Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including: Tetralogy of Fallot, Pneumonia, Bronchiolitis, Esophageal Foreign Body, Pneumothorax, ECMO
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: October CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Tuberculosis
- Button Battery Ingestion
- Constipation
- Hirschprung's Disease
- Aspiration Pneumonia
- Generalized Lymphatic Anomaly
- Pediatric Acute Respiratory Distress
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery week 1Sean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team as they post these weekly educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics!
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: May CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
Subcutaneous air
Osteopenia
Bronchiolitis
Constipation
Asthma exacerbation
Alveolar Rhabdomyosarcoma
Aspirated Foreign Bodies
Small Bowel Obstruction
Kyphoscoliosis
Pneumatocele
Cecal Volvulus
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery October CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Scoliosis
• Pneumothorax
• Parapneumonic Effusion
• Cardiomegaly
• Vaping associated lung injury
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: April CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Tension pneumothorax
• MIS-C
• Fungal Pneumonia
• Systemic JIA
• Large Pericardial Effusion
• Post-obstructive Pulmonary Edema
• Normal Thymus
• Pneumonia
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery: May CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Recurrent pneumothorax
• Parapneumonic effusion
• Pediatric ARDS
• Septic pulmonary emboli
• RUl Pneumonia
• GSW with pulmonary hemorrhage
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: December CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Hemopneumothorax
- COVID Pneumonia
- Metastatic Testicular Cancer
- Tension Pneumothorax
- Acute Chest Syndrome
- Status Asthmaticus
- Severe Anemia
- Pulmonary Infarct and Pulmonary Embolism
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: September CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Non-accidental Trauma (NAT)
• Hyperinflated Lungs
• Esophageal Foreign Body
• Neonatal Pulmonary Abscess
• Neonatal Pneumatocele
• Tuberculosis
• Interstitial Lung Disease of Prematurity
• Disseminated Neonatal HSV
• Aspirated Foreign Body
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: October CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Tuberculosis
- Button Battery Ingestion
- Constipation
- Hirschprung's Disease
- Aspiration Pneumonia
- Generalized Lymphatic Anomaly
- Pediatric Acute Respiratory Distress
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery week 1Sean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team as they post these weekly educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics!
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: May CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
Subcutaneous air
Osteopenia
Bronchiolitis
Constipation
Asthma exacerbation
Alveolar Rhabdomyosarcoma
Aspirated Foreign Bodies
Small Bowel Obstruction
Kyphoscoliosis
Pneumatocele
Cecal Volvulus
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery October CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Scoliosis
• Pneumothorax
• Parapneumonic Effusion
• Cardiomegaly
• Vaping associated lung injury
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: April CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Tension pneumothorax
• MIS-C
• Fungal Pneumonia
• Systemic JIA
• Large Pericardial Effusion
• Post-obstructive Pulmonary Edema
• Normal Thymus
• Pneumonia
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery: May CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Recurrent pneumothorax
• Parapneumonic effusion
• Pediatric ARDS
• Septic pulmonary emboli
• RUl Pneumonia
• GSW with pulmonary hemorrhage
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: December CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Hemopneumothorax
- COVID Pneumonia
- Metastatic Testicular Cancer
- Tension Pneumothorax
- Acute Chest Syndrome
- Status Asthmaticus
- Severe Anemia
- Pulmonary Infarct and Pulmonary Embolism
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: September CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Non-accidental Trauma (NAT)
• Hyperinflated Lungs
• Esophageal Foreign Body
• Neonatal Pulmonary Abscess
• Neonatal Pneumatocele
• Tuberculosis
• Interstitial Lung Disease of Prematurity
• Disseminated Neonatal HSV
• Aspirated Foreign Body
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: August CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Pneumatocele
- Croup
- Pulmonary Contusion
- Blast Injury
- Bowel Obstruction
- Lobar Pneumonia
- Cavitary Lung Lesions
- Ileus
- Malposition of Central Line
Drs. Milam and Thomas's CMC X-Ray Mastery Project: February CasesSean M. Fox
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on:
• Mycoplasma pneumonia
• Thoracic aortic aneurysm
• Hydropneumothorax
• Sternal fracture
• Foreign body
• Iatrogenic pneumothorax
• Pulmonary contusion
• Type A aortic dissection
• Cardiomegaly
• PCP pneumonia
• Pneumothorax
CMC Pediatric X-Ray Mastery: October CasesSean M. Fox
Drs. Neha Ray and Bradley Harris are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Bowel Obstruction
- Malrotation
- Hogkin’s Lymphoma
- Pericardial cyst
- Pneumothorax
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery January CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Swallowed Magnets
• Complex Left Lower Lobe Pneumonia
• Empyema
• Right Middle Lobe Pneumonia
• Pulmonary Hemorrhage
• Multifocal Pneumonia + Influenza
• Pectus Excavatum
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery September CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including: Tetralogy of Fallot, Congenital Diaphragmatic Hernia, Clavicle Fracture, Lung Agenesis, Ingested Foreign Body, Truncus Arteriosus.
