The Skeptics' Guide to EM

FEBRUARY 3, 2024

Case: You’re working the morning shift in the emergency department (ED) when you encounter a 3-year-old boy and his family. Authors’ Conclusions: “Imaging with CTA yielded radiological abnormalities in a few instances. She is also the director of the Pediatric Otolaryngology Fellowship at Children’s National Hospital.

Pediatrics 63

Pediatrics Radiology Radiology Head Injuries 63

Emergency Medicine Journal

JULY 24, 2023

Clinical Introduction An 80-year-old man with a medical history of hypertension, dyslipidaemia, coronary artery disease, alcohol consumption and atrial fibrillation, not anticoagulated, presented to the emergency department with sudden onset of pleuritic chest pain, dyspnoea and fever. A CXR was performed ( figure 1 ).

Radiology 40

Radiology Radiology Emergency Department 40

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

The Skeptics' Guide to EM

MARCH 25, 2023

Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Trauma Surg Acute Care Open 2022 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. Date: March 22, 2023 Reference: Hilsden et al.

Ultrasounds 52

Ultrasounds Emergency Department Dislocations Radiology 52

EM SIM Cases

MAY 9, 2023

EHS arrived, provided oxygen supplementation, and brought them to your tertiary emergency department, with access to PICU. Radiologic, Neurologic and Cardiopulmonary Aspects of Submersion Injury. Pediatric Emergency Care,32 (9), 623-626. Pediatric Drowning Download Hon, K. , Cheung, H. & & Cheung, K.

Pediatrics 52

Pediatrics CPR Radiology Radiology 52

PEMBlog

SEPTEMBER 20, 2023

Constipation is a clinical diagnosis and does not require testing, yet as many as 70% of children who are given a diagnosis of constipation in the emergency department have an abdominal x-ray completed. The diagnosis of constipation should be made based on a good history and clinical exam.

Pediatrics 123

Pediatrics Emergency Department Hospitals Ultrasounds 123

ACEP Now

MAY 9, 2024

It has been well over a year since the controversial publication of the Agency for Healthcare Research and Quality (AHRQ) report on diagnostic errors in the emergency department (ED). Active extravasation of blood into the hematoma was identified, and the patient was referred to interventional radiology. Ann Emerg Med.

Research 52

Research Emergency Department Infectious Diseases Hospitals 52

Taming the SRU

APRIL 14, 2024

This revealed that ultrasound can improve the ability to reduce an incarcerated inguinal hernia and may decrease the rate of emergency surgery. (1) 1) Table 1 - Study Protocol Table 2 - Results Conclusion Hernias are often encountered in the emergency department as an acute or non-acute finding. Strange, Chad D, et al.

Ultrasounds 82

Ultrasounds Emergency Department Pediatrics Wellness 82

EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. Internal hernia after laparoscopic Roux-en-Y gastric bypass: a correlation between radiological and operative findings. J Gastrointest Surg.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Emergency Medicine Journal

APRIL 22, 2024

Emergency departments (EDs) are required to have safe systems in place to manage radiology reports. All CXRs are reviewed for acute findings and actioned during the ED visit by the attending emergency medicine clinicians. Radiology reports typically only become available after the patient has been discharged.

Radiology 52

Radiology Radiology Emergency Department Outcomes 52

Taming the SRU

OCTOBER 23, 2023

THE CASE A female in her early 20s, G4P2012, presents to the emergency department (ED) with a 5 day history of left lower quadrant abdominal pain which has been worsening since onset. She states her pain is similar to pain that she felt during a prior ectopic pregnancy. Epub 2019 Mar 21. PMID: 30948256. J Ultrasound Med. 14607 14.

Ultrasounds 87

Ultrasounds Operations Radiology Radiology 87

The Skeptics' Guide to EM

DECEMBER 28, 2019

This is an SGEM Xtra and is a result of a paper that was published in three journals ( Annals of EM , Journal of Urology and Journal of the American College of Radiology ). There was a trial published in 2014 comparing radiology department ultrasound, POCUS and CT for suspected nephrolithiasis (Smith-Bindman et al. NEJM 2014 ).

