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. 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.

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

EMDocs

OCTOBER 30, 2023

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.

Radiology 73

Radiology Radiology Emergency Department Hospitals 73

EMDocs

NOVEMBER 1, 2023

2 , 4 , 5 Recommended by the American College of Radiology (ACR) Appropriateness Criteria but otherwise limited for cervical perforations or alternative etiologies of chest pain. 4 Prompt consultation is imperative with thoracic surgery, interventional radiology (IR), gastroenterology (GI), and/or critical care.

Operations 67

Operations Radiology Radiology Fluid Resuscitation 67

Emergency Medicine Journal

FEBRUARY 20, 2024

Reference standard was radiological or operative confirmation of AAS. Clinicians treating prospectively identified patients were asked to record their perceived likelihood of AAS, prior to any confirmatory testing. 30-day electronic patient record follow-up evaluated whether a subsequent diagnosis of AAS had been made and mortality.

Emergency Department 52

Emergency Department Operations Radiology Radiology 52

American Medical Compliance

OCTOBER 3, 2024

These multiple hazards include biological, chemical, ergonomic, and radiological risks. Dental practices must maintain radiation safety protocols and provide radiation safety training for staff operating radiographic equipment. The importance of safety should be emphasized in all aspects of patient care and practice operations.

PPE 95

PPE Hazardous Materials Documentation/Coding Operations 95

Pediatric Education

JULY 14, 2024

The patient was referred to neurosurgery and radiologic evaluation of a magnetic resonance imaging study revealed a dermoid cyst. The patient had no post-operative complications. Treatment is excision with or without pre-operative radiological imaging depending on patient age and location.

Radiology 52

Radiology Radiology Pediatrics Operations 52

American Medical Compliance

FEBRUARY 28, 2024

What You Will Learn Potential radiation hazards Principles to minimize radiation exposure How to safely operate fluoroscopy equipment Techniques to manage radiation dose Current regulatory requirements The types of personal protective equipment to reduce radiation exposure Details Course length: 1 hour.

Radiology 52

Radiology Radiology Fractures Operations 52

EMergucate

APRIL 19, 2015

The following frontal chest x-ray from a 80 year old was obtained as part of a pre-operative work up prior to lower limb surgery. What radiological sign can be noted?

Radiology 40

Radiology Radiology Operations EMS 40

EMDocs

SEPTEMBER 7, 2024

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 75

EMS Fluid Resuscitation Resuscitation Radiology 75

Taming the SRU

MAY 22, 2023

weight-bearing status, operative vs. non-operative) If necessary/helpful to ensure adequate follow-up At time of discharge: Counsel on expected course of injury, supportive care (e.g., A comparison between pre-operative ultrasonography and surgical findings. RICE), and symptomatic management (e.g., 2001;220:406-12. Acta Radiol.

Fractures 77

Fractures Dislocations Operations Radiology 77

RebelEM

NOVEMBER 20, 2023

Patients with torso hemorrhage present a clinical conundrum often requiring interventional radiology or surgery, both of which take time to mobilize. Case volume for operative hemorrhage control is much lower in UK compared to other countries, reflecting better road safety standards and low levels of interpersonal violence.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

Mount Sinai EM

DECEMBER 27, 2022

Lisfranc injury x-rays Management Depends on the severity of injury, so consult with your orthopedic surgeon to determine operative vs nonoperative management. Patients with stable nondisplaced injuries can be discharged with immobilization in a short leg cast, NWB status, crutches, RICE management and orthopedic surgery follow up.

Dislocations 130

Dislocations Fractures Operations Radiology 130

The Skeptics' Guide to EM

JUNE 4, 2017

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.

Radiology 52

Radiology Radiology CPR Hospitals 52

Total Medical ComplianceHIPAA

OCTOBER 9, 2024

Mold buildup, sanitary sewer systems operating correctly, surfaces being free of microorganisms, equipment being cleaned/disinfected/sterilized properly, and supplies being free of damage are just a few other issues to look out for. There are several concerns that will need to be addressed when reopening following a prolonged shutdown.

Hazardous Materials 59

Hazardous Materials Infectious Diseases PPE Shock 59

American Medical Compliance

APRIL 25, 2024

For radiologic technicians or healthcare professionals, our Level 2 Training will greatly enhance your expertise in MRI practices. This training covers everything from the detailed physics behind magnetic resonance imaging to practical tips on patient management during MRIs.

