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ToxCard: Iron

EMDocs

7 Workup other than serum iron concentration at 4 hours after ingestion not shown to accurately predict clinical outcomes or severity of toxicity. 5 Orogastric lavage may also be considered for GI decontamination but likely to be limited by location, size of tablets, and operator familiarity. Antiemetics as needed. 2 L/hr in adults.

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How Good is Ultrasound at Diagnosing PTA?

RebelEM

While operator dependent, the dynamic ability of POCUS augments bedside diagnosis and can assist with drainage. Additionally, potential increases in resource utilization, healthcare expense, and ED length of stay are also essential considerations. Ultrasound has become an extended part of our physical exam.

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Contrast Media Shortage of 2022 – Lessons Learned

EMDocs

2 In response to the constrained availability of contrast media, emergency medicine (EM) and radiology departments were compelled to enact modifications in their imaging techniques. In most cases, the radiology team functioned as the main decision-maker playing a key role in drafting institutional protocols. 11 Table 1.

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EM@3AM: Retroperitoneal Hematoma

EMDocs

In this patient with a penetrating posterior flank injury, trace-free fluid in the pelvis on eFAST, and ongoing signs of hemorrhagic shock despite fluid and blood product administration, transferring to the operating room for exploration is indicated, especially with high probability of zone III injury-related retroperitoneal bleeding.

EMS 93
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UK-REBOA on Trial: Innovative or Over-Inflated?

RebelEM

Patients with torso hemorrhage present a clinical conundrum often requiring interventional radiology or surgery, both of which take time to mobilize. Outcome: Primary Outcome: All-cause mortality at 90 days. The primary outcome focused on patient-centered outcomes. 97% of patients sustained blunt trauma.

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Ultrasound of the Month: No Definitive Yolk Sac, No Definitive IUP!

Taming the SRU

A radiology performed ultrasound is ordered and has similar findings– Impression: no definitive IUP with a small amount of free fluid within physiologic limits. At this point, the patient is taken to the operating room for a diagnostic laparoscopy. Given these findings along with her history, there is concern for ectopic pregnancy.

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SGEM#181: Did You Ever Have to Make Up Your Mind, Pan Scan or Leave Other Scans Behind?

The Skeptics' Guide to EM

However, when we assess major trauma that includes chest, abdominal and pelvic trauma, the initial radiologic evaluation is left to the treating physician’s judgement. Many studies (most retrospective) have assessed the use of pan scanning as an initial radiologic evaluation. Reference: Sierink et al.