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery December CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Esophageal foreign body
• Mucus plugging
• Pneumonia
• Atelectasis
• Bronchiolitis
• E-cigarette vaping associated lung injury (EVALI)
Dr. Kelsey Lena’s CMC Pediatric Orthopedic X-Ray Mastery Project: September C...Sean M. Fox
Dr. Kelsey Lena is Emergency Medicine Resident and interested in pediatric emergency medicine and medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, and supervision of Dr. Danielle Sutton, a Pediatric Emergency Medicine specialist, and Dr. Virginia Casey, a Pediatric Orthopedic Surgeon, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
- Buckle Fracture
- Greenstick Fracture
- Displaced Radial and Ulnar Fractures
- Non-Displaced Radial and Ulnar Fractures
- Comminuted Radial Fractures
- Monteggia Fracture
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: July CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Aortic Aneursym
• Aortic Coarctation
• Aspirated Foreign Body
• Ingested Foreign Body
• VP Shunt Malfunction
• Hemopneumothorax
• COVID-19 pneumonia and pneumothorax
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery July CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including: Retropharyngeal abscess, Metapneumovirus pneumonia requiring ECMO, Heart failure, Several cases of lobar pneumonia, Left mainstem placement of Dobhoff tube with pneumothorax, Mystery case from Tanzania!
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: November CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Line Identification
- Thoracic Trauma
- Neutropenic Fever
- ARDS
- ECMO
- Pneumomediastinum
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery: February CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Myocarditis
• Pulmonary Contusions
• Clavicle Fracture
• Pneumonia
• Acute Chest Syndrome
• Pleural Effusion
Drs. Lena, Avery, and Davis’s CMC Abdominal Imaging Mastery Project: April CasesSean M. Fox
Dr. Kelsey Lena is an Emergency Medicine Resident and Drs. Michael Avery and Joshua Davis are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s topics include:
- Large Bowel Obstruction
- Blunt Aortic Injury
- Abdominal Aortic Aneurysm with Rupture
Drs. Milam and Thomas's CMC X-Ray Mastery Project: January CasesSean M. Fox
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on:
• Pneumomediastinum
• Spontaneous Pneumothorax
• Deep Sulcus Sign
• Massive Pericardial Effusion
• Pulmonary Hypertension
• Mitral Stenosis
• Pulmonary Bullae
• Situs Inversus
• Dextrocardia
• Cavitary Lesions
CMC Pediatric X-Ray Mastery: January CasesSean M. Fox
Drs. Kaley El-Arab and Taylor Anderson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Pericardial cyst
- Acute chest syndrome
- Cavitary pneumonia
- Non-COVID coronavirus pneumonia with pulmonary arteriovenous malformations
- Multifocal pneumonia with ARDS
- COVID-19 pneumonia
- Round pneumonia
- Lobar pneumonia
- Aspiration pneumonia with parapneumonic effusion
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery: April CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• VP Shunt Disconnection
• E-cigarette Vaping Associated Lung Injury
• Apical Lung Mass
• Pulmonary Metastasis
• Vascular Ring
EMGuideWire's Radiology Reading Room: COVID 19 Chest X-rays UpdateSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to COVID-19 infections as represented on Chest Radiography. It is brought to you by Nikki Richardson, MD, Claire Milam, MD, Alyssa Thomas, MD, and Shelby Hixson, PA. It has special guest editor, Infectious Disease Specialist, Catherine Passeretti, MD. In addition, this update also includes another special guest editor, Radiologist, Dr. Johnathan Clemente, MD.
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: August CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Aortic Coarctation
• Tension pneumothorax
• Pneumonia
• COVID-19
• Tetralogy of Fallot
• L-Transposition of the Great Vessels
• Pediatric ARDS
• MIS-C
• Foreign Body Aspiration
• Aspiration Pneumonia
• Corner fracture
• Non-accidental Trauma
Drs. Lorenzen and Barlock’s CMC X-Ray Mastery Project: January CasesSean M. Fox
Drs. Breeanna Lorenzen and Travis Barlock are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
Perforated gastric ulcer with tension hemoperitoneum
Pulmonary arterial hypertension
Ruptured diaphragm
Cavitary tuberculosis
Pneumocystis pneumonia with spontaneous pneumothorax
Lower rib fractures and an associated splenic injury
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery Cases #2Sean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team as they post these weekly educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including: Diaphragmatic Hernia, Pneumomediastinum, Right Mainstem Intubation, Left Lung Collapse, Coarctation of the Aorta, Right Upper Lobe Pneumonia, Right Lower Lobe Pneumonia
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery November CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
- Tension Pneumothorax
- Atelectasis
- Esophageal Obstruction / Achalasia
- Right Upper Lobe Mass
- Right Upper and Right Middle Lobectomies
- Esophageal Foreign Body
- Transposition of the Great Vessels
Drs. Milam and Thomas's CMC X-Ray Mastery Project: May CasesSean M. Fox
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on:
• Spontaneous Pneumothorax
• Esophageal Stent
• Iatrogenic Pneumothorax
• Pleural Effusion
• Shoulder Dislocation
• Proximal Humeral Fracture
• Aspiration Event
• Subcutaneous Emphysema
• Metastatic Germ Cell Cancer