Radiology 52

Radiology Radiology Operations Research 52

Northwestern EM Blog

MAY 16, 2022

Follow up CT should depend on the patient and ultrasound operator. Lastly the POCUS operators were ED physicians with training “recommended by ACEP.” It is worth mentioning that this study was a multicenter study based in the US with representation from ED, Radiology, and Urology. were hospitalizations during f/u period; 26.4%

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

Don't Forget the Bubbles

MAY 22, 2023

These can be operated and maintained by patients and their families at home. Once he is medically stable, with improving inflammatory markers, resolving radiological changes, and lessening secretions, plans will be made for discharge. Advances in technology have also led to more portable ventilators. You go to see Robin.

Radiology 98

Radiology Radiology Hospitals Wellness 98

EMDocs

MARCH 25, 2024

o Difficulty obtaining biliary views due to patient body habitus or pain o Operator dependent o Consultants requesting radiology performed ultrasound How to Perform a Biliary Ultrasound The preferred ultrasound probe for biliary ultrasound is the curvilinear probe due to its wider field of view and lower frequency.

Ultrasounds 87

Ultrasounds Radiology Radiology Operations 87

The Skeptics' Guide to EM

MARCH 25, 2023

Do they need surgery, an ERCP or just analgesia and non-operative care? Many small trials have compared the accuracy of POCUS to the “gold standard” of “Radiology-performed ultrasound”. A focused Biliary US in the ED (BUSED) may be all that is required to guide the surgeon’s decision-making for this patient.

Ultrasounds 52

Ultrasounds Emergency Department Dislocations Radiology 52

PHEM Cast

DECEMBER 1, 2017

Journal of Special Operations Medicine : a Peer Reviewed Journal for SOF Medical Professionals , 13 (4), 53–58. Radiologic evaluation of alternative sites for needle decompression of tension pneumothorax. Radiologic assessment of potential sites for needle decompression of a tension pneumothorax. [link] Harcke, H. Branco, B.

Academics 52

Academics Radiology Radiology Resuscitation 52

Intensive Blog

MARCH 11, 2024

Current ventilator settings Recent pathology, radiology and ABG results What central access does the patient have? They are staffed by Ambulance attendants to help operate specialized bariatric equipment. multi organ dysfunction, severe sepsis, age, frailty, co-morbidities) What investigations and treatment has the patient had to date?

Hospitals 69

Hospitals Radiology Radiology Sepsis 69

Don't Forget the Bubbles

MARCH 11, 2024

Craniosynostosis needs urgent referral and is usually corrected operatively before a child’s first birthday. Craniosynostosis, The Radiology Assistant. The Radiology Assistant: Craniosynostosis Accessed 10.01.2024 Mawji, A., Craniosynostosis can lead to raised intracranial pressure and failure to thrive. Vollman, A. McNeil, D.

Radiology 59

Radiology Radiology Pediatrics Documentation/Coding 59

RebelEM

JANUARY 25, 2023

Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43 Absent bowel sounds Peritoneal signs (i.e. rebound and guarding) Diagnostics Laboratory Tests Commonly ordered lab tests (i.e. 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

ACEP Now

MAY 4, 2023

On hospital day 2, he was taken to the operating room for surgical rib fixation. The direct movement of air into the chest wall was improved with the placement of a pigtail catheter and ultimately treated with operative repair. The patient continued to have an oxygen requirement and significant pain.

EMS 52

EMS Fractures Operations Ultrasounds 52

Don't Forget the Bubbles

OCTOBER 11, 2023

She spent around five days as an inpatient post-operatively. One magnet was found in the jejunum, and the other was in the ileum. They were stuck to each other with bowel wall in between. There was one perforation, which was repaired. She tolerated eating and drinking normally. No long-term complications are expected.

Pediatrics 116

Pediatrics Operations Radiology Radiology 116

EMDocs

DECEMBER 6, 2024

5 Orogastric lavage may also be considered for GI decontamination but likely to be limited by location, size of tablets, and operator familiarity. Radiology in the management of acute iron poisoning. 9 Typical dose: Polyethylene glycol (Go-Lytely ) 25 mL/kg/hr in small children and 1.5-2 2 L/hr in adults. doi: 10.1097/PEC.0b013e3182302604.

