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The 79th Bubble Wrap x Bristol Royal Hospital For Children

Don't Forget the Bubbles

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. Reviewed by: John Coveney Article 2: How do we define sepsis in children? doi:10.1001/jama.2024.0179

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Ultrasound of the Month: Gallbladder Perforation

Taming the SRU

A bedside right upper quadrant ultrasound was performed, and the images are below. He was transitioned to cefdinir and fluconazole for a full 7-day course of antibiotics and discharged from the hospital on day three, with instructions to follow up with general surgery for an outpatient cholecystectomy. coli and rare budding yeasts.

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Putting Clinical Gestalt to Work in the Emergency Department

ACEP Now

For example, experienced emergency physicians have great clinical gestalt and accuracy to predict sepsis in critically ill patients at just 15 minutes from patient arrival—more so than scoring tools like the qSOFA, MEWs, and even machine-learning trained artificial intelligence models. A testicular ultrasound confirmed restored blood flow.

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The Latest in Critical Care, 2/5/24 (Issue #28)

PulmCCM

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. In 42 patients getting PET scans in a neuro-ICU over 10 years, four of the six with sepsis had infectious foci identified. You can read the document here. What’s a Fever?

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Fetal Growth Restriction and Small for Gestational Age Babies

Don't Forget the Bubbles

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.

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REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

RebelEM

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 136
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Mallia – Critical Care Ultrasound and Volume Resuscitation

University of Maryland CC Project

Mallia, Assistant Professor of Emergency Medicine and Associate Program Director of the Pulmonary and Emergency Medicine-Critical Care Fellowship at MedStar Washington Hospital presents on critical care ultrasound and the volume resuscitation dilemma as part of the DC5 lecture series.