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81-84 of 84 results with category "Administration"

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Title: Pericarditis vs STEMI

Category: Administration

Keywords: STEMI, pericarditis, (PubMed Search)

Posted: 6/12/2023 by Leen Alblaihed, MBBS, MHA

a 37 year old patient comes in with chest pain, you obtain the following ECG. Is this a STEMI or Pericarditis? 

 

 

How can you tell? well, you follow the algorithm Dr. Mattu taught us....

 

 

The ECG above, if you go through the algorithm you will see that it is most likely pericarditis. 

note that PR depression can be transient and you might not see them. 

When in doubt, it is not wrong to consult cardiology. Getting serial ECGs also is important, STEMIs will usually evolve. 

 



Title: Using M-Mode for Lung Ultrasound

Category: Administration

Keywords: POCUS, Lung Ultrasound, Pneumothorax (PubMed Search)

Posted: 5/29/2023 by Alexis Salerno Rubeling, MD

We hope that you enjoy your Memorial Day!

Don't forget your Sandy Beach Sign vs Barcode Sign of Lung Ultrasound:

Normal lung will have good pleural sliding. When you image the lung with M-Mode it looks like a Sandy Beach. 

 

 

 

 

 

 

 

 

 

 

 

A lung with a pneumothorax will have poor lung sliding. When you image the lung with M-Mode it looks like a classic barcode or "stratosphere sign."

Make sure that you are on "Lung Mode" or decrease the gain to better image the movement of the pleural line. The negative predictive value for lung sliding on ultrasound is 99%. This means that if you see lung sliding you do not have a pneumothorax in that area. However, lung sliding is affected by certain conditions such as blebs, pulmonary fibrosis, pleural adhesions and right mainstem intubation. So, like any other radiology study, clinically correlate! 

Thinking about placing a chest tube or have a patient with multiple rib fractures? Take a look at how to perform a Serratus Anteror Plane Block here: https://www.thepocusatlas.com/thoracoabdominal-blocks#Serratus

 

Show References

Husain LF, Hagopian L, Wayman D, Baker WE, Carmody KA. Sonographic diagnosis of pneumothorax. J Emerg Trauma Shock. 2012 Jan;5(1):76-81. doi: 10.4103/0974-2700.93116. PMID: 22416161; PMCID: PMC3299161.



Title: Clinician Well-Being and the Patient Experience

Category: Administration

Keywords: patient experience, clinician wellbeing (PubMed Search)

Posted: 5/24/2023 by Mercedes Torres, MD

Clinician Well-Being and the Patient Experience

Did you know that most patient experience responses are overwhelmingly positive?  Rather than focusing all our attention on the bad, let’s focus on the good to promote clinician well-being.  See below for a few key points from a recent study on this:

  • Physicians worry that the people who respond to patient experience surveys are more likely to be critical of their care.  The opposite is actually true.
  • The authors found a 4:1 positive-to-negative ratio among 2.2 million patient experience responses collected by these authors.
  • Physicians and everyone else in health care are deeply motivated by the experience of giving good, patient-centered care.

Consider emphasizing positive patient experiences when providing feedback to emergency physicians.  It will promote clinician well-being and help improve performance in your practice.

Show References

Dudley J and Lee TH.  Patient Experience and Clinician Well-Being Aren’t Mutually Exclusive. Harvard Business Review. Published online at hbr.org, July 18, 2022.



Title: Femoral arterial doppler during cardiac arrest

Category: Administration

Keywords: POCUS, Cardiac Arrest, Arterial Doppler (PubMed Search)

Posted: 5/15/2023 by Alexis Salerno Rubeling, MD (Updated: 10/19/2026)

Did you know that you can use the linear probe with pulse wave (PW) doppler over the femoral artery to look for a pulse during CPR pauses? 

 

Well, the researchers of this article took this skill one step further to evaluate if they could use the femoral artery PW doppler while CPR was in progress to look for signs of a pulse.  

 

The authors found that: 

- pulsations due to compressions were organized with uniform pulsations.  

- when there was also native cardiac activity, the pulsations were nonuniform and may have an irregular cadence.  

 

Although there were several limitations, Arterial doppler was 100% specific and 50% sensitive in detecting organized cardiac activity during active CPR.  

 

Take Home Point: Take a look at your arterial doppler for signs of organized cardiac activity during a resuscitation. 

 

Show References

Reference: Gaspari RJ, Lindsay R, Dowd A, Gleeson T. Femoral Arterial Doppler Use During Active Cardiopulmonary Resuscitation. Ann Emerg Med. 2023 May;81(5):523-531. doi: 10.1016/j.annemergmed.2022.12.002. Epub 2023 Feb 7. PMID: 36754697. 



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