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.

Radiology 69

Radiology Radiology Emergency Department Ultrasounds 69

Emergency Medicine Ireland

JUNE 14, 2021

While not commonly seen you can rest assured that critical care will be expected to turn up and manage these patients if an incident does occur so it is something we need to know fairly well. Ultimately you’re going to get an edited selection of the available nasty agents.

Radiology 52

Radiology Radiology Hospitals Wellness 52

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

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! Several are simultaneous.

Resuscitation 100

Resuscitation Radiology Radiology Administration 100

PEMBlog

APRIL 24, 2024

There is a validated Pediatric Stroke Scale from the NIH that can be used in conjunction with a stroke protocol that involves Neurology, Radiology, and a local/regional Stroke Team. Pediatric strokes are rare and challenging to diagnose. Retrospective use has been shown to be valid and reliable in one cross-sectional study ( Beslow 2012 ).This

Stroke 59

Stroke Pediatrics Blood Transfusions Radiology 59

ALiEM

SEPTEMBER 29, 2023

Additional Images Physical Exam General : Well-appearing male in no distress Neck : Hemostatic wound to his left neck. doi: 10.1148/radiology.216.2.r00jl25356. He now presents requesting “Neosporin.” ” His tetanus status is out of date. No significant pain, no hematoma, no bruits. 2000 Aug;216(2):356-62. r00jl25356.

Radiology 70

Radiology Radiology Academics Ultrasounds 70

RebelEM

JUNE 26, 2023

4F-PCC contains factors II, VII, IX, X as well as Proteins S and C. Some clinicians have advocated for early administration of 4-factor prothrombin complex concentrate (4F-PCC) based on limited observational data. High-quality studies are needed to determine the utility of this intervention. Severe acute traumatic coagulopathy = PT >1.5

Administration 140

Administration Outcomes Resuscitation Radiology 140

RebelEM

FEBRUARY 29, 2024

Patient data anonymized when presented to adjudication committee to avoid detection bias Well-balanced patient characteristics between groups. SECONDARY OUTCOMES At day 28 , ceftriaxone group had (vs placebo): Lower VAP risk (20% vs 36%); hazard ratio 0.62 Medication prepared by nurses in another unit not involved in the patients’ care.

CDC 114

CDC Radiology Radiology Outcomes 114

Sensible Medicine

APRIL 12, 2024

For probably the twelfth time on Sensible Medicine, I’ll reference Lisa Rosenbaum’s essay, Being Well while Doing Well — Distinguishing Necessary from Unnecessary Discomfort in Training which brought some of the current inter-generational angst to the fore.

Radiology 68

Radiology Radiology Hospitals Documentation/Coding 68

American Medical Compliance

OCTOBER 3, 2024

As dental professionals, it’s crucial to understand and adhere to OSHA dental compliance standards to ensure the well-being of both staff and patients. These multiple hazards include biological, chemical, ergonomic, and radiological risks. According to NSC Injury Facts, workplace injuries cost businesses $167 billion in 2021.

PPE 93

PPE Hazardous Materials Documentation/Coding Operations 93

American Medical Compliance

FEBRUARY 28, 2024

While there are benefits to using this therapeutic treatment method, there are risks as well. Radiation Protection in Interventional Radiology Over the last decade there has been a rapid increase in the number of interventional radiology (IR) procedures performed.

Radiology 52

Radiology Radiology Fractures Operations 52

Sensible Medicine

SEPTEMBER 27, 2024

We are lucky to work at a time when a review of a discharge summary, lab findings, and radiology results can usually give you a pretty perfect sense of what has happened and what remains necessary. I am sure Dr. Fred knew this well. And Old-fashioned doctors view consultants as opinion givers, not decision makers.

Radiology 99

Radiology Radiology Wellness Hospitals 99

Don't Forget the Bubbles

MAY 22, 2023

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. This may include neonatology, paediatric intensive care, respiratory, cardiology, ENT, spinal injury, neuromuscular or neuro-disability specialists, as well as access to palliative care.

Radiology 98

Radiology Radiology Hospitals Wellness 98

Taming the SRU

SEPTEMBER 15, 2023

ultrasound grand rounds: bedside dvt studies - family presence in the ed/icu - r1 clinical knowledge: aicd - r3 small groups: difficult airway management Ultrasound grand rounds: DVT studies WITH Dr. minges Why should we perform bedside DVT studies in the ED?

