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 73

Ultrasounds Infectious Diseases COPD Shock 73

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 73

Ultrasounds Leadership Hyperthermia / Hypothermia Poisoning 73

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

A bedside cardiac ultrasound was normal, with no effusion. He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. Assessment was severe sudden cardiogenic shock. He remained hypotensive and in shock. He was intubated and then went pulseless.

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Shock EKG/ECG Outcomes Hospitals 52

Dr. Smith's ECG Blog

MARCH 26, 2024

A 30-something woman with chest pain and h/o pulmonary hypertension due to chronic pulmonary emboli A 30-something with 8 hours of chest pain and an elevated troponin Syncope, Shock, AV block, Large RV, "Anterior" ST Elevation. Cardiac Ultrasound may be a surprisingly easy way to help make the diagnosis Answer: pulmonary embolism.

EKG/ECG 65

EKG/ECG Shock Ultrasounds Wellness 65

EB Medicine

NOVEMBER 17, 2020

Write us at emplify@ebmedicine.net.

Emergency Department 40

Emergency Department Shock Resuscitation CPR 40

Dr. Smith's ECG Blog

DECEMBER 15, 2015

No shock was ever delivered. He was in profound shock. A bedside cardiac ultrasound was recorded: Here is a still image of the echo: The red arrows outline the right ventricle and the yellow arrows outline the left ventricle chamber. There is no pericardial fluid to account for shock. Sixth: Severe shock (e.g.,

Shock 52

Shock Ultrasounds EKG/ECG Wellness 52

ACEP Now

MAY 9, 2024

6 The increasing mortality rate led to an additional emergency regulation in 2022 requiring the consenting physician to perform the critical steps of the case, limiting surgeons to three cases per day, and mandating continuous, recorded ultrasound guidance for gluteal AFT procedures. References Garcia SE. Butt Lifts Are Booming.

Emergency Department 52

Emergency Department Operations Ultrasounds Hospitals 52

EMDocs

APRIL 22, 2024

Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. Multiorgan POCUS The diagnostic power of POCUS often resides in combining multiple ultrasound exams. 1-3 As many as 25% of acute PE cases present as sudden cardiac death.

Ultrasounds 79

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Shock 79

RebelEM

FEBRUARY 7, 2024

Triple antibiotic coverage is recommended. Suggested regimens include: Ampicillin AND Gentamicin AND Clindamycin OR Metronidazole Update tetanus vaccination Usually requires dilation and curettage to remove any retained products of conception or foreign bodies.

Sepsis 75

Sepsis Shock Hospitals Ultrasounds 75

Ultrasound Gel

AUGUST 20, 2018

It's a reliably easy to recall hypotensive protocol that uses ultrasound to help determine the etiology of a patient's shock. Well here's a new idea - trauma patient's can be in shock too, right? It's a reliably easy to recall hypotensive protocol that uses ultrasound to help determine the etiology of a patient's shock.

Shock 52

Shock Ultrasounds Wellness 52

Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

Shocked x 2 without effect. Pads were placed with ultrasound guidance, so they were in the correct position. Warning: if this is VT, a calcium channel blocker can result in shock and death. We are told that " the Patient was Shocked X2 Without Effect." However, this is not SVT. What to do now? K returned 3.6

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EKG/ECG Shock Documentation/Coding Academics 127

Taming the SRU

FEBRUARY 19, 2024

A recent observational study was performed to pragmatically assess clinically meaningful differences in BP in a diverse critically ill cohort with shock. In general, radial artery readings in patients with shock likely underestimate central pressure which can lead to increasing vasopressor dosing. Cite As: Snyder, B. Broadstock, A.

Shock 59

Shock Resuscitation Ultrasounds Research 59

RebelEM

APRIL 29, 2024

The current standard of practice has moved away from landmark-based central line placement given the efficacy and safety of ultrasound-based techniques. Studies have compared IO to peripheral intravenous (PIV) and central venous (CVC) access for resuscitation. This study also showed the median time for IO placement was only 1.2

Resuscitation 102

Resuscitation Administration Emergency Department Hospitals 102

Dr. Smith's ECG Blog

APRIL 2, 2024

He was unidentified and there were no records available After 7 shocks, he was successfully defibrillated and brought to the ED. Bedside ED ultrasound showed exceedingly poor global LV function, and no B lines. Patient received 11 shocks by ICD and was in V-fib when EMS arrived. Here is the initial ED ECG. What do you think?