• ARDS
• Right Lower Lobe Pneumonia
• Mediastinal Mass
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: March CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Acute Chest Syndrome
• Pneumothorax
• Tuberculosis
• Small Bowel Obstruction
• Intra-abdominal Abscess
• COVID-19
• Subcutaneous Emphysema
• Pneumoperitoneum
• Pneumomediastinum
• ECMO
• Pleural Effusions
• Cavitary Lung Lesions
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: August CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Pneumatocele
- Croup
- Pulmonary Contusion
- Blast Injury
- Bowel Obstruction
- Lobar Pneumonia
- Cavitary Lung Lesions
- Ileus
- Malposition of Central Line
Drs. Milam and Thomas's CMC X-Ray Mastery Project: February CasesSean M. Fox
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on:
• Mycoplasma pneumonia
• Thoracic aortic aneurysm
• Hydropneumothorax
• Sternal fracture
• Foreign body
• Iatrogenic pneumothorax
• Pulmonary contusion
• Type A aortic dissection
• Cardiomegaly
• PCP pneumonia
• Pneumothorax
CMC Pediatric X-Ray Mastery: October CasesSean M. Fox
Drs. Neha Ray and Bradley Harris are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Bowel Obstruction
- Malrotation
- Hogkin’s Lymphoma
- Pericardial cyst
- Pneumothorax
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery January CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Swallowed Magnets
• Complex Left Lower Lobe Pneumonia
• Empyema
• Right Middle Lobe Pneumonia
• Pulmonary Hemorrhage
• Multifocal Pneumonia + Influenza
• Pectus Excavatum
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery September CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including: Tetralogy of Fallot, Congenital Diaphragmatic Hernia, Clavicle Fracture, Lung Agenesis, Ingested Foreign Body, Truncus Arteriosus.
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery December CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Esophageal foreign body
• Mucus plugging
• Pneumonia
• Atelectasis
• Bronchiolitis
• E-cigarette vaping associated lung injury (EVALI)
Dr. Kelsey Lena’s CMC Pediatric Orthopedic X-Ray Mastery Project: September C...Sean M. Fox
Dr. Kelsey Lena is Emergency Medicine Resident and interested in pediatric emergency medicine and medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, and supervision of Dr. Danielle Sutton, a Pediatric Emergency Medicine specialist, and Dr. Virginia Casey, a Pediatric Orthopedic Surgeon, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
- Buckle Fracture
- Greenstick Fracture
- Displaced Radial and Ulnar Fractures
- Non-Displaced Radial and Ulnar Fractures
- Comminuted Radial Fractures
- Monteggia Fracture
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: July CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Aortic Aneursym
• Aortic Coarctation
• Aspirated Foreign Body
• Ingested Foreign Body
• VP Shunt Malfunction
• Hemopneumothorax
• COVID-19 pneumonia and pneumothorax
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery July CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including: Retropharyngeal abscess, Metapneumovirus pneumonia requiring ECMO, Heart failure, Several cases of lobar pneumonia, Left mainstem placement of Dobhoff tube with pneumothorax, Mystery case from Tanzania!
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: November CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Line Identification
- Thoracic Trauma
- Neutropenic Fever
- ARDS
- ECMO
- Pneumomediastinum
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery: February CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Myocarditis
• Pulmonary Contusions
• Clavicle Fracture
• Pneumonia
• Acute Chest Syndrome
• Pleural Effusion
Drs. Lena, Avery, and Davis’s CMC Abdominal Imaging Mastery Project: April CasesSean M. Fox
Dr. Kelsey Lena is an Emergency Medicine Resident and Drs. Michael Avery and Joshua Davis are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s topics include:
- Large Bowel Obstruction
- Blunt Aortic Injury
- Abdominal Aortic Aneurysm with Rupture
Drs. Milam and Thomas's CMC X-Ray Mastery Project: January CasesSean M. Fox
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on:
• Pneumomediastinum
• Spontaneous Pneumothorax
• Deep Sulcus Sign
• Massive Pericardial Effusion
• Pulmonary Hypertension
• Mitral Stenosis
• Pulmonary Bullae
• Situs Inversus
• Dextrocardia
• Cavitary Lesions
CMC Pediatric X-Ray Mastery: January CasesSean M. Fox
Drs. Kaley El-Arab and Taylor Anderson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Pericardial cyst
- Acute chest syndrome
- Cavitary pneumonia
- Non-COVID coronavirus pneumonia with pulmonary arteriovenous malformations
- Multifocal pneumonia with ARDS
- COVID-19 pneumonia
- Round pneumonia
- Lobar pneumonia
- Aspiration pneumonia with parapneumonic effusion
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery: April CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• VP Shunt Disconnection
• E-cigarette Vaping Associated Lung Injury
• Apical Lung Mass
• Pulmonary Metastasis
• Vascular Ring
EMGuideWire's Radiology Reading Room: COVID 19 Chest X-rays UpdateSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to COVID-19 infections as represented on Chest Radiography. It is brought to you by Nikki Richardson, MD, Claire Milam, MD, Alyssa Thomas, MD, and Shelby Hixson, PA. It has special guest editor, Infectious Disease Specialist, Catherine Passeretti, MD. In addition, this update also includes another special guest editor, Radiologist, Dr. Johnathan Clemente, MD.
