Taming the SRU

JULY 24, 2023

A bedside right upper quadrant ultrasound was performed, and the images are below. 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). The remainder of his exam was unremarkable.

Ultrasounds 78

Ultrasounds Sepsis Radiology Radiology 78

ALiEM

MARCH 7, 2024

Given her pain with a history of intermittent hematuria and dysuria, you perform a renal and bladder point of care ultrasound (POCUS) examination. Pre-warmed ultrasound gel is helpful when available. Then test your skills on the ALiEMU course page to receive your PEM POCUS badge worth 2 hours of ALiEMU course credit.

Ultrasounds 70

Ultrasounds Pediatrics Radiology Radiology 70

ACEP Now

SEPTEMBER 5, 2024

What Is the Sensitivity of Ultrasound for Detecting Volvulus in Infants When Compared to An Upper GI Study? But what about ultrasound? In cases where the clinical suspicion is lower for a midgut volvulus, but you feel it still needs to be explored, can ultrasound help? Not all studies included all of these ultrasound signs.

Ultrasounds 40

Ultrasounds Wellness Pediatrics Poisoning 40

RebelEM

JANUARY 25, 2024

Background: Point-of-care ultrasound (PoCUS) is a valuable clinical tool in the assessment of acute dyspnea. Impact of serial cardiopulmonary point-of-care ultrasound exams in patients with acute dyspnoea: a randomized, controlled trial. PoCUS evaluations included lung ultrasound (LUS) and focused cardiac ultrasound (FoCUS).

Ultrasounds 129

Ultrasounds Outcomes COPD Hospitals 129

Mount Sinai EM

NOVEMBER 14, 2022

As Emergency medicine doctors, we rely on ultrasound for so many procedures (central venous access, pericardiocentesis, paracentesis, etc.), Tl;Dr < 5 minutes Ultrasound guided LP increases the rate of success while decreasing procedure time, passes with needle, and pain score Use Ultrasound to only identify anatomy.

Ultrasounds 130

Ultrasounds Wellness 130

Ultrasound Gel

MARCH 15, 2021

Acute chest syndrome is such a great application for lung ultrasound, especially in pediatrics where we do everything we can to dodge the harmful affects of ionizing radiation. This is a recent well-done study that takes another look to see how ultrasound compares to the commonly employed chest radiography.

Ultrasounds 52

Ultrasounds Pediatrics Wellness 52

Ultrasound Gel

MARCH 4, 2019

Many ultrasound enthusiasts have been using point of care ultrasound to assist in the diagnosis of acute decompensated heart failure, but it has not been widely adopted. It has been shown by many studies that ultrasound can visualize pulmonary edema easily so that treatment can be started quickly.

Ultrasounds 52

Ultrasounds Wellness 52

Life in the Fast Lane

SEPTEMBER 11, 2024

one of the most difficult and risky emergency procedures, but one you already have the ultrasound and line skills to perform well. James Miers and John Mackenzie Procedure: Pericardiocentesis Emergency Procedure: Pericardiocentesis.

Ultrasounds 101

Ultrasounds Wellness 101

ACEP Now

FEBRUARY 11, 2024

The ultrasound-guided clavipectoral plane block (CPB) is a newly described technique in the emergency medicine literature. Ultrasound Survey Scan FIGURE 1A: Ultrasound probe should be placed at the clavicle with the probe marker facing cephalad (toward the head). FIGURE 1B: Ultrasound image with labeled relevant anatomy.

Ultrasounds 52

Ultrasounds Fractures Emergency Department Hospitals 52

Taming the SRU

OCTOBER 14, 2024

Ocular point-of-care-ultrasound (POCUS) was performed as seen below. Our patient underwent anterior orbitotomy, but there are case reports in the literature of ultrasound-guided drainage (4). In addition, there are studies that discuss missed cases of abscess on CT that were detected with use of ultrasound. Brzycki et al.

Ultrasounds 52

Ultrasounds Urgent Care Emergency Department Documentation/Coding 52

Greater Sydney Area HEMS

FEBRUARY 20, 2024

The evidence for improved safety and quality with the use of ultrasound for CVC implementation is well established [i]. How can this situation be rectified or has the use of ultrasound rendered this blind subclavian “trauma line” a thing of the past? One approach to obtaining BCV origin access (fig.1) 2020;35(3):303-321.

Ultrasounds 98

Ultrasounds Shock Research Operations 98

Pediatric EM Morsels

JULY 26, 2024

These females should have imaging with either MRI or CT as well as abdominal or transvaginal ultrasound to assess for ovarian teratoma. Prevalence decreases with decreasing age. Risk of teratoma is higher in African American and Asian women. Moral of the Morsel It’s NOT always psych!