CPR 88

CPR Burns Airway Management Wellness 88

Pediatric Education

JULY 14, 2024

He was overall well but his father noted that he had a “bump” on the side of his forehead. The patient was referred to neurosurgery and radiologic evaluation of a magnetic resonance imaging study revealed a dermoid cyst. Patient Presentation A 24-month-old male came to clinic for his health supervision visit.

Radiology 52

Radiology Radiology Pediatrics Operations 52

SheMD

APRIL 24, 2023

Well there were two other ones that were in morula phase but needed to progress to blastocyst. Well that night, I had the residency over for a wellness Thanksgiving dinner. I got wheeled through the hospital corridors to radiology, in a patient gown, past residents, past firefighters, past a lot of puzzled faces.

Ultrasounds 83

Ultrasounds Radiology Radiology Emergency Department 83

EMDocs

NOVEMBER 1, 2023

ECG – May show tachycardia or rate related ST depressions Laboratory evaluation: CBC w/ differential – may reveal leukocytosis with left shift CMP, Lipase – can reveal alternative intra-abdominal diagnoses as well as show findings of end-organ hypoperfusion (elevated serum creatinine, transaminitis, etc.)

Operations 67

Operations Radiology Radiology Fluid Resuscitation 67

ALiEM

MARCH 7, 2024

It is usually large, nodular, well-defined, homogeneous, and slightly hypoechoic (Figure 13) [6]. Renal cysts can be confused for hydronephrosis, and both warrant further imaging by Radiology. This has led to controversy whether to perform a renal ultrasound versus CT, even when the Radiology department performs the ultrasound.

Ultrasounds 70

Ultrasounds Pediatrics Radiology Radiology 70

The Trauma Pro

OCTOBER 23, 2023

But as we have seen with vision systems and game playing (think chess), computers are getting pretty good at doing this as well. In doing this, they can identify a wide variety of diseases, anomalies, and injuries. Is it only a matter of time until computer artificial intelligence (AI) starts reading x-rays?

Fractures 147

Fractures EKG/ECG Hospitals Wellness 147

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 14, 2024

You may place cold packs or ice packs to the hernia site to help reduce inflammation and swelling, as well as to assist in local analgesia. Symptoms include persistent tenderness in the area, as well as symptoms of obstruction including nausea, vomiting, and pain, despite reduction. (2) Emergency Radiology (Print) , vol.

Ultrasounds 92

Ultrasounds Emergency Department Pediatrics Radiology 92

Pediatric Education

NOVEMBER 5, 2023

Patient Presentation A 4-month-old male came to clinic for his well child appointment. He was doing well, was breastfeeding, smiling and had good head control during tummy time. The pertinent physical exam showed a well-appearing male with all three growth parameters growing normally at approximately 50%.

Radiology 52

Radiology Radiology Pediatrics Wellness 52

EMDocs

DECEMBER 4, 2023

The Wells’ Criteria for DVT can help risk stratify [2,3]. If the patient’s Wells score is ≤ 0, DVT is nearly clinically excluded and no further immediate lab or ultrasound is necessary. In patients with a Wells’ score of 1-2 (moderate risk), DVT can be ruled out with a negative d-dimer rather than an US. Published 2020 Feb 11.

Ultrasounds 71

Ultrasounds Documentation/Coding Wellness EMS 71

EMDocs

APRIL 27, 2024

The changing face of malignant (necrotising) external otitis: clinical, radiological, and anatomic correlations. The changing face of malignant (necrotising) external otitis: clinical, radiological, and anatomic correlations. and Staphylococcus spp. The Lancet. Infectious diseases , 4 (1), 34–39. link] Grandis, J., Branstetter, B.

EMS 84

EMS Infectious Diseases Radiology Radiology 84

EM SIM Cases

MAY 9, 2023

However, if you find yourself treating a drowning patient in the ED, this case will have you well prepared. Radiologic, Neurologic and Cardiopulmonary Aspects of Submersion Injury. WHY IT MATTERS Every year as the weather warms and more people take advantage of water sports and outdoor activities there is increased risk of drowning.

