RebelEM

APRIL 17, 2023

However, It is unclear how well POCUS performs in ruling in or ruling out the diagnosis of PTA. Question: How well does the US perform in diagnosing PTA compared to CT, needle aspiration, or Incision and Drainage? While operator dependent, the dynamic ability of POCUS augments bedside diagnosis and can assist with drainage.

Ultrasounds 123

Ultrasounds Radiology Radiology Operations 123

ACEP Now

MAY 4, 2023

The chest X-ray showed multiple displaced right rib fractures and chest wall subcutaneous emphysema without definitive evidence of a pneumothorax, as well as right lower lobe atelectasis versus contusion (Figure 1). On hospital day 2, he was taken to the operating room for surgical rib fixation. A chest tube was placed at that time.

EMS 52

EMS Fractures Operations Ultrasounds 52

Taming the SRU

MAY 22, 2023

Use your exam to guide your initial management as well as your imaging decisions and differential diagnosis. 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., 12): e0244291. 2001;220:406-12.

Fractures 75

Fractures Dislocations Operations Radiology 75

Pediatric Education

AUGUST 4, 2024

Angiography and/or venography may be considered as well. Recurrence can occur and also presentations on the contralateral side after operation have also been noted. .” Imaging may include ultrasound, computed tomography or magnetic resonance imaging depending on the patient age and circumstances.

Pediatrics 52

Pediatrics Radiology Radiology Operations 52

Don't Forget the Bubbles

MARCH 11, 2024

There are many causes, and it is less well understood than plagiocephaly. 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., Vollman, A. McNeil, D.

Radiology 59

Radiology Radiology Pediatrics Documentation/Coding 59

Don't Forget the Bubbles

MAY 22, 2023

These can be operated and maintained by patients and their families at home. Gemma tells you that as well as the physio, Robin’s LTV Consultant has also prescribed some oral antibiotics. Since then, he has been well in himself. Advances in technology have also led to more portable ventilators. You go to see Robin.

Radiology 98

Radiology Radiology Hospitals Wellness 98

ALiEM

MAY 13, 2024

They may be well-circumscribed or may have irregular borders. Well-circumscribed abscess with heterogeneous debris C. Larger abscess with well-circumscribed borders D. Superficial abscess with well-circumscribed borders Table 1. The rim may be echogenic or blend in with surrounding tissue. 97.4%) 85.4% (78.9-90.2%)

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

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. Reference: Sierink et al.

Radiology 52

Radiology Radiology CPR Hospitals 52

Taming the SRU

APRIL 5, 2023

The kidney will have a different axis as well as level of lie, so care should be taken to scan broadly if the renal cortex is not immediately apparent. 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. 2017;27(2):133-140.

Ultrasounds 52

Ultrasounds Pediatrics Radiology Radiology 52

RCEM Learning

NOVEMBER 28, 2022

It is important to closely monitor the patient’s haemodynamic status and repeat the pelvic x-ray post binder removal because a well-applied pelvic binder can mask fracture. Operative management is required with either External Fixation or Open Reduction with Internal Fixation (ORIF). Usually managed conservatively.

Fractures 52

Fractures Blood Transfusions Sepsis Operations 52

Dr. Smith's ECG Blog

DECEMBER 18, 2022

Importantly, there is also STE in aVL, as well as V1. The operative report and radiology reads do not comment specifically as to whether the dissection flap was partially or fully obstructing coronary flow, or whether it was obstructing the left main or the RCA. Intraoperative TEE noted "Type A aortic dissection arising 1.0

Ultrasounds 52

Ultrasounds EKG/ECG EMS Radiology 52

Northwestern EM Blog

DECEMBER 20, 2021

Typically well appearing with normal labs, however, this is a diagnosis of exclusion and a septic joint should be ruled out. Commonly hematogenous spread from bacteremia; clinical suspicion should prompt radiologic evaluation. Management is orthopedic consultation for operative stabilization [12]. 2012;97(5):185-193.

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

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

ALiEM

AUGUST 9, 2023

F Heart Rate 138 bpm Blood Pressure 102/61 Respiratory Rate 32 Oxygen Saturation (room air) 100% He is well appearing but has increased work of breathing. The lung POCUS is also operator-dependent, and it has a steep learning curve. He presents with persistent cough and fever and now has increased work of breathing.

