Cook County EM Blog

APRIL 11, 2023

Radiology is called to conduct bedside x-ray prior to reduction. So, you reach for your ultrasound… Why It Matters : Shoulder dislocations are a common presentation to the emergency department and account for approximately 200,000 visits annually [1]. You suspect a shoulder dislocation.

Dislocations 52

Dislocations Ultrasounds Emergency Department Radiology 52

ALiEM

AUGUST 9, 2023

Read this tutorial on the use of point of care ultrasonography (POCUS) for pediatric lung ultrasound. Take the ALiEMU PEM POCUS: Pediatric Lung Ultrasound Quiz Module Goals List indications for performing a pediatric lung point-of-care ultrasound (POCUS). Identify anatomical landmarks on ultrasound (Figure 3, Video 1).

Ultrasounds 98

Ultrasounds Pediatrics Emergency Department Operations 98

Taming the SRU

OCTOBER 23, 2023

A bedside ultrasound is completed to assess the location of the pregnancy. A radiology performed ultrasound is ordered and has similar findings– Impression: no definitive IUP with a small amount of free fluid within physiologic limits. Laboratory evaluation reveals a hemoglobin and hematocrit of 12.6/37.1

Ultrasounds 97

Ultrasounds Operations Radiology Radiology 97

Taming the SRU

JULY 24, 2023

A bedside right upper quadrant ultrasound was performed, and the images are below. The following day, Interventional Radiology placed a percutaneous cholecystostomy tube. Ultrasound is the gold standard for diagnosing cholelithiasis because it is more sensitive for detecting gallstones. Gallbladder visualized in long axis.

Ultrasounds 77

Ultrasounds Sepsis Radiology Radiology 77

ALiEM

APRIL 12, 2023

You set up everything, have the patient positioned, and then notice there is no sterile ultrasound gel. The trick is to eliminate anything of poor acoustic impedance between the ultrasound probe and the patient’s skin. Note that some ultrasound manufacturers do not recommend the use of isopropyl alcohol on their transducers.

Ultrasounds 103

Ultrasounds Emergency Department Resuscitation Wellness 103

Medagadget

AUGUST 22, 2023

Researchers at MIT have developed a wearable ultrasound system that is intended to allow women at high risk of breast cancer to perform an ultrasound scan on themselves at home, and may also let patients with early-stage malignancy or suspicious lesions to monitor how they are progressing.

Ultrasounds 75

Ultrasounds Research Radiology Radiology 75

Cook County EM Blog

MARCH 28, 2023

On point-of-care ocular ultrasound of the affected eye using the linear probe a round, mobile structure was noted in the posterior chamber with an absence of the lens in its typical position, consistent with posterior lens dislocation. What is the utility of point-of-care ultrasound in identifying lens dislocation?

Dislocations 52

Dislocations Ultrasounds Fractures Radiology 52

EM Ottawa

JUNE 20, 2024

This case report demonstrates the utility of point-of-care ultrasound (POCUS) to identify complicated gallbladder disease. POCUS demonstrated signs of small bowel obstruction and subsequently guided the decision to pursue radiology-performed imaging.

Radiology 66

Radiology Radiology Ultrasounds Infectious Diseases 66

ALiEM

FEBRUARY 16, 2024

This patient was admitted to the hospital’s general surgical service and treated with IV broad-spectrum antibiotics and a percutaneous cholecystostomy tube placed by interventional radiology. Gangrenous cholecystitis: diagnosis by ultrasound. doi: 10.1148/radiology.148.1.6856839. Ultrasound, 30: 270-274.

Radiology 64

Radiology Radiology Ultrasounds COPD 64

Taming the SRU

APRIL 5, 2023

Given her age, history of nephrolithiasis, and frequent urinary tract infections, a bedside renal ultrasound was performed to assess for hydronephrosis due to concern her generalized weakness may be secondary to an infected stone or obstructive uropathy. Horseshoe Kidney: Radiology Reference Article. Images are seen below.

Ultrasounds 52

Ultrasounds Pediatrics Radiology Radiology 52

RebelEM

FEBRUARY 12, 2024

The panel included physicians from Emergency Medicine, Urology and Radiology and was published in major journals of all three specialities. Research from our very own SIUH department of radiology recommended that contrast-enhanced CT scans can safely exclude obstructive urolithiasis just as well as noncontrast CTs. 2011; 18(7):699-707.

Radiology 85

Radiology Radiology Emergency Department Ultrasounds 85

The Skeptics' Guide to EM

AUGUST 24, 2024

More recently, the April 2024 SGEMHOP reviewed a trial on how effective and safe an ultrasound-guided erector spinae plane block (ESPB) in adult patients with rib fractures is. The block is typically performed under ultrasound guidance, which allows for precise placement of the anesthetic and minimizes the risk of complications.