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: August CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Aortic Coarctation
• Tension pneumothorax
• Pneumonia
• COVID-19
• Tetralogy of Fallot
• L-Transposition of the Great Vessels
• Pediatric ARDS
• MIS-C
• Foreign Body Aspiration
• Aspiration Pneumonia
• Corner fracture
• Non-accidental Trauma
Drs. Lorenzen and Barlock’s CMC X-Ray Mastery Project: January CasesSean M. Fox
Drs. Breeanna Lorenzen and Travis Barlock are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
Perforated gastric ulcer with tension hemoperitoneum
Pulmonary arterial hypertension
Ruptured diaphragm
Cavitary tuberculosis
Pneumocystis pneumonia with spontaneous pneumothorax
Lower rib fractures and an associated splenic injury
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery Cases #2Sean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team as they post these weekly educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including: Diaphragmatic Hernia, Pneumomediastinum, Right Mainstem Intubation, Left Lung Collapse, Coarctation of the Aorta, Right Upper Lobe Pneumonia, Right Lower Lobe Pneumonia
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery November CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
- Tension Pneumothorax
- Atelectasis
- Esophageal Obstruction / Achalasia
- Right Upper Lobe Mass
- Right Upper and Right Middle Lobectomies
- Esophageal Foreign Body
- Transposition of the Great Vessels
Drs. Milam and Thomas's CMC X-Ray Mastery Project: May CasesSean M. Fox
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on:
• Spontaneous Pneumothorax
• Esophageal Stent
• Iatrogenic Pneumothorax
• Pleural Effusion
• Shoulder Dislocation
• Proximal Humeral Fracture
• Aspiration Event
• Subcutaneous Emphysema
• Metastatic Germ Cell Cancer
• ARDS
• Right Lower Lobe Pneumonia
• Mediastinal Mass
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: March CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Acute Chest Syndrome
• Pneumothorax
• Tuberculosis
• Small Bowel Obstruction
• Intra-abdominal Abscess
• COVID-19
• Subcutaneous Emphysema
• Pneumoperitoneum
• Pneumomediastinum
• ECMO
• Pleural Effusions
• Cavitary Lung Lesions
Dr. Escobar’s CMC X-Ray Mastery Project: December CasesSean M. Fox
Drs. Daniel Escobar, Angela Pikus, and Alex Blackwell are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
- Blunt hemothorax
- Pulmonary contusion
- Lung Cancer with Bone Metastases
- Pneumomediastinum
- Pneumopericardium
Drs. Lorenzen and Barlock’s CMC X-Ray Mastery Project: May CasesSean M. Fox
Drs. Breeanna Lorenzen and Travis Barlock are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
Pneumonia
Lung Masses
Pulmonary Nodules
Hilar Lymphadenopathy
Aorto-enteric Fistula
Diaphragmatic Hernia
Intra-aortic Balloon Pump
Pacemaker
Impella
EMGuideWire's Radiology Reading Room: Septic Pulmonary EmboliSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Septic Pulmonary Emboli and is brought to you by Victoria Serven, MD, Travis Barlock, MD, and Katherine Sillman, NP.
Drs. Milam and Thomas's CMC X-Ray Mastery Project: September CasesSean M. Fox
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on: Septic Pulmonary Emboli, Severe Rib Fractures, Left Lower Lobe Resection, Pneumonia, Esophageal Stent, COPD, Hyperinflation, Pulmonary Contusion, Aortic Dissection, Tuberculosis
Drs. Pikus, Blackwell, Baumgarten, and Malloy-Posts’s CMC X-Ray Mastery Proje...Sean M. Fox
Drs. Angela Pikus, Alex Blackwell, Mark Baumgarten, Rosa Malloy-Post are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
• Naloxone-Associated Aspiration Pneumonitis & Pulmonary Edema
• Superior Vena Cava Syndrome
• Pulmonary Aspergillosis And The “Air Crescent Sign”
• Needle-Chest Decompression & Recent Pneumothorax Literature
Drs. Lorenzen and Barlock’s CMC X-Ray Mastery Project: March CasesSean M. Fox
Drs. Breeanna Lorenzen and Travis Barlock are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
• Miliary tuberculosis
• Mediastinal mass
• Esophageal perforation
• Mucus plugging and left lung collapse
• Naloxone associated pulmonary edema
• Unilateral pulmonary edema in setting of severe Mitral Regurgitation
• ARDS and Ventilator-Acquired Pneumonia (VAP)
Acute Chest Syndrome - EMGuidewire's Radiology Reading RoomSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Acute Chest Syndrome and is brought to you by Angela Pikus, MD, Mark Baumgarten, MD, Andres Gil Bustamante, and Ahmed Mashal, MD. As always, Michael Gibbs, MD serves as the projects editor.
Drs. Milam and Thomas's CMC X-Ray Mastery Project: April CasesSean M. Fox
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on:
• Esophageal Perforation
• Perforated Viscous
• Pneumothorax
• Traumatic Diaphragmatic Hernia
• Pulmonary Contusion
• COVID-19 associated Pneumonia
• COVID-19
• Influenza Like Illness
EMGuideWire's Radiology Reading Room: PneumomediastinumSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Pneumomediastinum and is brought to you by Jacob Leedekerken, MD and Chelsea Wilson, MD.
