Early detection of myocardial infarction with reference to baseline levels during health: impact on biological variation of high-sensitivity cardiac troponin.

A 78-year-old male was seen in the emergency department (ED) with chest pain. Fifteen months earlier, he had presented to the ED with shoulder and elbow pain. High-sensitivity cardiac troponin I (hs-cTnI) testing was conducted at that time, which produced normal results of 10 and 13 ng/L (cutoff <48 ng/L).

Implementation and analysis of a multifaceted intervention for alcohol use disorder from a single academic urban emergency department.

Background: From 2006 to 2014, alcohol-related visits to the emergency department (ED) increased by 76% in the United States, highlighting the need for improved ED-driven interventions addressing alcohol use disorder (AUD). Naltrexone is an FDA-approved medication for AUD shown to decrease craving and self-administration of alcohol. While oral naltrexone and extended-release naltrexone have been long utilized in primary care and inpatient hospital settings, the use of naltrexone in the ED is limited.

The Development, Implementation, and Evolution of an Emergency Medicine Ultrasound-guided Regional Anesthesia Curriculum.

Introduction: Despite the inclusion of both diagnostic and procedural ultrasound and regional nerve blocks in the original Model of the Clinical Practice of Emergency Medicine (EM), there is no recommended standardized approach to the incorporation of ultrasound-guided regional anesthesia (UGRA) education in EM training.

Methods: We developed and implemented a structured curriculum for both EM residents and faculty to learn UGRA in a four-hour workshop. Each Regional Anesthesia Anatomy and Ultrasound Workshop was four hours in length and followed the same format.

Concurrent COVID-19 and Acute HIV: A Case Report and Diagnostic Review.

A 26-year-old male presented to the emergency department feeling unwell in February of 2021 with symptoms including diaphoresis, loose stools, and loss of taste sensation. Workup not only confirmed a diagnosis of COVID-19 but also revealed discordant HIV test results, with a reactive fourth-generation antigen/antibody test but a negative HIV-1/2 differentiation immunoassay. Subsequent HIV viral load testing obtained two days later ultimately established a diagnosis of acute HIV (AHI).

Virtual anatomy and point-of-care ultrasonography integration pilot for medical students.

Despite its significant clinical use, there is no standardized point-of-care ultrasonography (POCUS) curriculum in undergraduate medical education. As Covid-19 abruptly mandated the use of virtual education, instructors were challenged to incorporate and improve POCUS education within these new constraints. It was hypothesized that integrating POCUS into anatomy via brief video lessons and a subsequent interactive virtual lesson would lead to an objective understanding of POCUS concepts, improved understanding of the corresponding anatomy, and subjective improvement of student confidence with POCUS.

Point-of-Care Ultrasound Predicts Clinical Outcomes in Patients With COVID-19.

Objectives: Point-of-care ultrasound (POCUS) detects the pulmonary manifestations of COVID-19 and may predict patient outcomes.

Methods: We conducted a prospective cohort study at four hospitals from March 2020 to January 2021 to evaluate lung POCUS and clinical outcomes of COVID-19. Inclusion criteria included adult patients hospitalized for COVID-19 who received lung POCUS with a 12-zone protocol.

Lung Ultrasound Findings in Patients Hospitalized With COVID-19.

Objectives: Lung ultrasound (LUS) can accurately diagnose several pulmonary diseases, including pneumothorax, effusion, and pneumonia. LUS may be useful in the diagnosis and management of COVID-19.

Methods: This study was conducted at two United States hospitals from 3/21/2020 to 6/01/2020.

Interobserver Agreement of Lung Ultrasound Findings of COVID-19.

Background: Lung ultrasound (LUS) has received considerable interest in the clinical evaluation of patients with COVID-19. Previously described LUS manifestations for COVID-19 include B-lines, consolidations, and pleural thickening. The interrater reliability (IRR) of these findings for COVID-19 is unknown.

Interdisciplinary approach to enhance trauma residents education of Extended-Focused Assessment for Sonography in Trauma in the emergency department.

Background: Despite the utilization of point-of-care ultrasound (POCUS) by trauma surgeons, formal POCUS requirements do not exist for general surgery residents. We sought to evaluate surgery resident comfort with performing and interpreting of Extended-Focused Assessment for Sonography in Trauma (E-FAST) scans after a brief educational session.

Methods: A pre-survey, sent to PGY-2 and -3 surgical residents before their trauma rotation, evaluated comfort with eight components of the E-FAST.

'Never say never': the first successful management of a type A aortic dissection in Liberia.

The West African country of Liberia ranks as one of the lowest in the world in most measures of health. The diagnosis and management of complex surgical cases such as aortic dissection is extremely challenging, for reasons ranging from lack of diagnostic imaging capabilities to the high resources required for definitive surgical intervention. We present the first known successfully managed case of aortic dissection in the country's history and with it highlight the challenges faced and a number of lessons learned that are beneficial to anyone working in resource-limited environments.