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EKG/ECG Shock CPR Stroke 118

PulmCCM

NOVEMBER 11, 2023

Diagnosis because P ra is non-invasively transduced with ultrasound, for instance via the size and collapsibility of the inferior vena cava [1] and/or the Venous Excess Ultrasound Score [VExUS] [2-4]. If changes in P ra cause changes in CO, shouldn’t we then know the etiology of shock with certainty?

Ultrasounds 87

Ultrasounds Operations Shock 87

Ultrasound Gel

SEPTEMBER 17, 2018

The authors here took on an important question - does point of care ultrasound make a difference in mortality when applied to patients in shock? The authors here took on an important question - does point of care ultrasound make a difference in mortality when applied to patients in shock?

Shock 52

Shock Ultrasounds Wellness 52

Taming the SRU

MAY 5, 2023

doi:10.1056/NEJMoa2212663 BACKGROUND Sepsis, including severe sepsis and septic shock, is a frequently encountered condition in the emergency department and carries a high mortality rate. Each subsequent one-hour delay in antimicrobial administration increases mortality by 35% in patients with septic shock (Im, Kang et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

ACEP Now

MAY 4, 2023

Diagnosis: Complex Hydrocele (Pyocele) The testicular ultrasound revealed a small left complex hydrocele suspicious for pyocele. J Emerg Trauma Shock. There were no rashes, discharge, or palpable inguinal hernias. The testicle did not appear to be malpositioned. Left testicle trans upper-lower scan image. Click to enlarge.)

Urgent Care 52

Urgent Care Ultrasounds Sepsis Emergency Department 52

Life in the Fast Lane

JULY 12, 2023

Fahad Yousif POCUS Made Easy: Basic Echo Focussed ECHO in Life support (FELS) is used to define cardiac pathologies such as cardiogenic shock, pericardial tamponade, signs of submassive/massive PE or hypovolaemia

Shock 52

Shock Ultrasounds 52

Northwestern EM Blog

FEBRUARY 14, 2022

The ATHOS-3 trial in 2017 explored the efficacy of angiotensin II as a vasopressor for severe vasodilatory shock. Severe shock is defined as persistent hypotension requiring vasopressors to maintain a mean arterial pressure of 65mmHg and serum lactate <2 despite adequate volume resuscitation. were more likely to respond.

Shock 52

Shock Resuscitation Outcomes Fluid Resuscitation 52

EMDocs

NOVEMBER 4, 2023

An ultrasound of the testes reveals the following: What is the diagnosis? J Emerg Trauma Shock. He reports approximately one month of dysuria, and around two weeks ago noticed a dull aching sensation in his testicles that has progressively gotten worse. Insights Imaging. 2016;7(5):689-711. Scrotal pyocele: Uncommon urologic emergency.

EMS 67

EMS Ultrasounds Emergency Department Infectious Diseases 67

PHEM Cast

APRIL 16, 2018

Ultrasound during TCA: Cureton et al. The heart of the matter: utility of ultrasound of cardiac activity during traumatic arrest. The outcomes from different resuscitative interventions in a haemorrhagic shock model in porcine model: From: Watts et al. Use of CPR in hemorrhagic shock, a dog model. 2012; 73: 102-10.

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Resuscitation Shock Ultrasounds CPR 52

AED Leader

OCTOBER 25, 2023

AEDs are designed to safely deliver the required life-saving shocks to restore a normal heart rhythm during this type of cardiac emergency. An ultrasound of the heart is performed to inspect blood flow within the heart and assess overall heart function. Causes of CPVT CPVT is the result of a gene defect. Implantable Loop Recorder.

EKG/ECG 52

EKG/ECG Shock Ultrasounds Research 52

AED Leader

OCTOBER 25, 2023

AEDs are designed to safely deliver the required life-saving shocks to restore a normal heart rhythm during this type of cardiac emergency. An ultrasound of the heart is performed to inspect blood flow within the heart and assess overall heart function. Causes of CPVT CPVT is the result of a gene defect. Implantable Loop Recorder.

EKG/ECG 52

EKG/ECG Shock Ultrasounds Research 52

PEMBlog

OCTOBER 26, 2023

Other complications include obstruction due to intussusception or volvulus, leading to bowel ischemia and shock. Ultrasound and CT may not differentiate it from normal bowel. The most common presentation in children under 5 years of age is rectal bleeding, which may be intermittent or massive. The bleeding is usually painless.

