Trick of the Trade: Patient positioning for ultrasound-guided ulnar nerve block

Patients with 5th metacarpal fractures (commonly termed “boxer’s fracture”) are frequently treated in the emergency department (ED) with closed reduction and splinting. Obtaining analgesia and a successful closed reduction can often be challenging without procedural sedation. Severe swelling can make a hematoma block difficult, often resulting in inadequate analgesia. An ultrasound-guided ulnar nerve block provides a simple method to facilitate pain relief and allow for improved fracture site manipulation.

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By Kara Toles, MD|2018-10-28T21:25:09-07:00Jan 20, 2016|Tricks of the Trade, Ultrasound|

Ultrasound For the Win! Case – 55-year-old man with chest 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 55-year-old man presents with acute-onset chest pain.

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By Jeffrey Shih, MD, RDMS|2017-07-19T00:06:58-07:00Dec 9, 2015|Cardiovascular, Ultrasound, Ultrasound for the Win|

PV Card: Normal Values for Ultrasound Measurements

As emergency medicine providers become more proficient in using bedside ultrasonography as a diagnostic tool, it can be difficult to remember all of the normal cutoff values. Is it 3 or 5 mm as the cutoff? Thanks to the team at UCSF (Dr. Maria Beylin, Dr. Scott Fischette, and Dr. Nate Teismann) for creating a succinct PV card listing the key numbers to remember. You can download this PV card into your mobile device as a reference guide, or you can even print and attach to each of your ultrasound machines!

PV Card: Normal Values for Ultrasound Measurements

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Adapted from [1–4]

References

Horrow M. Ultrasound of the extrahepatic bile duct: issues of size. Ultrasound Q. 2010;26(2):67-74. [PubMed]
Beigel R, Cercek B, Luo H, Siegel R. Noninvasive evaluation of right atrial pressure. J Am Soc Echocardiogr. 2013;26(9):1033-1042. [PubMed]
Doubilet P, Benson C, Bourne T, et al. Diagnostic criteria for nonviable pregnancy early in the first trimester. N Engl J Med. 2013;369(15):1443-1451. [PubMed]
Adhikari S, Zeger W, Thom C, Fields J. Isolated Deep Venous Thrombosis: Implications for 2-Point Compression Ultrasonography of the Lower Extremity. Ann Emerg Med. 2015;66(3):262-266. [PubMed]

By Michelle Lin, MD|2021-10-04T09:56:16-07:00Oct 15, 2015|ALiEM Cards, Ultrasound|

NEXUS Chest CT Decision Instruments in Blunt Trauma

One of the five 2014 American College of Surgeons’ Choosing Wisely recommendations is to avoid routing whole-body CT imaging of trauma patents, also known as the ‘pan-CT’. Until now, no validated decision instrument existed to help guide clinicians decide whether to obtain a chest CT in the setting of blunt trauma. This month, Dr. Robert Rodriguez and the multi-institutional NEXUS Chest CT research team published a paper describing the derivation and validation of 2 decision instruments in PLOS Medicine [1].

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By Michelle Lin, MD|2019-01-28T21:43:56-08:00Oct 13, 2015|Radiology, Trauma|

Ultrasound For The Win! Case – 76M with Right-Sided Vision Loss #US4TW

Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this case series, we focus on a real clinical case where bedside ultrasound changed the management or aided in the diagnosis. In this case, a 76-year-old man presents with sudden-onset right-sided vision loss.

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By Jeffrey Shih, MD, RDMS|2017-07-19T00:07:06-07:00Aug 18, 2015|Ophthalmology, Ultrasound, Ultrasound for the Win|

Ultrasound For the Win! Case: 38-year-old pregnant woman with acute right-sided abdominal 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 38-year-old pregnant woman presents with acute right-sided abdominal pain radiating to her flank.
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By Jeffrey Shih, MD, RDMS|2017-07-19T00:07:14-07:00Jul 14, 2015|Expert Peer Reviewed (Clinical), Ultrasound, Ultrasound for the Win|

Ultrasound For The Win! Case – 101M with Altered Mental Status #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 101-year-old man presents after being found down with altered mental status.

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By Jeffrey Shih, MD, RDMS|2017-07-19T00:07:20-07:00May 20, 2015|Cardiovascular, Expert Peer Reviewed (Clinical), Ultrasound, Ultrasound for the Win|

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