PHEM Cast

JULY 27, 2021

Some useful videos: Hopefully you found the podcast interesting, but since this is quite a visual topic we have put together some videos to demonstrate some of the pathologies discussed and what they look like on ultrasound: How does ultrasound work? Want to know how to use ultrasound? Kenji Inaba. 2015 Marik PE, Cavallazzi R.

Ultrasounds 52

Ultrasounds Fractures Resuscitation EMS 52

Broome Docs

SEPTEMBER 9, 2023

In this episode we do a deep dive into the BUCKLED trial that looked at the use of bedside ultrasound vs. plain film X-rays for the initial investigation of paediatric forearm fractures. Bottom line: ultrasound appears to be non-inferior to X-ray when used as a first line investigation in terms of functional, patient-oriented outcomes.

Fractures 114

Fractures Ultrasounds Outcomes 114

PulmCCM

SEPTEMBER 4, 2024

Kenny MD [ @heart_lung ] Since its first description [1], the Venous Excess Ultrasound Score [VExUS] has received much research attention. Subsequently in the late 1970s, Sivaciyan and Ranganathan [9] confirmed these findings with Doppler ultrasound of the IJV. The ultrasound journal 12: 1-12 2. Jon-Emile S. Echocardiography 7.

Ultrasounds 84

Ultrasounds Operations Research Outcomes 84

Ultrasound Gel

JUNE 24, 2019

It is great to see more and more research on ultrasound in cardiac arrest. Here is a nice study that looks to see if ultrasound is associated with increased resuscitation efforts or better survival outcomes. link] It is great to see more and more research on ultrasound in cardiac arrest.

Outcomes 52

Outcomes Ultrasounds Resuscitation Research 52

Emergency Medicine Journal

JULY 22, 2024

Background and objectives The ability to rule appendicitis in or out using ultrasound is limited by studies where the appendix is not visualised. For those patients who had formal ultrasound, direct and indirect findings of ultrasound were abstracted from the ultrasound report. 95% CI 1.7 95% CI 3.8 95% CI 1.4

Ultrasounds 52

Ultrasounds Radiology Radiology Emergency Department 52

The Skeptics' Guide to EM

JULY 30, 2022

Point-of-Care Ultrasound-First for the Evaluation of Small Bowel Obstruction: National Cost Savings, Length of Stay Reduction, and Preventable Radiation Exposure. Point-of-Care Ultrasound-First for the Evaluation of Small Bowel Obstruction: National Cost Savings, Length of Stay Reduction, and Preventable Radiation Exposure.

Ultrasounds 52

Ultrasounds Operations Documentation/Coding Outcomes 52

Don't Forget the Bubbles

JUNE 19, 2023

There were no issues during the pregnancy, and estimated fetal growth by ultrasound was constant. Differential diagnosis of small babies The differential diagnosis for SGA and growth-restricted babies is extensive: The diagnosis of growth restriction in utero has improved because of the better use of ultrasound but still remains challenging.

Pediatrics 143

Pediatrics Ultrasounds Hyperthermia / Hypothermia Sepsis 143

RebelEM

JANUARY 29, 2024

in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 to 4.0mg/hr typically given in EKOS therapy (See Below). to 4.0mg/hr typically given in EKOS therapy (See Below).

Stroke 136

Stroke Outcomes Hospitals Administration 136

Emergency Medicine Journal

SEPTEMBER 27, 2023

Background Serial point-of-care ultrasound (PoCUS) can potentially improve acute patient care through treatment adjusted to the dynamic ultrasound findings. Methods This was a randomised, controlled, blinded-outcome trial conducted in three EDs in Denmark between 9 October 2019 and 26 May 2021.

Ultrasounds 52

Ultrasounds Outcomes 52

PulmCCM

FEBRUARY 5, 2024

Also, many patients with infection won’t have fevers, and those that don’t may be at the highest risk for poor outcomes. But thoracic ultrasounds on every febrile ICU patient with a mildly abnormal chest film would likely result in many unhelpful thoracenteses of harmless effusions, and some avoidable pneumothoraces.

Best Practices 111

Best Practices Ultrasounds Infectious Diseases Sepsis 111

RebelEM

JUNE 26, 2023

Interventions such as early application of hemorrhage control, tranexamic acid, reduction of crystalloid fluid administration and balanced ratio blood product transfusion have improved many patients’ outcomes. However, mortality still remains high due to trauma-induced coagulopathy. Severe acute traumatic coagulopathy = PT >1.5

Administration 145

Administration Outcomes Resuscitation Radiology 145

Sensible Medicine

NOVEMBER 6, 2023

Today I will tell you about one-year results of the SWISS-APERO trial—which compared outcomes with the two most common types of closure devices. This study report included only 45-day outcomes. They main outcome measure was patency of the left atrial appendage. This is a decidedly bad outcome. Pause there.

