Tell me if you’ve heard this one before: A young man gets wheeled into the trauma bay. He’s calm–doing his thing–probably texting–when the EMT or police officer reports that he’s been stabbed in the chest. “In the chest?” you ask. “In the chest,” she says. For emphasis she points. And sure enough, right in the center of his chest you see a small wound–not horrible looking, but a wound nonetheless. You look at the patient. He looks up from his phone, then down at his chest. He

The Article: Point-of-Care Ultrasonography for Evaluation of Acute Dyspnea in the ED. Zanobetti et al. (2017). Chest. 151(6): 1295-1301. The Idea: To determine the feasibility and diagnostic accuracy of bedside emergency ultrasound in the management of ED patients presenting with acute dyspnea. The Study: A prospective, blinded, observational study at one teaching hospital of all patients over age 18 who presented to the ED with any degree of dyspnea who were admitted to the

The Article: Moore CL, Rose GA, Kline JA et al. “Determination of Left Ventricular Function by Emergency Physician Echocardiography of Hypotensive Patients” Academic Emergency Medicine Journal.  9(2002): 186-193 The Idea: Systemic hypotension is a common and life threatening emergency. Differentiation of shock determines diagnosis and treatment. Can Emergency Physicians (EP) trained in cardiac ultrasound accurately assess left ventricular function in hypotensive ED patients?

The Article: Tezel et al (2014). A Comparison of Suprascapular Nerve Block and Procedural Sedation Analgesia in Shoulder Dislocation Reduction. American Journal of Emergency Medicine; 32 (2014) 549-552. Background: Shoulder joints are the most frequently dislocated joints seen in the Emergency Department. Reduction of shoulder joint is a necessary but painful procedure that patients must endure. Procedural sedation has become common in order to aid with analgesia during shoul

The Article: Emergency department point-of-care ultrasound in out-of-hospital and in-ED cardiac arrest. Gaspari et al. Resuscitation 109 (2016) 33-39. The Idea: To determine whether cardiac activity on US during ACLS was associated with improved survival. The Study: A multicenter, non-randomized, prospective, protocol-driven observational study of patients presenting with out-of-hospital or in-ED arrests with a rhythm of PEA or asystole.  Patients meeting criteria had an ultr

The Article: Carotid Flow Time Changes With Volume Status in Acute Blood Loss. David C. Mackenzie, MD et al. American College of Emergency Physicians, September 2015, Vol. 66, Issue 3, Pages 277–282. The Goal: To determine the effect of acute blood loss and the passive leg raise maneuver on corrected carotid artery flow time. Also, to identify if corrected carotid artery flow time is a predictor of volume responsiveness. The Study: A prospective, observational study using a c

The Article: Bedside ultrasound evaluation of tendon injuries Wu, T.S., et al. Am J of Emerg Med 2012; 30:1617-21 The Idea: Physical exam can be unreliable in evaluating suspected tendon injuries in the ED due to limitations of exam (pain, intoxication, etc) and full range of motion can be preserved in even significant partial tendon tears. More definitive means of diagnosis such as wound exploration or MRI can be time and resource intensive. This study sought to evaluate the

The Article: A Review of Lawsuits Related to Point-of-Care Emergency Ultrasound Applications. Stolz L, O’Brien K, Miller M, et al. Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 16 (1) 2015. The Idea: Point of care ultrasound is being used with increasing frequency in the emergency medicine. New medical technologies carry medico-legal risk. This study aims to review reported legal decisions related to ultrasound in emergency medicine

The Article: Ultrasonography versus Computed Tomography for Suspected Nephrolithiasis. The New Engl J Med. 2014 Sep 18. The Idea: Which initial imaging modality, ultrasound vs. CT, is better for patients with suspected nephrolithiasis? The Study: 2759 patients ages 18-76 with suspected nephrolithiasis by an attending physician were randomized to initial imaging study of POC ultrasound by trained EM physician, ultrasound by radiologist, or abdominal CT. Primary endpoints were

The Article: Point-of-care ultrasonography in patients admitted with respiratory symptoms: a single blind, randomised controlled trial. Christian B Laursen et al. Lancet Respiratory Medicine 2014. The idea: Whether point of care US of heart, lungs, and deep veins + diagnostic tests leads to a greater number of correct diagnoses at 4 hours of admission when compared with diagnostic tests alone. The Study: Single blinded randomized control trial of 320 patients with respirat