Radiology 64

Radiology Radiology Administration Shock 64

Mind The Bleep

AUGUST 5, 2023

Example of pneumoperitoneum following perforated NEC Other Investigations Blood tests and abdominal ultrasound. Abdominal ultrasound may show bowel wall thickening, altered vascular state and free fluid. Bloods may show anaemia, thrombocytopenia, leukocytosis/leukopenia, hyponatraemia, raised CRP, metabolic acidosis.

Sepsis 52

Sepsis Ultrasounds Radiology Radiology 52

EMDocs

JANUARY 16, 2024

VF/asystole), a pulse cannot be identified via Doppler ultrasound for a full minute, or if lack of organized cardiac activity is confirmed on bedside echocardiogram. This is a good time to utilize an arterial line or use the ultrasound to find a central pulse. doi.org/10.1016/j.resuscitation.2018.11.004

Hyperthermia / Hypothermia 83

Hyperthermia / Hypothermia Resuscitation CPR EMS 83

Critical Care Now

JUNE 21, 2022

His main areas of interest are Critical Care, Ultrasound, Prehospital Resuscitation, and Medical Education. Paramedics continued chest compressions, gave epinephrine via an intraosseous route, and delivered one shock. Reading Time: 3 minutes Mohamed Hagahmed, MD, EMT-P Mohamed is an Emergency Medicine Physician and EMS director.

Seizures 52

Seizures EKG/ECG CPR Shock 52

Emergency Medicine Cases

MARCH 10, 2020

Dr. Allan Shefrin tells his Best Case Ever of a child who presents in shock and discusses the causes of tension hydrothorax, indications for tube thoracostomy for hydrothorax and integration of POCUS into pediatric resuscitation. The post BCE 81 Tension Hydrothorax appeared first on Emergency Medicine Cases.

Shock 52

Shock Pediatrics Resuscitation Ultrasounds 52

EM Guide Wire

JULY 30, 2019

Orbital cellulitis IV abx, CT scan Unvaccinated children H. Orbital cellulitis IV abx, CT scan Unvaccinated children H.

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Shock Resuscitation Ultrasounds 40

Dr. Smith's ECG Blog

DECEMBER 18, 2022

It was notable for a normal cardiac ultrasound with no pericardial fluid, normal LV and RV function (though the quality was not sufficient to evaluate for wall motion abnormalities) and normal IVC dynamics. Bedside ultrasound is another very important piece. Ultrasound can be very helpful to distinguish causes of hypotension.

Ultrasounds 52

Ultrasounds EKG/ECG EMS Radiology 52

EM Curious

SEPTEMBER 2, 2015

CORE CATEGORIES Airway Preparation EM in 5 Ultrasound Case 56 year old male presents with right sided hemiparesis and expressive aphasia. Ultrasound of the Week Procedure Pearl Ear foreign body removal with modified suction setup.

Ultrasounds 52

Ultrasounds EMS Shock Hospitals 52

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

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Literature 1. Widespread ST-depression with reciprocal aVR ST-elevation can be cause by: Heart rate related: tachyarrhythmia (e.g., Widespread ST-depression with reciprocal aVR ST-elevation can be cause by: Heart rate related: tachyarrhythmia (e.g.,

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52

Greater Sydney Area HEMS

FEBRUARY 20, 2024

Obtaining access in shocked trauma patients can be notoriously difficult due to circulatory collapse. Those who are shocked, shut down with limited or no other options for peripheral access require central access. The evidence for improved safety and quality with the use of ultrasound for CVC implementation is well established [i].

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Ultrasounds Shock Research Operations 98

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

She arrives in the emergency department (ED) with decreased level of consciousness and shock. Her point-of-care ultrasound (POCUS) shows appropriate-appearing global ejection fraction and no marked wall motion abnormalities.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

EMDocs

JANUARY 11, 2024

Individualize the choice of using inotropes, vasopressors, or fluids to treat post-CA hypotension and to target the likely cause(s) contributing to the shock and hemodynamic state (100%, 23/23). In patients with enteral intolerance or shock, start with trophic EN (rates of 10–20 mL/h) and adjust according to tolerance (91%, 19/21).

Seizures 73

Seizures Shock Infectious Diseases CPR 73