Fractures 51

Fractures Emergency Department Ultrasounds Radiology 51

EMergucate

MAY 17, 2016

– CT – MRI – Nuclear Medicine – Radiation – Ultrasound

Radiology 40

Radiology Radiology EMS Ultrasounds 40

ALiEM

FEBRUARY 28, 2024

We also must recognize the important contributions of media such as clinical photographs, radiology images, and ECGs. Photographs, ECGs, Radiology Images These fall into the category of “other multimedia” in the AMA Manual of Style, and here is my best attempt to interpret this to clinical media. Apps App Title app. Version number.

Radiology 52

Radiology Radiology Academics Fractures 52

Taming the SRU

APRIL 14, 2024

2) Management: Confirmed by CT Surgical consult Utility of Ultrasound Ultrasound can be helpful in identifying hernias and in assisting in reduction. 8) “Ultrasound may decrease the emergency surgery rate of incarcerated inguinal hernia” by Chen et al. (1) If the ultrasound-guided attempt failed, emergency surgery was scheduled.

Ultrasounds 92

Ultrasounds Emergency Department Pediatrics Radiology 92

ACEP Now

OCTOBER 29, 2024

The patient was started on antibiotics covering Klebsiella species (grown from urine culture obtained during the first visit) and the SPC was immediately replaced with confirmation of placement into the bladder with ultrasound. Suprapubic catheter insertion using an ultrasound-guided technique and literature review. Hong Kong Med J.

Ultrasounds 52

Ultrasounds Best Practices Radiology Radiology 52

ALiEM

SEPTEMBER 29, 2023

doi: 10.1148/radiology.216.2.r00jl25356. Author information Andrew Shannon, MD, MPH Ultrasound Director Associate Professor of Emergency Medicine Lakeland Regional Health | The post SAEM Clinical Images Series: Only a Flesh Wound appeared first on ALiEM. Múnera F, Soto JA, Palacio D, Velez SM, Medina E. 2000 Aug;216(2):356-62.

Radiology 70

Radiology Radiology Academics Ultrasounds 70

EM Ottawa

OCTOBER 10, 2024

Fortunately, there’s a better way to anesthetize the plantar foot, and avoid getting kicked in the face or causing a needle-stick injury: performing an ultrasound-guided tibial nerve block.1 If you have, you’ll understand the incredible pain and difficulty in trying to anesthetize this region.

Ultrasounds 69

Ultrasounds Radiology Radiology 69

Pediatric Education

JUNE 9, 2024

The radiologic evaluation of ultrasound showed an enlarged right ovary with a large follicular cyst and decreased blood flow in the pedicle. On Doppler ultrasound arterial blood flow may or may not be seen. The laboratory evaluation showed she was not pregnant, her white blood cell count was 11.5 Overall outcomes are good.

Pediatrics 52

Pediatrics Ultrasounds Radiology Radiology 52

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? Many patients in the ultrasound groups did get additional imaging, but this was not the majority. How do you proceed? In this study, 40.7%

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

Pediatric Education

FEBRUARY 4, 2024

A right-sided suprarenal mass had been identified on routine ultrasound during the third trimester that was thought to likely be an adrenal hemorrhage. The radiologic evaluation of an ultrasound examination showed a small hypoechoic mass in the area of right adrenal gland that was smaller than previously recorded prenatally.

Ultrasounds 52

Ultrasounds Radiology Radiology Pediatrics 52

The Skeptics' Guide to EM

MARCH 25, 2023

Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Ultrasound is usually the first line imaging modality for diagnosing acute biliary disease.

Ultrasounds 52

Ultrasounds Emergency Department Dislocations Radiology 52

EMergucate

MAY 11, 2020

30 year old male presents to ED with onset of right sided chest pain 2 hours ago. pain is pleuritic in nature and is associated with some Shortness of breath. His Vitals are HR 90, BP 130/70, RR 18…

Ultrasounds 52

Ultrasounds Radiology Radiology 52

EM Ottawa

OCTOBER 3, 2024

Point-of-care ultrasound (POCUS) is often taught to answer binary questions, like, “Is there free fluid in the abdomen?” ” However, when we combine POCUS images with clinical documentation, we are telling a story — and every good story has a beginning, middle, and end.

Ultrasounds 50

Ultrasounds Documentation/Coding Radiology Radiology 50

Taming the SRU

MAY 27, 2024

Ultrasound in recent years has become a very helpful tool in diagnosing smaller effusions, and is noted to be almost 100% sensitive for effusions > 100 mL (2). While historically reported rates were ~20%, more recent literature with ultrasound guidance suggests much lower rates of ~3% (3, 4).