Drs. Penzler, Ricker, and Ahmad’s CMC Abdominal Imaging Mastery Project: Dece...Sean M. Fox
Dr. Morgan Penzler is an Emergency Medicine Resident and Drs. Raza Ahmad and Ansley Ricker are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s cases include:
- Gastric Perforation
- Pneumoperitoneum
- Lower GI Bleed
- Parastomal Hernia
Drs. Milam, Thomas, Lorenzen, and Barlock’s CMC X-Ray Mastery Project: August...Sean M. Fox
Drs. Claire Milam, Alyssa Thomas, Breeanna Lorenzen, and Travis Barlock are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
• Diaphragmatic Injury
• Malignant Pleural Effusion
• Subcutaneous Emphysema
• Tension Pneumothorax
• Pulmonary Contusion
• Complete Lung Consolidation
• Tuberculosis
Implanted Devices - VP Shunts: EMGuidewire's Radiology Reading RoomSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Ventriculoperitoneal Shunts and their Complications and is brought to you by Brandon Friedman, MD, Kelsey Patterson, and L. Erin Miller MD. It is has special guest editor: Scott Wait, MD
Sternal Fractures & Dislocations - EMGuidewire Radiology Reading RoomSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Sternal Fractures and Dislocations and is brought to you by Carrie Bissell, MD, Aaron Fox, MD, Kendrick Lim, MD, Stephanie Jensen, MD, and Olivia Rice, MD. It is has special guest editor: Sean Dieffenbaugher, MD and Laurence Kempton, MD
Diaphragmatic Injuries - Radiology Reading RoomSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Diaphragm Injury and is brought to you by Kylee Brooks, MD, Parker Hambright, MD, Alexis Holland, MD, and William Lorenz, MD. It is has special guest editor: Kyle Cunningham, MD
Adult Orthopedic Imaging Series: Presentation #2 Native Hip DislocationsSean M. Fox
Drs. Carrie Bissell, Aaron Fox, and Kendrick Lim are Emergency Medicine Residents at Carolinas Medical Center and are interested in emergency medicine and medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine and Dr. Laurence Kempton, an Orthopedic Surgeon, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides that focus on Adult Orthopedic cases. This set will cover:
- Hip Dislocations
Neuroimaging Mastery Project: Presentation #5 Subdural HematomasSean M. Fox
Drs. Faith Meyers, Madison Watts and Steven Perry are Emergency Medicine Residents at Carolinas Medical Center who are interested in medical education. Dr. Rebecca DeCarlo, MD is a Neurosurgical resident at Carolinas Medical Center. Along with the guidance of Dr. Michael Gibbs (Chair of Emergency Medicine), Dr. Jonathan Clemente (Chief of the Department of Radiology and Neuroradiology specialist), Dr. Christa Swisher (Neurocritcal Care Intensivist), and Dr. Scott Wait (Chief of Pediatric Neurosurgery) they aim to help educate us on Neuroimaging. In this presentation they will address Subdural Hematomas. Follow along with the EMGuideWire.com team as they post the CMC Neuroimaging Case Studies.
- Subdural Hematomas
Neuroimaging Mastery Project Presentation #4: Acute Epidural HematomasSean M. Fox
Drs. Faith Meyers, Madison Watts and Steven Perry are Emergency Medicine Residents at Carolinas Medical Center who are interested in medical education. Along with the guidance of Dr. Michael Gibbs (Chair of Emergency Medicine), Dr. Jonathan Clemente (Chief of the Department of Radiology and Neuroradiology specialist), Dr. Christa Swisher (Neurocritcal Care Intensivist), and Dr. Scott Wait (Chief of Pediatric Neurosurgery) they aim to help educate us on Neuroimaging. In this presentation they will address Atraumatic Neurosurgical Intracranial Infections. Follow along with the EMGuideWire.com team as they post the CMC Neuroimaging Case Studies.
- Acute Epidural Hematomas
Pediatric Orthopedic Imaging Case Studies #7 Pediatric Elbow FracturesSean M. Fox
Dr. Haley Dusek is an Emergency Medicine Resident and interested in pediatric emergency medicine and medical education. Dr. Ainsley Bloomer is an Orthopedic resident at Carolinas Medical Center. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, and supervision of Dr. Danielle Sutton, a Pediatric Emergency Medicine specialist, and Dr. Virginia Casey, a Pediatric Orthopedic Surgeon, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
•Lateral condyle
•Medial epicondyle
•Monteggia
•Posterior dislocation
•Transphyseal separation
Adult Orthopedic Imaging Mastery Project - Pelvic Ring FracturesSean M. Fox
Drs. Carrie Bissell, Aaron Fox, and Kendrick Lim are Emergency Medicine Residents at Carolinas Medical Center and are interested in emergency medicine and medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine and Dr. Laurence Kempton, an Orthopedic Surgeon, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides that focus on Adult Orthopedic cases. This set will cover:
- Pelvic Ring Fractures
Neurosurgical Intracranial Infections - FINAL 10-17-23.pptxSean M. Fox
Drs. Faith Meyers and Steven Perry are Emergency Medicine Residents and Trent VanHorn is a Neurosurgical Resident at Carolinas Medical Center who are interested in medical education. Along with the guidance of Dr. Michael Gibbs (Chair of Emergency Medicine), Dr. Jonathan Clemente (Chief of the Department of Radiology and Neuroradiology specialist), Dr. Christa Swisher (Neurocritcal Care Intensivist), and Dr. Scott Wait (Chief of Pediatric Neurosurgery) they aim to help educate us on Neuroimaging. In this presentation they will address Atraumatic Neurosurgical Intracranial Infections. Follow along with the EMGuideWire.com team as they post the CMC Neuroimaging Case Studies.