Poisoning 76

Poisoning Fluid Resuscitation Seizures Resuscitation 76

EMDocs

JUNE 3, 2023

4 This is the framework the ED resuscitationist should be operating under, as hemodynamically unstable pelvic trauma patients require a different approach compared to stable patients who will undergo CT, routine pelvic fixation, and definitive surgical repair. Note placement over the greater trochanters.

Fractures 54

Fractures Resuscitation Operations EMS 54

Pediatric Education

AUGUST 4, 2024

Recurrence can occur and also presentations on the contralateral side after operation have also been noted. Overall long-term success rate reported is good at 75-90% and is better for arterial or venous causes. Neurological causes also have a clear benefit but not at the rate of vascular causes. Questions for Further Discussion 1.

Pediatrics 52

Pediatrics Radiology Radiology Operations 52

Advanced Emergency Nursing from AENJ

DECEMBER 18, 2014

Clinical Chemistry and Laboratory Medicine , 52 (2), 183-187. Teaching in accident and emergency medicine: 10 commandments of accident and emergency radiology. Teaching in accident and emergency medicine: 10 commandments of accident and emergency radiology. Touquet, R., Driscoll, P., & Nicholson, D.

Mass Casualty Incidents 40

Mass Casualty Incidents Burns Urgent Care Pediatrics 40

ACEP Now

MARCH 14, 2024

18 The finger is inserted through the stoma alongside the endotracheal tube and, while 90 percent success rate has been reported with this method in controlling bleeding, the pressure must be maintained until the patient is transferred to the operating room. Operative technique for trachea-innominate artery fistula repair. J Vasc Surg.

Operations 52

Operations Pediatrics Radiology Radiology 52

Taming the SRU

MAY 27, 2024

This often is seen in trauma, cancer, post-operatively, and end-stage metabolic conditions with excessive colloid or protein leak. Seminars in interventional radiology,28(1), 75–86. If the volume of fluid is anticipated to re-accumulate quickly, a drain should be placed. How to do thoracentesis - pulmonary disorders. link] Yu H.

Emergency Department 86

Emergency Department Ultrasounds Radiology Radiology 86

ALiEM

SEPTEMBER 9, 2024

General surgery and neurosurgery should be consulted emergently for further operative interventions. Imaging should be obtained to confirm diagnosis, and broad-spectrum antibiotics with CNS coverage should be started early. References Paff, M, Alexandru-Abrams, D, Muhonen, M, Loudon, W. Ventriculoperitoneal shunt complications: A review.

Sepsis 60

Sepsis Academics Operations Wellness 60

Pediatric Emergency Playbook

MARCH 1, 2016

Adults tolerate hypotension relatively well, and is sufficient until we send them to the OR or interventional radiology suite. Often children even with high-grade splenic and liver lacerations can be managed non-operatively. To avoid this, we target a MAP of 65 and look for clinical signs of sufficient perfusion.

Resuscitation 40

Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

ACEP Now

SEPTEMBER 3, 2024

While secrecy surrounds the operations of many PE-owned groups, Envision serves as a case study. Private equity firm, accused of trying to build a monopoly in radiology, dismissed as defendant in FTC lawsuit. Radiology Business. Usually, they’ll get two or three every now and then, but if everybody is fresh, who’s teaching who?”

Hospitals 69

Hospitals Radiology Radiology Administration 69

Taming the SRU

APRIL 5, 2023

Operators should take care to obtain clear images of the upper renal poles with the understanding that inferior pole evaluation will be limited from the isthmus. Horseshoe Kidney: Radiology Reference Article. A midline approach, with the transducer over the umbilicus, is useful for identifying the isthmus itself [4]. Clinical imaging.

Ultrasounds 52

Ultrasounds Pediatrics Radiology Radiology 52

Medagadget

OCTOBER 17, 2023

Recent studies have also demonstrated a benefit in recurrence-free survival after pre-operative embolization. Preoperative embolization occludes blood flow to the tumor bed and can result in reduced blood loss during surgery. Medgadget: How does Neocast differ from pre-existing embolic technologies? What are its advantages?

Operations 69

Operations Radiology Radiology 69

RCEM Learning

NOVEMBER 28, 2022

Operative management is required with either External Fixation or Open Reduction with Internal Fixation (ORIF). Learning bite All unstable pelvic fractures require operative management. Case courtesy of Dr Paul Clarke Learning bite Avoid unnecessary movement of the patient. Usually managed conservatively.

Fractures 40

Fractures Blood Transfusions Sepsis Operations 40