Pediatrics 52

Pediatrics CPR Radiology Radiology 52

Pediatric Education

JUNE 9, 2024

She said she hadn’t felt well for a couple hours before that and had had some nausea and emesis before the pain. She had eaten the same food as her college roommates who were all well. The radiologic evaluation of ultrasound showed an enlarged right ovary with a large follicular cyst and decreased blood flow in the pedicle.

Pediatrics 52

Pediatrics Ultrasounds Radiology Radiology 52

Don't Forget the Bubbles

NOVEMBER 8, 2023

Tilly is normally fit and well, with no significant past medical history. The Shera Score Children with a low Shera score (less than 3) who are otherwise systemically well may be suitable for discharge home with safety netting advice , whereas patients with high scores (8 or more) warrant immediate surgical referral. Doria, A.S.,

Emergency Department 105

Emergency Department Ultrasounds Pediatrics Best Practices 105

Pediatric Education

OCTOBER 22, 2023

Patient Presentation A 2-week-old female came to clinic for her 2 week well child appointment. Her parents felt that she was doing well with feeding every 2-3 hours with many urine and stool diapers per day. The radiologic evaluation confirmed that these were subcutaneous fat necrosis. Her mild jaundice had disappeared.

Radiology 52

Radiology Radiology Fractures Pediatrics 52

Don't Forget the Bubbles

MARCH 11, 2024

There are many causes, and it is less well understood than plagiocephaly. Craniosynostosis, The Radiology Assistant. The Radiology Assistant: Craniosynostosis Accessed 10.01.2024 Mawji, A., Craniosynostosis Craniosynostosis is rare. Prevalence, risk factors, and natural history of positional plagiocephaly: a systematic review.

Radiology 59

Radiology Radiology Pediatrics Documentation/Coding 59

Emergency Medicine Ireland

JANUARY 4, 2021

Typically this would be in a patient with progressive respiratory failure with no cause found despite an extensive work up (eg radiology, bronch, micro, fancy acronym ridden blood tests) The CXR will be usually diffuse bilateral infiltrates. When would you consider such an invasive and complication ridden procedure in the ICU?

Radiology 52

Radiology Radiology Wellness 52

Taming the SRU

JULY 24, 2023

The following day, Interventional Radiology placed a percutaneous cholecystostomy tube. Risk factors associated with increased risk of acute perforated cholecystitis include age greater than 65 years old, as well as diabetes mellitus, atherosclerosis, or organ failure (1, 2). Fluid cultures obtained during the procedure grew E.

Ultrasounds 77

Ultrasounds Sepsis Radiology Radiology 77

Don't Forget the Bubbles

SEPTEMBER 18, 2024

. ■ Case 1 focuses on a case seen in the emergency department and explores the common parental query of a “weak immune system” in a young child who has had several recurrent upper respirator tract infections back-to-back but is otherwise well. His parents are both fit and well and there is no family history of any medical conditions.

Emergency Department 98

Emergency Department Wellness Infectious Diseases Pediatrics 98

Northwestern EM Blog

MAY 16, 2022

vs. It is worth mentioning that this study was a multicenter study based in the US with representation from ED, Radiology, and Urology. Third, for those with proper training, and with some exceptions (see the systematic review paper for case vignettes that highlight these), POCUS is non-inferior to radiology-performed US.

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

RebelEM

MAY 25, 2023

CRYSTALLOIDS Too much crystalloid resuscitation in traumatic hemorrhagic shock can increase dilutional coagulopathy, as well as increase morbidity and mortality Bickell WH et al. Ann Emerg Med 2017 [6] This was a retrospective database review of 7521 traumatic brain injury patients SBP target ≥90mmHg resulted in a mortality of 7.8%

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

Don't Forget the Bubbles

JUNE 30, 2023

Well, one study in Kornelson’s systematic review and meta-analysis is interesting. She’s wheeled to radiology. But – these findings are all from observational cohort studies with small numbers and significant heterogeneity, especially regarding the dosing of TXA. The SHO interjects – “So the evidence isn’t clear cut.

Head Injuries 145

Head Injuries Seizures Outcomes Pediatrics 145

Taming the SRU

OCTOBER 1, 2023

This topic is additionally complicated by the development of multiple diagnostic tools now available for diagnosis as well as variable sizing algorithms used around the world. doi:10.1148/radiology.144.4.7111716 Institutional resources and specialty services may further dictate the management of PTX. AJR Am J Roentgenol.

Fractures 95

Fractures COPD Hospitals Radiology 95

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