Emergency Department 85

Emergency Department Ultrasounds Radiology Radiology 85

EMDocs

MARCH 4, 2024

12 Ultrasound and computed tomography (CT) can both identify CBD and are available in most emergency departments. Ultrasound is cost-effective and radiation-sparing. Ultrasound has approximately 90% sensitivity for detecting common bile duct dilation. 13 CT is also superior to ultrasound in its ability to detect malignancy.

Emergency Department 86

Emergency Department Ultrasounds EMS Radiology 86

SheMD

APRIL 24, 2023

I waited until my 6 week ultrasound. On my ultrasound day, I had started to feel pregnant. A colleague met me at the hospital and performed an ultrasound once more to confirm. My friend did an ultrasound and we saw free fluid- a lot of it. I waited in radiology for my formal ultrasound.

Ultrasounds 83

Ultrasounds Radiology Radiology Emergency Department 83

EMDocs

DECEMBER 4, 2023

The facility does not have ultrasound (US) availability at the time of the patient’s presentation, as the sonographer comes to the hospital only 2 days a week. First, examine the patient and risk-stratify them for the diagnosis of DVT before deciding on the clinical utility of an ultrasound. Ultrasound. J Thromb Thrombolysis.

Ultrasounds 70

Ultrasounds Documentation/Coding Wellness EMS 70

ACEP Now

AUGUST 12, 2024

Every 30 minutes, a range of topics draws new participants to discuss everything from mastering ultrasound techniques to finding career mentorship. Get a personal financial plan, immerse yourself in hands-on training, brush up on your ultrasound and more. Emergency Ultrasound Management Course: (Sept. 28: 10 a.m.–5 28: 8 a.m.–5:30

Ultrasounds 52

Ultrasounds Research Radiology Radiology 52

EM Ottawa

APRIL 4, 2024

Point-of-care ultrasound (PoCUS) is becoming a cornerstone tool in our assessment of patient presentations and is helping us guide our clinical management. This is also represented in the amount of literature that has been published on the use of PoCUS in 2023.

Ultrasounds 71

Ultrasounds Infectious Diseases COPD Shock 71

The Skeptics' Guide to EM

DECEMBER 28, 2019

He is also the Chief for the Section of Emergency Ultrasound and […] The post SGEM Xtra: Come Together, Right Now – Over Renal Colic first appeared on The Skeptics Guide to Emergency Medicine. He is also the Chief for the Section of Emergency Ultrasound and Director of the Emergency Ultrasound Fellowship. NEJM 2014 ).

Radiology 40

Radiology Radiology Ultrasounds Emergency Department 40

Mind The Bleep

MAY 12, 2023

The first step is confirmation of pleural effusion clinically or radiologically (chest x-ray or ultrasound). The management will vary depending on the causes of pleural effusion, therefore the diagnostic approach is important. mmol/L (110 mg/dL), is diagnostic.

Radiology 52

Radiology Radiology Ultrasounds 52

EMergucate

MAY 12, 2020

30 year old male presents to ED with onset of right sided chest pain 2 hours ago. pain is pleuritic in nature and is associated with some Shortness of breath. His Vitals are HR 90, BP 130/70, RR 18…

Ultrasounds 40

Ultrasounds Radiology Radiology 40

The Skeptics' Guide to EM

NOVEMBER 9, 2019

Chip is the CEO of an ultrasound education company called Practical POCUS which is based in the United States but is expanding into an international market. However, ultrasound does have its limitations especially in obese patients or those unable to comply with the exam for reasons such as pain.

Ultrasounds 52

Ultrasounds Fractures Pediatrics Radiology 52

Total Medical ComplianceHIPAA

OCTOBER 9, 2024

Maintenance should be performed on any equipment before using in the delivery of patient care, this includes autoclaves, suction lines, ultrasounds, radiology equipment, etc. Sterilized instruments that have become compromised should be cleaned, repackaged and sterilized again. Perform spore testing on autoclaves prior to use.

Hazardous Materials 59

Hazardous Materials Infectious Diseases PPE Shock 59

PEMBlog

OCTOBER 26, 2023

Ultrasound and CT may not differentiate it from normal bowel. Radiology of Meckel’s Diverticulum. The feeding artery of the Meckel diverticulum is an anomalous superior mesenteric artery branch. It has a long and non-branching course and ends toward the right lower quadrant. References Dixon P & Nolan D. Clin Radiol.

Radiology 64

Radiology Radiology Administration Resuscitation 64

Don't Forget the Bubbles

NOVEMBER 8, 2023

Ultrasound has been associated with lower rates of negative appendicectomy. In a meta-analysis of 26 paediatric studies, the pooled sensitivity and specificity of ultrasound for diagnosing appendicitis in children were 88% and 94%, respectively [10]. However, the test performance depends on whether the appendix is visualised or not.

Emergency Department 105

Emergency Department Ultrasounds Pediatrics Best Practices 105