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PV Card: Focused Echocardiography Ultrasound

Ultrasound cardiac focus echocardiography

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


Adapted from [1, 2]

References

  1. 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]
  2. 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 |2021-10-05T13:03:32-07:00Feb 11, 2015|ALiEM Cards, Cardiovascular, Ultrasound|
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Trick of the Trade: L5 medial hamstring reflex

Reflex HammerTraditionally in medical school, it is taught that lower extremity deep tendon reflexes for L4 and S1 nerve root levels can be elicited by tapping on the patella and Achilles tendons. It was just taught that L5 didn’t have a reflex to check. Knowing if an L5 radiculopathy existed would be especially helpful when assessing a patient for a potential lumbar disc herniation where a careful lower extremity neurologic exam is important. It turns out one can actually check for a L5 reflex.

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By |2019-01-28T21:44:46-08:00Feb 9, 2015|Neurology, Tricks of the Trade|
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Sepsis in Older Adults: The Presentation May Be Subtle

sepsis260% of patients in the United States who develop severe sepsis are older adults (age 65 and over) [1], and the mortality of severe sepsis increases steadily with age to nearly 40% in those over 85 [2]. There are many factors that make older adults more susceptible to sepsis, and that can also make sepsis more difficult to detect. Here are some tips to help explain why this is, and how you can identify it sooner.

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By |2017-07-21T09:52:48-07:00Feb 5, 2015|Geriatrics, Infectious Disease|
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PV Card: Focused Lung Ultrasound

focused lung ultrasound A LinesBedside pulmonary ultrasonography is becoming increasingly popular in the Emergency Department. You can you use it to assess for pneumothoraces, pleural effusion, pneumonia, pulmonary edema, and other etiologies. There are subtle nuances to help you differentiate these diagnoses. What are A-lines and B-lines? This PV card on the focused lung ultrasound by Drs. Anne Aspler, Clare Heslop, and Mike Stone outline some great bedside tips.

PV Card: Focused Lung Ultrasound


Adapted from [1–3]

References

  1. Blaivas M, Lyon M, Duggal S. A prospective comparison of supine chest radiography and bedside ultrasound for the diagnosis of traumatic pneumothorax. Acad Emerg Med. 2005;12(9):844-849. [PubMed]
  2. Liteplo A, Marill K, Villen T, et al. Emergency thoracic ultrasound in the differentiation of the etiology of shortness of breath (ETUDES): sonographic B-lines and N-terminal pro-brain-type natriuretic peptide in diagnosing congestive heart failure. Acad Emerg Med. 2009;16(3):201-210. [PubMed]
  3. Volpicelli G. Lung sonography. J Ultrasound Med. 2013;32(1):165-171. [PubMed]
By |2021-10-06T09:48:34-07:00Feb 4, 2015|ALiEM Cards, Pulmonary, Ultrasound|
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PV Card: Pericarditis – Diagnosis and Treatment Recommendations

pericarditis

When the topic of pericarditis is mentioned, the classic electrocardiogram (ECG) findings of diffuse ST elevation and PR depression are often the focus of discussion. What about the criteria for diagnosis, the 3-prong approach to treatment, and contraindications to colchicine? These are the great questions answered by Dr. Chris Bond (@socmobem) in this PV card, which summarize 3 key papers by Imazio et al from the New England Journal of Medicine, Archives of Internal Medicine, and Circulation.

 

PV Card: Pericarditis – Diagnosis and Treatment

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By |2021-10-06T09:52:27-07:00Feb 2, 2015|Cardiovascular|
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PV Card: Focused Ocular Ultrasound

ocular ultrasound vitreous hemorrhage ultrasound

 

Ocular injuries and pathology are a common cause for Emergency Department visits. With bedside ultrasonography, many of these conditions can be assessed. Did you know that you can check for a retinal detachment, vitreous hemorrhage, and even a lens dislocation? What do these look like? Check out this great PV card on the focused ultrasound assessment of the eye.

PV Card: Ocular Ultrasound


Adapted from [1, 2]
Go to ALiEM (PV) Cards for more resources.

References

  1. Blaivas M, Theodoro D, Sierzenski P. A study of bedside ocular ultrasonography in the emergency department. Acad Emerg Med. 2002;9(8):791-799. [PubMed]
  2. Kimberly H, Shah S, Marill K, Noble V. Correlation of optic nerve sheath diameter with direct measurement of intracranial pressure. Acad Emerg Med. 2008;15(2):201-204. [PubMed]
By |2021-10-06T09:57:27-07:00Jan 28, 2015|ALiEM Cards, Ophthalmology, Ultrasound|
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