PV Card: Focused 1st Trimester Pregnancy Transabdominal Ultrasound

Although history, physical, and lab tests are obtained for patients with first trimester vaginal bleeding and abdominal pain, none compare to the utility of bedside ultrasonography. Today’s PV card reviews the transabdominal approach to the focused pregnancy ultrasound and was written by Drs. Matt Lipton, Mike Mallon, and Mike Stone.

PV Card: Focused 1st Trimester Pregnancy Transabdominal Ultrasound

Adapted from [1, 2]

References

Tayal V, Cohen H, Norton H. Outcome of patients with an indeterminate emergency department first-trimester pelvic ultrasound to rule out ectopic pregnancy. Acad Emerg Med. 2004;11(9):912-917. [PubMed]
Wang R, Reynolds T, West H, et al. Use of a β-hCG discriminatory zone with bedside pelvic ultrasonography. Ann Emerg Med. 2011;58(1):12-20. [PubMed]

By Scott Kobner|2021-10-05T13:01:43-07:00Feb 25, 2015|ALiEM Cards, Ob/Gyn, Ultrasound|

Ultrasound For The Win: 46F with Right Abdominal and Flank Pain #US4TW

Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this peer-reviewed case series, we focus on a real clinical case where bedside ultrasound changed the management or aided in the diagnosis. In this case, a 46-year-old woman presents with acute right-sided abdominal and flank pain.

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By Jeffrey Shih, MD, RDMS|2021-03-10T10:02:08-08:00Feb 24, 2015|Expert Peer Reviewed (Clinical), Genitourinary, Ultrasound, Ultrasound for the Win|

Trick of the Trade: Needle-vein alignment in ultrasound guided peripheral IV

Placing a peripheral IV under ultrasound guidance is often much more challenging than it outwardly appears, especially for novice users. One of the more difficult aspects is in making sure that the target vessel is perfectly in the middle of the screen and then guessing where that corresponds to the middle of the ultrasound probe.

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By Jeff Wiswell, MD|2016-10-26T17:04:32-07:00Feb 23, 2015|Tricks of the Trade, Ultrasound|

Malignancy-Associated Hypercalcemia: Which Bisphosphonate is Best?

Malignancy-associated hypercalcemia (MAH) is the most common metabolic derangement encountered in the oncologic population in the ED. It can occur in up to 30% of cancer patients at some point during the disease.^1–3 Clinical manifestations include mental status changes (which may progress to coma) and renal impairment.³ These patients may be classified based on both type and severity. Therapies for managing MAH emergently should focus on correcting the underlying mechanism, as outlined below with their respective causes:³

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By Meghan Groth, PharmD, BCPS|2016-12-19T12:59:11-08:00Feb 19, 2015|Endocrine-Metabolic, Expert Peer Reviewed (Clinical), Tox & Medications|

Sulfamethoxazole-Trimethoprim for Skin and Soft Tissue Infections: 1 or 2 Tablets BID?

The 2014 Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections (SSTI) recommend sulfamethoxazole-trimethoprim (SMX-TMP) for purulent infections where methicillin-resistant S. aureus (MRSA) is a likely pathogen. ¹ But, what dose of SMX-TMP should we be prescribing? Both the SSTI and MRSA guidelines say 1-2 double strength tablets twice a day. ^1,2 So, which is it, 1 tablet or 2?

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By Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP|2016-11-11T19:36:10-08:00Feb 16, 2015|Infectious Disease, Tox & Medications|

Ultrasound For The Win: 22M with Scrotal Pain #US4TW

Welcome to another ultrasound-based case, part of the “Ultrasound For The Win” (#US4TW) Case Series. In this peer-reviewed case series, we focus on real clinical cases where bedside ultrasound changed management or aided in diagnoses. In this case, a 22-year-old man presents with acute scrotal pain.
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By Jeffrey Shih, MD, RDMS|2017-07-19T00:08:38-07:00Feb 12, 2015|Expert Peer Reviewed (Clinical), Genitourinary, Ultrasound, Ultrasound for the Win|

PV Card: Focused Echocardiography Ultrasound

So many great information can be gleaned from a focused echocardiogram in Emergency Department patients. What views are you obtaining? What is the importance of the e-point septal separation (EPSS) and how to measure this? Drs. Jimmy Fair, Mike Mallon, and Mike Stone provide a terrific step-by-step image-based guide to these questions that you can use at the bedside as a refresher.

PV Card: Focused Echocardiography Ultrasound

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Adapted from [1, 2]

References

Randazzo M, Snoey E, Levitt M, Binder K. Accuracy of emergency physician assessment of left ventricular ejection fraction and central venous pressure using echocardiography. Acad Emerg Med. 2003;10(9):973-977. [PubMed]
Nagdev A, Stone M. Point-of-care ultrasound evaluation of pericardial effusions: does this patient have cardiac tamponade? Resuscitation. 2011;82(6):671-673. [PubMed]

By Scott Kobner|2021-10-05T13:03:32-07:00Feb 11, 2015|ALiEM Cards, Cardiovascular, Ultrasound|