ARE YOU POSITIVE . . . OR FALSE POSITIVE? IMPROVING YOUR INTERPRETATION OF THE EFAST EXAM

ARE YOU POSITIVE . . .  OR FALSE POSITIVE? IMPROVING YOUR INTERPRETATION OF THE EFAST EXAM

The EFAST exam is an integral component of an emergency provider’s trauma evaluation. In the right hands, it has a specificity > 90% for intra-abdominal free fluid. There are some pitfalls, however, that can trick the provider into thinking a false positive represents free fluid. In this post, Dr. Gill and Dr. Kring help us improve our EFAST interpretation and recognize these “fake-outs.”

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Velocity Time Integral (VTI) and the Passive Leg Raise: Taking Volume Assessment to the Next Level

Velocity Time Integral (VTI) and the Passive Leg Raise: Taking Volume Assessment to the Next Level

Hypotensive patients requiring volume resuscitation are a regular occurrence for emergency physicians. Clinicians are often faced with determining whether patients will respond favorably to IV fluids both before and during vasopressor administration. The ability for point of care ultrasound (including assessment for B lines and IVC collapsibility) to predict volume status and fluid responsiveness has mixed evidence. Here we explore the velocity time integral (VTI), a measurement that can be coupled with a passive leg raise to more accurately assess for true fluid responsiveness.

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Locating the Dislocation: Shoulder Ultrasonography

Locating the Dislocation:  Shoulder Ultrasonography

Still using propofol and brutacaine for shoulder dislocations?  There is a better way.  Bedside ultrasound for shoulder dislocations has been shown to reduce narcotic use, number of sedations, length of stay, cost, and radiation. Let's review the technique for shoulder ultrasonography and intra-articular injection of the glenohumeral joint. 

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