almost here and hospitals around the country will welcome in their new interns. The transition from internal medicine or surgery intern to Radiology resident (or any other residency) feels daunting to most. Advocate · As a woman in radiology (and most fields in medicine), you are a minority. You CAN do this!

Radiology 52

Radiology Radiology Outcomes Hospitals 52

Sensible Medicine

SEPTEMBER 27, 2024

We are lucky to work at a time when a review of a discharge summary, lab findings, and radiology results can usually give you a pretty perfect sense of what has happened and what remains necessary. There are cases when it is necessary to pore through old records, but the EMR and diagnostic technology has undermined this claim.

Radiology 117

Radiology Radiology Wellness Hospitals 117

Don't Forget the Bubbles

MAY 22, 2023

Robin is an LTV patient and will likely need some extra planning should he need to be admitted to hospital. Gemma responds, ‘Ask the hospital physio to come and see him?’ Robin’s emergency care plan/RESPECT form and ventilator settings should be reviewed and updated while he is in hospital too. You think fast.

Radiology 98

Radiology Radiology Hospitals Wellness 98

PEMBlog

SEPTEMBER 20, 2023

The Choosing Wisely Pediatric Emergency Medicine Recommendations The Choosing Wisely Campaign Toolkit Expert Contributors Kelly Levasseur, DO Children’s Hospital of Michigan Detroit, MI, USA docklevasseur@gmail.com Jennifer Thull-Freedman, MD Alberta Children’s Hospital Calgary, Alberta, Canada Jennifer.Thull-Freedman@albertahealthservices.ca

Pediatrics 123

Pediatrics Emergency Department Hospitals Ultrasounds 123

Emergency Medicine Journal

NOVEMBER 28, 2023

Method and Design The ED and radiology departments collaborated to develop an MRI direct to scan (DTS) pathway bypassing radiology discussions. All DTS scans had documented senior review at radiology request to ensure governance. The number of hospital admissions and inter-hospital transfers has reduced by 50%.

Radiology 40

Radiology Radiology Documentation/Coding Hospitals 40

EMDocs

JUNE 22, 2023

As usual, I was the only physician staffing this rural critical access hospital with limited resources which sits 61 miles away from our state’s only Level 1 trauma center. The radiology tech has his hand on a weak femoral pulse. Did I mention that we only had one unit of blood in the hospital for emergent release?

Resuscitation 98

Resuscitation Ultrasounds Critical Access Radiology 98

Taming the SRU

OCTOBER 23, 2023

A radiology performed ultrasound is ordered and has similar findings– Impression: no definitive IUP with a small amount of free fluid within physiologic limits. After a short period of recovery in the hospital, she is discharged home in stable condition with follow-up with OBGYN. Am J Emerg Med. 2019 Jun;37(6):1165-1168. 2019.03.025.

Ultrasounds 99

Ultrasounds Operations Radiology Radiology 99

The Trauma Pro

OCTOBER 23, 2023

The trauma group at Stanford paired up with the Chang Gung Memorial Hospital in Taiwan to test the use of AI for interpreting images to identify a specific set of common pelvic fractures. Is it only a matter of time until computer artificial intelligence (AI) starts reading x-rays? Look at how good they already are at interpreting EKGs.

Fractures 147

Fractures EKG/ECG Hospitals Wellness 147

Intensive Blog

MARCH 11, 2024

Current ventilator settings Recent pathology, radiology and ABG results What central access does the patient have? Mildura is one of the furthest hospitals from Melbourne. Which hospitals currently have the capacity to initiate and manage patients on ECMO in Victoria? What has been the patient’s trajectory?

Hospitals 69

Hospitals Radiology Radiology Sepsis 69

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives CT Head scans are commonly requested in the Emergency Department (ED), but the increasing demand has led to longer radiology report turnaround times, affecting ED flow. In the prospective phase, 4,815 CT Head interpretations with linked radiology reports were recorded, and data analysis is ongoing.

Emergency Department 40

Emergency Department Radiology Radiology Research 40

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 91

CPR Burns Airway Management Wellness 91

Medagadget

JUNE 6, 2023

” Study in journal Nature Biotechnology : A fully integrated wearable ultrasound system to monitor deep tissues in moving subjects Via: UCSD

Ultrasounds 125

Ultrasounds Research Hospitals Radiology 125

The Skeptics' Guide to EM

AUGUST 24, 2024

Case: A 67-year-old male presents to your hospital emergency department (ED) after a fall from his bicycle. JAMA Surg 2024 Population: Patients aged 16 years or older with clinically suspected or radiologically confirmed rib fractures. Interests include information systems and digital health, research and education.

Fractures 54

Fractures Emergency Department Ultrasounds Radiology 54

Don't Forget the Bubbles

NOVEMBER 8, 2023

She had a low-grade fever and an episode of vomiting before coming to the hospital. Hospital Admitted Patient Care Activity. How does appendicitis present in kids? Tilly’s father explains that she has been unwell for two days with worsening abdominal pain. Tilly is normally fit and well, with no significant past medical history.

Emergency Department 105

Emergency Department Ultrasounds Pediatrics Best Practices 105

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

PEMBlog

SEPTEMBER 23, 2024

This case was submitted by Dr. Andrea De Jesús Martínez Chief PEM Fellow at Baylor College of Medicine | Texas Children’s Hospital Instagram: @bcm_pemfellows Co-author: Benjamin Silva, MD, MPH The Case A 4-year-old male with no significant past medical history presents with headache and vomiting. This is the first of the four cases.

Pediatrics 59

Pediatrics Radiology Radiology Research 59

Don't Forget the Bubbles

JANUARY 22, 2024

Repeated GP and hospital attendance might stimulate increased testing and unnecessary prescriptions. Clinical and radiological findings supported the diagnosis of pneumonia. Is blood culture a useful investigation in children admitted to hospital with community-acquired pneumonia? What exactly are Liver Function Tests?

Emergency Department 90

Emergency Department Best Practices Radiology Radiology 90

EMDocs

DECEMBER 4, 2023

The facility does not have ultrasound (US) availability at the time of the patient’s presentation, as the sonographer comes to the hospital only 2 days a week. If this is not possible in the hospital system, physicians should communicate directly with someone who can facilitate the order. Arch Intern Med. 2004;164(22):2477-2482.

Ultrasounds 95

Ultrasounds Documentation/Coding Wellness EMS 95

The Skeptics' Guide to EM

JULY 18, 2020

* SGEM#263 : Please Stop, Prescribing – Antibiotics for Viral Acute Respiratory Infections * SGEM#216: Pump It Up – Corticosteroids for Patients with Pneumonia Admitted to Hospital * SGEM#120 : One Thing or Two for Community Acquired Pneumonia?

Radiology 52

Radiology Radiology Emergency Department Outcomes 52

The Skeptics' Guide to EM

MARCH 25, 2023

Casey currently splits his time between Broome, a small rural hospital in the remote Kimberley region of Western Australia, and a large tertiary ED in sunny Perth. Many small trials have compared the accuracy of POCUS to the “gold standard” of “Radiology-performed ultrasound”. He is also now a fully-fledged “sonologist”.

Ultrasounds 52

Ultrasounds Emergency Department Dislocations Radiology 52