Ultrasounds 98

Ultrasounds Pediatrics Emergency Department Operations 98

EB Medicine

JULY 8, 2019

Jeff: Well that’s kind worrisome. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in. Nachi: Unfortunately this procedure is associated with a relatively high re-operation rate – one study found 20% of patients required removal or revision.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

The Trauma Pro

JULY 10, 2023

This stream of information continues after the patient leaves the trauma bay for CT, imaging, interventional radiology, operating room, ICU, or floor bed. During chart reviews, I have seen numerous examples of fluids, vital signs, and drug administration recorded well after the patient has been declared dead!

Resuscitation 100

Resuscitation Radiology Radiology Administration 100

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Farrington] Rebuilding of outdated hospitals put emergency rooms on ground level with nearby X-ray service, and, ideally, sometimes closer to the Blood Bank and the Operating Rooms. Rebuilding of EDs in proximity to Radiology, Blood Bank, OR, and ICU, becoming organic to the hospital. 1950s & 1960s Resuscitation Research.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

EB Medicine

JUNE 6, 2019

CT is good but you really should learn ultrasound, and lastly, sick patients need prompt consultation and resuscitation, not rapid trips to radiology. For example, patients with misdiagnosed disease has less RLQ pain and tenderness as well as diminished anorexia, nausea, and vomiting.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

Pediatric Emergency Playbook

FEBRUARY 1, 2016

Protocols work well for adults, but trauma in children requires that we exercise our clinical muscles just a bit more. REBOA If you have access to resuscitative endovascular balloon occlusion of the aorta or REBOA, this may be an option to temporize the child to get him to the relative control of the operating room.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

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

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

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

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. Figure 5: Pelvic binding with a sheet.

Fractures 54

Fractures Resuscitation Operations EMS 54

PEMBlog

JUNE 5, 2024

Infants can get a cervical spine injury during breech delivery or, unfortunately, during non accidental trauma as well. It’s a highly sensitive rule that is designed to prevent missing cervical spine injuries while limiting the amount of unnecessary radiologic examinations. That’s a spine or neurosurgery operation.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

EMDocs

NOVEMBER 13, 2023

2019) argue against a minimum NIHSS score to trigger the use of CTA, instead purporting that clinical suspicion of acute ischemic stroke presenting within 24 hours of the last known well was sufficient evidence to order the study. 8 The data in Mayer et al. 9 A later assessment of the VAN score in Beume et al. positivity rate on CTA for BCVI.

Stroke 87

Stroke Radiology Radiology Emergency Department 87

Pediatric Emergency Playbook

JUNE 1, 2017

This child is at risk for expected complications, as well as overdiagnosis and iatrogenia. These children depend on their preload to run blood passively into the pulmonary circuit; afterload reduction is also important to compensate for a poor left ejection fraction, as well as to avoid the development of pulmonary hypertension.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

EB Medicine

JANUARY 2, 2019

Jeff: Perhaps most importantly, no history or physical alone can rule in or out an ectopic pregnancy, for that you’ll need testing and imaging or operative findings. Jeff: All patients with a positive pregnancy test and vaginal bleeding should receive an ultrasound performed by either an emergency physician or by radiology.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

Taming the SRU

MAY 30, 2023

hours earlier and went to OR 3.5

OB/GYN 52

OB/GYN Ultrasounds Pediatrics Resuscitation 52

Pediatric Emergency Playbook

APRIL 1, 2017

Steady the operating hand by placing your hypothenar eminence on the child’s zygoma or temporal scalp, to avoid jutting the instrument into the ear canal with sudden movement. Look for a small tip diameter (to fit in the ear canal as well as the nose) and a strong “hold” (at least a 3-lb hold). button batteries in the nose or ears).29,30

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52

Advanced Emergency Nursing from AENJ

MAY 27, 2015

If mere criminality was the only matter, there’s some cash, personal electronics, appliances, and business machines; if not merely criminal, and well-studied beforehand, there are to be had radioactive materials, drugs, toxins, chemicals, and many who would pay a ransom for the loved ones within. Emergency Preparedness. Vernon , August. (No

Federal Emergency Management Agency 40

Federal Emergency Management Agency Military Hospitals Administration 40