Psychiatric 269

Psychiatric Seizures Outcomes Pediatrics 269

PulmCCM

FEBRUARY 5, 2024

Ultrasound Is Upvoted The panel weakly suggested bedside ultrasound for patients with fever and an abnormal chest radiograph, but only if an expert is available to interpret the often complex or borderline results. Ultrasound can quickly and more accurately identify significant biliary disease (e.g.,

Best Practices 111

Best Practices Ultrasounds Infectious Diseases Sepsis 111

Pediatric EM Morsels

AUGUST 4, 2023

Oka, 2023) Abdominal ultrasound with doppler can also be used to measure the angle, and with a trained ultra-sonographer was found to be as sensitive as CTA. Positional changes after intake can also be helpful including the lateral decubitus position as well as knee to chest. Typically this includes multiple small meals in a day.

Pediatrics 246

Pediatrics Burns Operations Ultrasounds 246

Taming the SRU

MAY 13, 2024

The patient is a well-appearing male who is awake, alert, and oriented. There is also a well-appearing, healed surgical scar. There is also a well-appearing, healed surgical scar. The skin is warm and well perfused with brisk capillary refill. The Ultrasound Journal, 11(1). Notable diagnostics CBC : WBC 19.2,

Ultrasounds 97

Ultrasounds Emergency Department Wellness Operations 97

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) 1) In a study performed by Chen et al.

Ultrasounds 93

Ultrasounds Emergency Department Pediatrics Radiology 93

Downeast Emergency Medicine

JUNE 7, 2021

Key concepts for Ultrasound Guided IV placement LENGTH Always use long IV (1.88 Use a tourniquet when you LOOK for the vein as well as when you place the IV otherwise the pressure from the probe will compress the veins and you won’t find anything. This lecture was presented at the 2021 Maine Medical Center Winter Symposium.

Ultrasounds 52

Ultrasounds Wellness 52

Don't Forget the Bubbles

JUNE 19, 2023

There were no issues during the pregnancy, and estimated fetal growth by ultrasound was constant. Fetal Growth Restriction (FGR) and dysmaturity are common in neonatology and are a leading cause of morbidity during the neonatal period, as well as later in life. Ultrasound Obstet Gynecol 2016;48:333-9. Francis J et al.

Pediatrics 143

Pediatrics Ultrasounds Hyperthermia / Hypothermia Sepsis 143

Downeast Emergency Medicine

NOVEMBER 5, 2021

RR 19 Physical exam: On exam he is well appearing and in no distress. Bedside chest ultrasound showed large bilateral pleural effusions. His additional vital signs are as follows: BP 99/53, HR 64, T 95.3, He has a normal work of breathing and no current complaints. He has peripheral edema of his bilateral lower extremities.

Ultrasounds 52

Ultrasounds Emergency Department EMS Wellness 52

Taming the SRU

JANUARY 1, 2024

Ultrasound Guided Peripheral IV (USGIV) Access anatomy of arm veins when considering USGIV. unported license [link] Ultrasound allows us to visualize deeper, typically larger veins in the forearm and upper arm. Place ultrasound machine on the opposite side of the bed to minimize neck strain. Check for flash in the IV chamber.

Emergency Department 91

Emergency Department Ultrasounds Administration Burns 91

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. Point-of-care ultrasound in pediatric nephrology. Images are seen below.

Ultrasounds 52

Ultrasounds Pediatrics Radiology Radiology 52

The Skeptics' Guide to EM

APRIL 20, 2024

Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergency department: A randomized controlled trial. It did not perform as well which is not unusual for a clinical decision instrument [5].

Fractures 83

Fractures Ultrasounds Emergency Department CDC 83

Taming the SRU

FEBRUARY 7, 2024

Ultrasound: Make “windows of access”. The Aircare package to increase DASH-1A airways includes placing patient on AirCare monitor, apneic oxygenation, 3 minutes NRB, bagging after paralytic given, starting only when patient > 97%, push dose pressors if needed for hypotension before paralytic, and make sure to use the checklist!

Administration 98

Administration PPE Ultrasounds Poisoning 98

The Trauma Pro

OCTOBER 25, 2024

Authors from several well-known trauma centers collaborated to re-analyze data from the CLOTT study. Here are the factoids: The original data were derived from a 17-center study conducted from 2018-2020; this study only included 1,387 patients who had pelvic fractures (as well as other injuries).

Fractures 113

Fractures Head Injuries Operations Ultrasounds 113

EMDocs

SEPTEMBER 28, 2024

It was ruled out as well with good specificity, with a bubble time < 40 seconds. 2: Ultrasound + Pediatric Appendicitis Risk Calculator = Rule Out? The authors found that combining a low pediatric Appendicitis Risk Calculator (pARC) result with a nondiagnostic ultrasound results in a high negative predictive value for appendicitis.