Stroke 132

Stroke Outcomes Ultrasounds Wellness 132

RebelEM

JUNE 19, 2023

PMID: 37314244 Clinical Question: In advanced trauma systems, does prehospital administration of TXA increase the rate of survival with a favorable neurologic outcome in patients at risk for trauma-induced coagulopathy? 1.00 (0.9 – 1.12) Secondary Outcome Mortality 24h 9.7% Prehospital Tranexamic Acid for Severe Trauma.

Outcomes 105

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 105

Taming the SRU

NOVEMBER 3, 2023

Ultrasound‐Guided Serratus Anterior Plane Block (SAPB) Improves Pain Control in Patients With Rib Fractures. Ultrasound Med. The primary outcome in this study was a change in pain score at rest 60 minutes after block. 41, 2695–2701 (2022).

Fractures 98

Fractures Ultrasounds Outcomes Research 98

Don't Forget the Bubbles

NOVEMBER 13, 2023

Should we use ultrasound to diagnose distal forearm fractures in children and adolescents? However, ultrasound is gaining popularity due to its portability, affordability, and lack of ionising radiation. However, ultrasound is gaining popularity due to its portability, affordability, and lack of ionising radiation.

Fractures 64

Fractures Ultrasounds Emergency Department Pediatrics 64

Emergency Medicine Journal

JULY 24, 2023

Ultrasound could be a reliable, cheap and radiation free alternative to diagnose fractures and ligamentous injuries. The purpose of this systematic review was to investigate the accuracy of ultrasound in diagnosing ankle injuries. No restrictions were applied for date and language.

Ultrasounds 40

Ultrasounds Fractures Outcomes 40

RebelEM

FEBRUARY 19, 2024

of cases) Catheter ultrasound confirmation: 49.8% (i.e. Not met in 16.7% of cases) Catheter location: 66.5% (i.e. Not met in 33.5% Not met in 50.2% of cases) Appropriate vasopressor dose: 84.3% (i.e. Not met in 15.7% No Extravasation Event vs Extravasation Event Age: 63 vs 67 years BMI: 28.3 All Catheter Criteria Met: 44.3%

Administration 137

Administration Sepsis EMS Shock 137

The Trauma Pro

OCTOBER 4, 2024

Clinical outcomes assessed at 60 days included an unplanned return to the emergency department (ED), re-admission, complications, and development of new bleeding confirmed by surgery, ultrasound, or computed tomography (CT) at 60 days post-injury. Adherence to guidelines was assessed by a follow-up phone call two months after injury.

Pediatrics 113

Pediatrics Outcomes Operations Emergency Department 113

Emergency Medicine Journal

NOVEMBER 28, 2023

Point-of-care ultrasound has been used to guide ED manipulations but its effect on the quality of fracture reduction or subsequent need for surgical fixation is unknown. This study aims to assess the feasibility of conducting a definitive randomised controlled trial to assess the use of ultrasound to guide these fracture manipulations.

Fractures 40

Fractures Ultrasounds Outcomes Research 40

Don't Forget the Bubbles

JANUARY 1, 2024

Lung ultrasound for the sick child: less harm and more information than a radiograph. Point-of-care ultrasound for non-vascular invasive procedures in critically ill neonates and children: current status and future perspectives. Outcomes From a Randomized Clinical Trial. Musolino AM, et al. Eur J Pediatr. 2023 Dec 22.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

The Trauma Pro

OCTOBER 25, 2024

The primary outcome was the development of VTE during the hospitalization. DVT was detected using duplex ultrasound, and PE was detected by CT angiography. If pulmonary clots were seen without concomitant DVT, they were not considered to be of embolic origin.

Fractures 113

Fractures Head Injuries Operations Ultrasounds 113

Don't Forget the Bubbles

DECEMBER 25, 2023

Interpreting Research Outcomes with a Little Bathroom Humour You have learned a method for how to read a research paper , and now you are faced with a bunch of outcomes. There are primary, secondary, composite , and safety outcomes. What are these outcomes? We know there is a bias towards reporting positive outcomes.

Research 83

Research Outcomes Fractures Hospitals 83

Broome Docs

MARCH 28, 2024

If you want to see Justin in the video format and his new Youtube series then click here: [link] If you would like to check out my current ultrasound training project then click here: WACHS Ultrasound Otherwise – enjoy the show and see you in a few weeks. Emerg Med J. 2024 Jan 22;41(2):96-102. doi: 10.1136/emermed-2023-213285.

PPE 107

PPE Ultrasounds Resuscitation Administration 107

The Skeptics' Guide to EM

DECEMBER 21, 2024

Outcomes: Clearly defined primary and secondary endpoints. Pick patient-oriented outcomes (POO) rather than disease-oriented outcomes (DOOs), surrogate-oriented outcomes (SOOs) or monitor-oriented outcomes (MOOs) Statistical Analysis Plan: Provides a roadmap for how data will be analyzed and reduces the risk of data dredging or p-hacking.

Outcomes 58

Outcomes Research Ultrasounds 58

Sensible Medicine

AUGUST 19, 2024

One of the core ideas in cardiology is that improving blood flow to a heart with severe reduction of flow due to coronary stenoses will improve outcomes. The addition of patients with a weak heart muscle makes it even more likely that improvement of blood flow should improve outcomes— over medical therapy. The median EF was 28%.