This set will cover:
Atraumatic Neurosurgical Intracranial Infections
Subdural Empyema and Brain Abscess
CMC Neuroimaging Case Studies - Cerebral Venous Sinus ThrombosisSean M. Fox
Drs. Faith Meyers, Steven Perry, Madison Watts, and Brandon Friedman are Emergency Medicine Residents at Carolinas Medical Center and interested in medical education. Along with the guidance of Dr. Michael Gibbs (Chair of Emergency Medicine), Dr. Jonathan Clemente (Chief of the Department of Radiology and Neuroradiology specialist), Dr. Christa Swisher (Neurocritcal Care Intensivist), and Dr. Scott Wait (Chief of Pediatric Neurosurgery) they aim to help educate us on Neuroimaging. In this presentation they will address Cerebral Venous Sinus Thrombosis. Follow along with the EMGuideWire.com team as they post the CMC Neuroimaging Case Studies.
This set will cover:
- Cerebral Venous Sinus Thrombosis
Abdominal Imaging Case Studies #27.pptxSean M. Fox
Drs. Kylee Brooks and Parker Hambright are Emergency Medicine Residents and Drs. Alexis Holland and William Lorenz are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham, Brent Matthews, and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s cases include:
• Iatrogenic Esophageal Perforation
• Emphysematous Cystitis
• Meckel’s Diverticulum
• Paraesophageal Hernia
Blood Can Be Very Very Bad - CMC Neuroimaging Case StudiesSean M. Fox
Drs. Faith Meyers and Steven Perry are Emergency Medicine Residents at Carolinas Medical Center and interested in medical education. Along with the guidance of Dr. Michael Gibbs (Chair of Emergency Medicine), Dr. Jonathan Clemente (Chief of the Department of Radiology and Neuroradiology specialist), and Dr. Scott Wait (Chief of Pediatric Neurosurgery) they aim to help educate us on Neuroimaging. In this initial educational slideset, they are also joined by Dr. Andrew Perron, the creator of the “Blood Can Be Very Bad” Head CT interpretation framework. Follow along with the EMGuideWire.com team as they post the CMC Neuroimaging Case Studies.
This set will cover:
- The Neuroimaging Framework “Blood Can Be Very Very Bad.”
Drs. Angela Pikus, Alex Blackwell, Mark Baumgarten, Rosa Malloy-Post are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
• Abnormalities of the Thoracic Aorta
o Traumatic aortic disruption
o Thoracic aortic aneurysm with acute dissection
Medical Device Imaging Mastery Project #4: Extracorporeal Membrane OxygenationSean M. Fox
Drs. Kaley El-Arab and Brandon Friedman are Emergency Medicine Residents at Carolinas Medical Center and interested in medical education and Critical Care. They have teamed with Ms. Emily Lipitz a PA with the Sanger Heart & Vascular Institute. Along with the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, and Dr. John Symanski, a cardiologist from the Sanger Heart & Vascular Institute, they aim to help augment our understanding of emergent imaging of implanted devices. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
- Extracorporeal Membrane Oxygenation
Drs. Brooks, Hambright, Holland, and Lorenz’s CMC Abdominal Imaging Mastery P...Sean M. Fox
Drs. Kylee Brooks and Parker Hambright are Emergency Medicine Residents and Drs. Alexis Holland and William Lorenz are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham, Brent Matthews, and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s cases include:
- Pyogenic Liver Abscess
- Bladder Rupture
- Sigmoid Volvulus
CMC Pediatric X-Ray Mastery: 27th Case SeriesSean M. Fox
Dr. Bradley Harris is interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Mary Grady and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Clavicle Fracture
• Congenital Diaphragmatic Hernia
• Thymic Shadow
• Duodenal Atresia
• Hirschsprung’s Disease
• Malpositioned lines and tubes
Dr. Haley Dusek’s CMC Pediatric Orthopedic X-Ray Mastery Project: #6 Presenta...Sean M. Fox
Dr. Haley Dusek is an Emergency Medicine Resident and interested in pediatric emergency medicine and medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, and supervision of Dr. Danielle Sutton, a Pediatric Emergency Medicine specialist, and Dr. Virginia Casey, a Pediatric Orthopedic Surgeon, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
• Tufts fracture
• Mallet fracture
• Seymour fracture
• Volar Plate Injury
• Base fracture
• Phalangeal neck
• Condyle fracture
• Phalanx dislocations
Drs. Pikus, Blackwell, Baumgarten, and Malloy-Posts’s CMC X-Ray Mastery Proje...Sean M. Fox
Drs. Angela Pikus, Alex Blackwell, Mark Baumgarten, Rosa Malloy-Post are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
• Peripartum Cardiomyopathy
• Left Ventricular Assist Devices
• Pleural Effusions
Drs. Escobar, Pikus, and Blackwell’s CMC X-Ray Mastery Project: 43rd Case SeriesSean M. Fox
Drs. Daniel Escobar, Angela Pikus, and Alex Blackwell are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
- Traumatic Pneumothorax
- Flail Chest And Surgical Rib Fixation
- Traumatic Pulmonary Pseudocyst
- Stab Wound To The Heart
CMC Pediatric X-Ray Mastery: 26th Case SeriesSean M. Fox
Drs. Kaley El-Arab and Taylor Anderson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Penetrating Chest Trauma
- Meconium Aspiration Syndrome
- Respiratory Distress Syndrome
- Pneumothorax
- Pneumatosis
- Rickets of prematurity
- Disseminated HSV
- VACTERL
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery August Cases
1. Pediatric Chest X-Rays Of The Month
Nikki Richardson MD & Jennifer Potter MD
Department of Emergency Medicine
Carolinas Medical Center & Levine Children’s Hospital
Michael Gibbs MD, Faculty Editor
Chest X-Ray Mastery Project
August 2019
2. Disclosures
This ongoing chest X-ray interpretation series is proudly sponsored by the
Emergency Medicine Residency Program at Carolinas Medical Center.
