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Sonographic Murphy sign; There are three principal techniques used to visualize gallbladder pathology using POCUS. A low frequency transducer is needed to achieve adequate depth of imaging. Generally, a curvilinear probe is preferred, although a phased array probe may also be used. Subcostal Sweep
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Definition: Orthostatic hypotension (OH) is a form of low blood pressure that occurs with positional change (i.e. sitting up from lying down, standing up from sitting). It is commonly used for the diagnosis of volume depletion. Orthostatic Vital Signs. A reduction of systolic blood pressure (SBP) of at least 20 mm Hg
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Sonographic Murphy sign; There are three principal techniques used to visualize gallbladder pathology using POCUS. A low frequency transducer is needed to achieve adequate depth of imaging. Generally, a curvilinear probe is preferred, although a phased array probe may also be used.
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Cervical Spine Anatomy. The Atlas. C1 (Atlas) (Figure 1)- Specialized cervical vertebra devoid of a vertebral body, in its stead is the dens of C2. C1 ring is composed of an anterior arch, lateral masses, and posterior arch. The lateral masses contain the superior and inferior articular facets that articulate with the occipital condyles and C2.
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There exist 11 common signs necessary for lung ultrasound interpretation. (Lichtenstein, et al. PMID: 24401163 ) The bat sign: view created by the pleural line and ribs on either side. This view represents a normal lung surface, where the bright lateral line is the visceral and parietal interface, and the dark "bat wings" are rib shadows.
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Introduction: The Emergency Department management of ankle fractures varies greatly between stable and unstable injuries. Unstable Fractures: Fractures that compromise the stability of the MORTISE (formed by the medial and posterior malleolae of the tibia, the lateral malleolus of the fibula and associated ligaments) are considered unstable. They often involve fractures to two or more of the ...
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Introduction: The Emergency Department management of ankle fractures varies greatly between stable and unstable injuries. Unstable Fractures: Fractures that compromise the stability of the MORTISE (formed by the medial and posterior malleolae of the tibia, the lateral malleolus of the fibula and associated ligaments) are considered unstable. They often involve fractures to two or more of the ...
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Determine whether the atrial fibrillation is chronic or recent-onset and delineate the time of onset if possible. Consider that the AF is being caused by another underlying process and treat that cause. In lone, recent-onset (< 48 hours) AF, either rhythm control or rate control management may be pursued.
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Definition: Orthostatic hypotension (OH) is a form of low blood pressure that occurs with positional change (i.e. sitting up from lying down, standing up from sitting). It is commonly used for the diagnosis of volume depletion
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Abnormal fat pad: an elevated anterior fat pad or any visualized posterior fat pad is indicitive of an elbow injury. Sail sign: An elevated, sharply demarcated anterior fat pad. It is often the only radiographic signs for a radial head injury.
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X-ray Elbow: Sail Sign. Abnormal fat pad: an elevated anterior fat pad or any visualized posterior fat pad is indicitive of an elbow injury. Sail sign: An elevated, sharply demarcated anterior fat pad. It is often the only radiographic signs for a radial head injury.
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X-ray Elbow: Sail Sign. Abnormal fat pad: an elevated anterior fat pad or any visualized posterior fat pad is indicitive of an elbow injury. Sail sign: An elevated, sharply demarcated anterior fat pad. It is often the only radiographic signs for a radial head injury.
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The Emergency Department management of ankle fractures varies greatly between stable and unstable injuries. Unstable Fractures: Fractures that compromise the stability of the MORTISE (formed by the medial and posterior malleolae of the tibia, the lateral malleolus of the fibula and associated ligaments) are considered unstable.
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Barcode or Stratosphere sign: lack of lung sliding using M-mode indicating a pneumothorax. (The presence of lung pleura sliding back and forth creating lung sliding has been found to have 100% negative predictive value for pneumothorax. (Lichtenstein et al., PMID: 7587439) Seashore sign: indicating lung sliding on M-mode.
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Anterior fat pad: Small and normall visible on a lateral XRay X-ray Elbow: Sail Sign. Abnormal fat pad: an elevated anterior fat pad or any visualized posterior fat pad is indicitive of an elbow injury. Sail sign: An elevated, sharply demarcated anterior fat pad. It is often the only radiographic signs for a radial head injury.
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Anterior fat pad: Small and normall visible on a lateral XRay X-ray Elbow: Sail Sign. Abnormal fat pad: an elevated anterior fat pad or any visualized posterior fat pad is indicitive of an elbow injury. Sail sign: An elevated, sharply demarcated anterior fat pad. It is often the only radiographic signs for a radial head injury.
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The mortise joint space should uniformly be < 4mm and the distal tibio-fibular joint should be < 5.5mm. Disruption or widening of the normal anatomy is evidence of an unstable injury pattern, and widening of the mortise at the medial malleolus in particular suggests injury to the deltoid ligament.
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The system is a little complicated, and is probably beyond what most of us can memorize for use in everyday practice. Luckily the Danis-Weber classification divides ankle fractures based on the location of the fibular injury compared to the level ankle mortise. Within these two systems most ankle fractures fall into three distinct categories.
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Third Step: Check a Stress View. You correctly classify this injury as a Dennis-Webber B (the fibular fracture is at the level of the mortise). As we just learned, there is no way to tell by looking at the above x-ray if the fracture is an isolated injury (ie an SER 2), or if it is associated with an occult deltoid ligament tear (SER 4).
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Amiodarone for Atrial Fibrillation Cardioversion. Termination of recent-onset atrial fibrillation (AF) or flutter (AFl) can be accomplished either by chemical or electrical cardioversion in the ED. Chemical cardioversion is typically pursued with amiodarone. Meta-analyses have demonstrated an increased conversion rate for amiodarone versus placebo (Chevalier 2003, Letelier 2003).
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