Outcomes 96

Outcomes Ultrasounds Wellness 96

Sensible Medicine

DECEMBER 28, 2023

One makes an ultrasound device, the other a radiofrequency device. Here is Kaul again: My translation is that the Recor device (ultrasound) approval was very weak. Longer term data (3 years) found higher rates of poor outcomes. III Renal Denervation for high blood pressure. This was a recent FDA approval.

Stroke 124

Stroke Ultrasounds Outcomes Hospitals 124

Emergency Medicine Journal

NOVEMBER 28, 2023

Manipulation performed under ultrasound guidance has the potential to decrease the number of reduction attempts. Patients aged ≥16 years presenting to the ED with a distal radius fracture requiring closed reduction were randomised to either point-of-care ultrasound (PoCUS)-guided or standard reduction.

Fractures 40

Fractures Ultrasounds Emergency Department Operations 40

EB Medicine

APRIL 30, 2017

Topics covered in this episode of EMplify include Basics of acute decompensated heart failure Key differences in the pathophysiology of heart failure with reduced ejection fraction and heart failure with preserved ejection fraction Prehospital Care Initial ED Evaluation of acute decompensated heart failure Narrowing down the differential Physical exam (..)

Outcomes 40

Outcomes Best Practices Burns Ultrasounds 40

Taming the SRU

AUGUST 7, 2023

The patient needs a transvaginal ultrasound w/ doppler with gynecology consult and possible laparotomy TVUS is not just for torsion, it can also be used for ectopic pregnancies or pregnancy of unknown location Acute Ischemic Stroke Updates WITH Drs. hours increased the NNT for a good outcome to 20. The expanded window of 3-4.5

Stroke 93

Stroke Outcomes EKG/ECG Research 93

Northwestern EM Blog

MAY 16, 2022

What is your initial imaging test of choice, ultrasound (US) or non-contrast CT, and why? Would you be confident in a point-of-care-ultrasound evaluation or a formal ultrasound? Do outcomes for patients with suspected nephrolithiasis differ based on the initial imaging? How do you proceed?

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

PulmCCM

JULY 3, 2023

If those grizzled veterans give you a hard time, remember, they’re also the ones who dispensed attaboys in the pre-ultrasound era like “if you’re not cannulating the carotid artery or dropping lungs, you’re not doing enough central lines!”) (Who themselves would be less experienced at video.) (If

Airway Management 105

Airway Management Outcomes Hospitals Emergency Department 105

EMDocs

NOVEMBER 13, 2024

Older age, recurrent episodes of SBP, hepatorenal syndrome, hepatic encephalopathy, acute kidney injury (AKI), concurrent GI bleeding, and higher MELD scores are predictors of worse outcomes. Ultrasound can assist: confirm ascites, evaluate for best site, abdominal wall thickness, blood vessels along needle track. 2019 Jan 14;11:13-22.

Hyperthermia / Hypothermia 79

Hyperthermia / Hypothermia Ultrasounds Shock Hospitals 79

PulmCCM

JUNE 26, 2023

No outcomes regarding the delirium itself were reported (i.e., Private equity-backed firms are buying and expanding physician practices and squeezing them for profit, with little regard for patient outcomes, professional standards, or ethics. whether haloperidol actually reduced delirium).

Outcomes 98

Outcomes Ultrasounds Hospitals Wellness 98

Emergency Medicine Journal

MAY 28, 2024

Head turner—new concepts. Game changer—this paper could/should change practice. 1 Conducted in two US hospitals, the study enrolled patients ≥18 years with a final.

Ultrasounds 52

Ultrasounds Hospitals Outcomes 52

The Skeptics' Guide to EM

NOVEMBER 23, 2019

Increased Sensitivity of Focused Cardiac Ultrasound for Pulmonary Embolism in Emergency Department Patients With Abnormal Vital Signs. Increased Sensitivity of Focused Cardiac Ultrasound for Pulmonary Embolism in Emergency Department Patients With Abnormal Vital Signs. Date: November 21st, 2019 Reference: Daley et al.

Ultrasounds 52

Ultrasounds Emergency Department Academics Outcomes 52

Mount Sinai EM

OCTOBER 11, 2024

There was significant heterogeneity among studies and outcomes were not measured consistently. Hennepin Ultrasound has a blog post on how to perform this both statically and dynamically–visualizing the needle as it aspirates the PTA. Intraoral: Transcervical: Image Credit: Long et al.,

Ultrasounds 100

Ultrasounds Wellness Outcomes Hospitals 100

Don't Forget the Bubbles

JULY 17, 2023

Reviews and opinion articles Point-of-care ultrasound in pediatric nephrology. Clinical Outcomes of COVID-19 in Newborns and Infants: A Multicenter Experience of 576 Cases. 2023 Jun Oral food challenge outcomes in children and adolescents in a tertiary centre: A 5-year experience. Sethi SK, et al. Pediatr Nephrol. Eur J Pediatr.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98