The goal is to promote widespread mastery of CXR interpretation.
There is no personal health information [PHI] within, and ages have been
changed to protect patient confidentiality.
3. Process
Many are providing cases and these slides are shared with all contributors.
Contributors from many CMC departments, and now… Tanzania and Brazil.
Cases submitted this week will be distributed monthly.
When reviewing the presentation, the 1st image will show a chest X-ray
without identifiers and the 2nd image will reveal the diagnosis.
6. 5 year old female transferred from Mission
Hospital presented to our hospital for evaluation
of septic shock in the setting of Methicillin-
Susceptible Staphylococcus aureus bacteremia.
Per outside hospital report, the patient had been
seen in various outside hospital emergency
departments 3-4 times in the week leading up to
her hospitalization with complaints of abdominal
pain and rash
7. 5 year old female transferred from Mission
Hospital presented to our hospital for evaluation
of septic shock in the setting of Methicillin-
Susceptible Staphylococcus aureus bacteremia.
Per outside hospital report, the patient had been
seen in various outside hospital emergency
departments 3-4 times in the week leading up to
her hospitalization with complaints of abdominal
pain and rash
On arrival to our hospital, a chest x-ray was
obtained which shows diffuse patchy infiltrates,
small right pleural effusion, and L pigtail chest
tube with resolution of prior left sided
pneumothorax
10. Upon arrival, the patient was noted
to be persistently hypoxic despite
maximum ventilator settings and
persistently hypotensive despite
multiple vasopressors
(norepinephrine, epinephrine,
vasopressin, angiotensin) thus
decision was made to place the
patient on ECMO
Dx: Successful ECMO cannulation,
worsening airspace disease
11. Day 1 of Extracorporeal Membrane
Oxygenation (ECMO) with very poor
lung aeration
12. Day 2 of Extracorporeal Membrane
Oxygenation (ECMO) with improved
lung aeration bilaterally
13. Patient was noted to have decreasing
oxygen saturations after she was
lifted to change her bedding. STAT
chest x-ray obtained
14. Patient was noted to have decreasing
oxygen saturations after she was
lifted to change her bedding. STAT
chest x-ray obtained
Dx: Spontaneous R pneumothorax
15. Post procedural chest x-ray shows
adequate lung re-expansion after
pigtail chest tube placement.
16. 2-year-old female presented to the emergency
department with fever, non-productive cough,
and upper respiratory tract symptoms
CXR shows prominent perihilar
streaky opacities
Dx: Viral Process
17. 2-year-old female presented to the
emergency department for
evaluation of shortness of breath
RR 36, SpO2 94% on RA
Physical Exam: Corse rhonchi
bilaterally, +tachypnea, nasal flaring
18. 2-year-old female presented to the
emergency department for
evaluation of shortness of breath
RR 36, SpO2 94% on RA
CXR shows perihilar bronchial wall
thickening
Dx: Bronchiolitis
Work of breathing improved with
high flow nasal canula
Physical Exam: Corse rhonchi
bilaterally, +tachypnea, nasal flaring
19. 6 year old boy presented with throat
pain, drooling and raspy voice.
Respiratory Rate: 18
SpO2: 100%
20. 6 year old boy presented with throat
pain, drooling and raspy voice.
Respiratory Rate: 18
SpO2: 100%
Later reported he was throwing a
quarter up in the air and catching it
in his mouth…
Dx: Esophageal Foreign Body
21. Coin Vs. Button Battery
• Why does it matter?
• An electric current is generated when the battery comes in contact with mucosa, leading to localized burn
injury.
• If the alkaline battery leaks, corrosive injury and liquefactive necrosis can occur. This is more common with
non-lithium batteries and is usually not the cause of tissue damage that is seen to occur within 2 hours.
• The negative terminal, which is on the narrower side of the battery, generates hydroxide ions and is where
necrosis occurs. This can be remembered as “narrow-negative-necrotic.”