Radiology 40

Radiology Radiology Ultrasounds Emergency Department 40

Mind The Bleep

NOVEMBER 6, 2023

The “teardrop sign” is a radiological sign of inferior orbital wall fractures in which intraorbital fat +/- inferior rectus muscle herniates through the fracture. 46(7); 605-606 Gardiner (2022) Overview of eye injuries in the emergency department. Curr Eye Res. British Journal of Oral and Maxillofacial Surgery. UpToDate. <

Fractures 52

Fractures Radiology Radiology Emergency Department 52

ALiEM

MAY 13, 2024

Case Introduction: Child with abdominal pain Wendy is a 7-year-old girl who comes into the emergency department with redness, swelling, and pain on her left calf. Ann Emerg Med 2020 [5] 2,656 Systematic review of adult and pediatric studies 94.6% (89.4-97.4%) Pediatr Emerg Care. J Emerg Med. 97.4%) 85.4% (78.9-90.2%)

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

EMDocs

MARCH 25, 2024

2, 3 Biliary POCUS can help decrease patient length of stay in the Emergency Department. 1 A biliary point-of-care ultrasound (POCUS) is the fastest and most accurate way to assess for biliary pathology, but it can be difficult to locate the gallbladder, as it is not a fixed organ. 4 Benefits of Biliary POCUS?

Ultrasounds 85

Ultrasounds Radiology Radiology Operations 85

EMDocs

NOVEMBER 4, 2023

aureus infections among patients in the emergency department. Skin and Soft Tissue Infections in the Emergency Department. Emerg Med Clin North Am. Radiology Key. Managing a Cutaneous Abscess in the Emergency Department. Ann Emerg Med. Methicillin-resistant S. N Engl J Med. Testicular.

EMS 67

EMS Ultrasounds Emergency Department Infectious Diseases 67

SheMD

APRIL 24, 2023

I break bad news almost every shift in the emergency department. An email with a sad face to a woman jacked up hormones was not the best approach. I put on my scrubs (I was on the schedule… again) and drove myself to the Emergency Department (ED). I waited in radiology for my formal ultrasound. It was certain.

Ultrasounds 83

Ultrasounds Radiology Radiology Emergency Department 83

Cook County EM Blog

MARCH 28, 2023

When a lens dislocation is identified in the emergency department, ophthalmology should be consulted emergently. Ectopia Lentis: Radiology Reference Article.” Other complications of untreated lens dislocation include uveitis, glaucoma, cataracts, and permanent vision loss. What is the management of lens dislocation?

Dislocations 52

Dislocations Ultrasounds Fractures Radiology 52

The Skeptics' Guide to EM

JULY 18, 2020

Background: Depending on the time of year, fever and cough can be one of the most common presentations seen in the emergency department. However, being an evidence-based medicine enthusiast, you wonder what aspects of the patient’s presentation are going to be truly helpful in making a diagnosis.

Radiology 52

Radiology Radiology Emergency Department Outcomes 52

RebelEM

AUGUST 30, 2023

Diagnostic Radiology: Musculoskeletal and Breast Imaging. Evaluation and Treatment of Acute Back Pain in the Emergency Department. Orthopedic Emergencies 2015 May; 33(2) 311-26. J Spinal Disord Tech. 2015 Jul;28(6):E316-27 PMID: 26079841 Chowdhury V, Gupta A, Khandelwal N. PMID: 25892724 Gouliouris T, et al.

Infectious Diseases 73

Infectious Diseases Fractures Radiology Radiology 73

ALiEM

AUGUST 9, 2023

Child with Cough and Fever: Case Introduction A 6-year-old boy presents to the emergency department complaining of cough for 3 days and fever for the last day. His work of breathing increased during his emergency department visit, and he was started on high flow nasal cannula at 30 L/min with improvement in his respiratory status.

Ultrasounds 98

Ultrasounds Pediatrics Emergency Department Operations 98

Don't Forget the Bubbles

MAY 22, 2023

You’ve just started working in the Children’s Emergency Department (CED). Robin’s emergency care plan/RESPECT form and ventilator settings should be reviewed and updated while he is in hospital too. The triage nurse comes to let you know about Robin.

Radiology 98

Radiology Radiology Hospitals Wellness 98

EMDocs

DECEMBER 4, 2023

Johnson, MD ( Community EM, Salina Regional Health Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra, MD (Cleveland Clinic Foundation, EM-CCM); Brit Long, MD (@long_brit) Case A 40-year-old woman presents to a rural emergency department (ED) with left leg pain and swelling for the past 5 days.

Ultrasounds 69

Ultrasounds Wellness Documentation/Coding EMS 69

EMDocs

MAY 11, 2024

Brainstem stroke: anatomy, clinical and radiological findings. Available from: [link] American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Use of Intravenous tPA for Ischemic Stroke:; Brown MD, Burton JH, Nazarian DJ, Promes SB. Ann Emerg Med. Erratum in: Ann Emerg Med.

Stroke 79

Stroke EMS EKG/ECG Radiology 79

ALiEM

APRIL 12, 2023

emDOCs.net – Emergency Medicine Education. Author information Ivan Ivanov, DO Resident Physician Emergency Department South Brooklyn Health | The post Trick of the Trade: Gel-free ultrasound-guided peripheral IV technique appeared first on ALiEM. US Probe: Ultrasound Water Bath for Distal Extremity Evaluation.