Ultrasounds 78

Ultrasounds Pediatrics Emergency Department Wellness 78

Taming the SRU

JULY 19, 2023

Fundamentals of ECMO - leadership curriculum - ultrasound GR - macgyver techniques fundamentals of ecmo WITH dr. bonomo ECPR from the ED: The ideal patients: Young patients with refractory VF/VT arrest ≤ 30 min since arrest onset Poisonings with cardiogenic shock Severe hypothermia with arrest Massive PE with arrest Key points: Good CPR/advanced ACLS (..)

Ultrasounds 84

Ultrasounds Leadership Hyperthermia / Hypothermia Poisoning 84

Medagadget

SEPTEMBER 14, 2023

While some melanoma patients respond well to certain immunotherapies, approximately 50% do not, and even amongst those that do, treatment resistance can later emerge. So far, the researchers have tested the patch in a mouse model of melanoma, and treated the tumors using focused ultrasound and a nanoparticle-based immunotherapy.

Research 99

Research Ultrasounds Wellness 99

RebelEM

DECEMBER 10, 2023

Background: The use of ultrasound is well established for trauma patients in the emergency department, with almost every patient receiving a FAST (Focused Assessment with Sonography in Trauma) examination as part of the “ABC’s” of trauma. Not so FAST- Chest ultrasound underdiagnoses traumatic pneumothorax.

Ultrasounds 40

Ultrasounds Emergency Department Wellness EMS 40

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. What findings make a DVT more likely?

Ultrasounds 71

Ultrasounds Documentation/Coding Wellness EMS 71

Dr. Smith's ECG Blog

SEPTEMBER 23, 2024

Answer : Bedside ultrasound! Smith : RV infarct may also have this appearance on ultrasound. So hypoxia without B lines on lung ultrasound strongly weights toward PE. _ Here are some representative stills with red arrows pointing to the emboli. Instead, IR performed pulmonary thrombectomy and the patient did well.

EKG/ECG 118

EKG/ECG Ultrasounds Shock EMS 118

Taming the SRU

FEBRUARY 5, 2024

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). As may be seen in the table below, there are several themes as well a range of stringency. This resource offers additional information on ultrasound assisted LP’s. WHO - Who Needs an LP in the ED?

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97

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. ” This means they probably did not. If not, then we still don’t know the answer.

Pediatrics 113

Pediatrics Outcomes Operations Emergency Department 113

Dr. Smith's ECG Blog

APRIL 14, 2024

A bedside cardiac ultrasound performed by a true EM expert (Robert Reardon, who wrote the cardiac ultrasound chapter in Ma and Mateer) showed an inferior wall motion abnormality. But there are also new Q-waves, stronly suggesting new infarction. Overall interpretation: this does not look like OMI to me.

EKG/ECG 116

EKG/ECG Ultrasounds EMS Wellness 116

ACEP Now

AUGUST 12, 2024

Well, it happens that my interest in birding seemed to parallel a simultaneous growth in the practice of mindfulness in medicine. Dr. Prats is an associate professor of emergency medicine at the Ohio State University Wexner Medical Center and runs the Ultrasound GEL podcast that reviews articles in point-of-care ultrasound.

Ultrasounds 115

Ultrasounds Emergency Department Wellness 115

Don't Forget the Bubbles

AUGUST 9, 2023

His thyroid ultrasound is normal, and thyroid antibodies are negative. Six months later, his weight and height remain normal, he still does not have a goitre and his thyroid ultrasound is unchanged. She has a normal thyroid ultrasound and negative anti-microsomal and anti-thyroglobulin antibodies. She also has a goitre.

Ultrasounds 98

Ultrasounds Pediatrics Wellness 98

ALiEM

OCTOBER 23, 2023

There was a well-healed scar on the bottom eyelid. On ultrasound, it appears as a heterogeneous isoechoic collection that abuts the right globe. The hyperdense foreign body is again seen on CT, as well as a small focus of air within the anterior chamber. The lateral canthus appeared inferiorly displaced.

Academics 111

Academics Emergency Department Ultrasounds Wellness 111

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

Bedside cardiac ultrasound with no obvious wall motion abnormalities. He had a previous ECG on file: Proving the findings are new The cath lab was activated. He was given aspirin and sublingual nitro and the pain resolved. He was started on nitro gtt. BP initially 160s/90s, O2 sats 95% on room air.

EKG/ECG 123

EKG/ECG Ultrasounds Documentation/Coding Wellness 123