Ultrasounds 103

Ultrasounds Emergency Department Resuscitation Wellness 103

Taming the SRU

OCTOBER 1, 2023

This post aims to broadly cover the types of PTX, the diagnostic modalities available, and the ideal management by PTX type in the Emergency Department. doi:10.1148/radiology.144.4.7111716 Chest ultrasonography versus supine chest radiography for diagnosis of pneumothorax in trauma patients in the emergency department.

Fractures 85

Fractures COPD Hospitals Emergency Department 85

ACEP Now

MAY 4, 2023

A 58-year-old male with a history of alcohol abuse presented to the emergency department (ED) as a category 2 trauma for a fall with a reported flail chest. Dr. Jones is professor of emergency medicine at Case Western Reserve University School of Medicine in Cleveland, Ohio. Click to enlarge.)

EMS 52

EMS Fractures Operations Ultrasounds 52

The Skeptics' Guide to EM

NOVEMBER 9, 2019

Case: A 6-year-old boy comes into your emergency department at around midnight with his parents complaining of abdominal pain. 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.

Ultrasounds 52

Ultrasounds Fractures Pediatrics Radiology 52

Taming the SRU

JULY 24, 2023

THE CASE A male in his 60s presented to the emergency department for right upper quadrant abdominal pain. The following day, Interventional Radiology placed a percutaneous cholecystostomy tube. coli) empyema due to complicated pneumonia, and a prior perisplenic abscess requiring percutaneous drainage.

Ultrasounds 68

Ultrasounds Sepsis Radiology Radiology 68

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 79

CPR Burns Airway Management Wellness 79

ALiEM

MARCH 7, 2024

Renal cysts can be confused for hydronephrosis, and both warrant further imaging by Radiology. Facts and Literature Review Bladder volume estimation Measuring bladder volume via POCUS in pediatric patients has been studied, demonstrating a benefit on Emergency Department workflow and length of stay (Table 1). Dessie et al.,

Ultrasounds 70

Ultrasounds Pediatrics Emergency Department Radiology 70

Taming the SRU

APRIL 5, 2023

THE CASE An elderly female patient presents to the emergency department (ED) with 1 week of generalized weakness leading to numerous falls. Horseshoe Kidney: Radiology Reference Article. She denies any fevers, abdominal pain, nausea, or vomiting. She denies any current dysuria or hematuria. Indian J Radiol Imaging.

Ultrasounds 52

Ultrasounds Pediatrics Radiology Radiology 52

Northwestern EM Blog

DECEMBER 20, 2021

Written by: Tommy Ng, MD (NUEM ‘24) Edited by: Patricia Bigach, MD (NUEM ‘22) Expert review by : Terese Whipple, MD '20 So your kid won’t walk One of the most common complaints in a pediatric Emergency Department is a child refusing or inability to ambulate.

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

Taming the SRU

MAY 22, 2023

Most frequent reasons for emergency department visits, 2018. Musculoskeletal health literacy in patients with foot and ankle injuries: A cross-sectional survey of comprehension. Foot & Ankle Specialist. 9(1):31-36. doi: 10.1177/1938640015593078 Weiss AJ, Jiang J. Agency for Healthcare Research and Quality. Statistical brief #286.

Fractures 69

Fractures Dislocations Operations Radiology 69

ACEP Now

MARCH 14, 2024

A 24-year-old male with history of quadriplegia and traumatic brain injury presents to the emergency department with hemorrhage in his oral cavity and blood from his tracheostomy tube. 15,19 Endovascular intervention depends upon the patient’s hemodynamic stability and availability of interventional radiology.

Operations 52

Operations Pediatrics Airway Management Radiology 52

Don't Forget the Bubbles

SEPTEMBER 20, 2023

Do not obtain abdominal radiographs for suspected constipation The parents of 4-year-old Matthew bring him into the Emergency Department with abdominal pain. Functional constipation and nonspecific, generalized abdominal pain are common presenting complaints for children in emergency departments. of cases.

Pediatrics 133

Pediatrics Emergency Department Radiology Radiology 133

ACEP Now

JULY 7, 2023

Case A 50-year-old woman presents to the emergency department (ED) complaining of epigastric pain and nausea for 36 hours. Will this be enough for the general surgeon, or will they want an US performed by the radiology department to make their surgical decision? Click to enlarge. Reference: Hilsden, et al.

Ultrasounds 52

Ultrasounds Radiology Radiology Emergency Department 52