• Batteries lodged in the esophagus may cause serious burns in as little as 30 minutes and the patient might
be asymptomatic initially.
• Certain button batteries carry greater risk than others. Patients with lithium battery ingestions have worse
outcomes, as these have the potential to generate a higher current than other batteries and cause greater
damage.
• A button battery in the esophagus is an emergency and should be removed within 2 hours
AP/PA view – look for “halo
sign” – a ring of
radiolucency inside the
outer edge of the object
“TOXCard: Button Battery Ingestions.” EmDOCs.net - Emergency Medicine Education, 25 Feb. 2019, www.emdocs.net/toxcard-button-battery-
Remember
from April….
22. 1 year old hospitalized patient
presented with tachypnea and
increased work of breathing
23. 1 year old hospitalized patient
presented with tachypnea and
increased work of breathing
Dx: Spontaneous left upper lobe
collapse
24. History: 4 year old female presented with 3 days of generalized abdominal pain,
fever, nausea and vomiting.
Physical Exam:
Vital signs: Temperature 101.8, HR 169 bpm, RR 26, SpO2 100%, BP 129/86
Lungs: Clear to auscultation bilaterally. Non-labored respirations
Abdomen: Firm, tender to palpation diffusely with severe tenderness in the right
lower quadrant. Voluntary and involuntary guarding noted. Pain worse with any
movement of the bed or patient
Laboratory Evaluation:
WBC: 21.3, neutrophil count 16.68
CRP: 11.9
Imaging obtained:
RLQ ultrasound: A noncompressible, tubular structure measuring up to 7mm in
diameter seen in the right lower quadrant with increased flow within the wall.
Suggestive of acute appendicitis.
25. Patient seen by pediatric surgery
with concern for acute appendicitis.
Patient taken to the operating room
where a normal, non-inflamed
appendix was identified.
Dx: Left Lower Lobe Community
Acquired Pneumonia
Post-procedural chest X-ray was
obtained for further evaluation of
symptoms.
26.
27. Pediatric Appendicitis
• Scoring systems for pediatric
appendicitis include the Alvarado
score and the Pediatric Appendicitis
Score
• When utilizing scoring systems, it is
important to take into account pre-
test probability.
• In a systemic review of the literature
comparing these scoring systems, the
determined pre-test probability from
the literature was noted to be 33% for
children
• At a pre-test probability of 33%,
likelihood ratios for the Alvarado score
were as follows: 0.02 (<4 points), 0.27
(4 to 6 points), and 4.2 (≥ 7 points);
and 0.04 (<5 points) and for the
Pediatric Appendicitis Score,
likelihood ratios were 0.13 (<4 points),
0.70 (4 to 7 points), and 8.1 (≥ 8
points).Ebell MH1, Shinholser J2. What Are the Most Clinically Useful Cutoffs for the Alvarado
and Pediatric Appendicitis Scores? A Systematic Review. Ann Emerg Med.
2014 Oct;64(4):365-372.
28. Remember, not all scoring systems are perfect…
• For our patient, his PAS score was 9 (likely appendicitis) and his Alvarado score
was 9 (indicative of appendicitis).
• Early involvement of pediatric surgeons prior to imaging is recommended
when appendicitis is highly suspected based on clinical decision scoring
system or clinical gestalt
• The best imaging modality continues to be debated. When unperforated
appendicitis is suspected, the American College of Radiology recommends
initial use of US imaging, with CT (versus MR) reserved for equivocal US
findings1.
• A large retrospective, single-center study of 1982 children revealed the
sensitivity of unequivocal US to be 98.7% with a positive predictive value of
89.8%, and specificity of 97.1%, with a negative predictive value of 99.7%2.
• As seen in this case, no imaging modality or clinical decision tool is perfect.
Don’t forget your differential diagnosis!
1. Smith MP, Katz DS, Lalani T et al. ACR appropriateness criteria right lower quadrant pain: suspected appendicitis. Ultrasound 2015;31(2):85–91.
2. Dibble EH, Swenson DW, Cartagena C, Baird GL, Herliczek TW. Effectiveness of a staged US and unenhanced MR imaging algorithm in the diagnosis of pediatric
appendicitis. Radiology 2018;286(3):1022–1029.
29. What’s With These kids?
For the next section, we will review a series of cases/images with a
unifying diagnosis. Try to identify the similarities and come up with the
diagnosis! After each series of cases, we will discuss the
pathophysiology and imaging characteristics of the diagnosis.
These images and cases have been graciously shared with us from our
colleagues in the pediatric cardiovascular surgery department. We thank
you for your continued support of this project!
30. 4 month old male who initially presented from outside
hospital due to murmur heard at birth. Birth history
notable for small for gestational age (SGA), weighing
2.1kg at 38 weeks gestation. No respiratory distress or
feeding difficulties noted.
Physical exam notable for a long 3/6 systolic ejection
murmur at the base which radiates to the back. 2+
femoral pulses bilaterally.
31. 5 month old female who initially presented from
immediately after birth due to abnormal prenatal
echocardiogram. Patient noted to be SGA (2.7 kg at term
birth) with no respiratory distress or feeding difficulties
noted.
Physical exam notable for a 3/6 low frequency systolic
ejection murmur at the left sternal boarder
32. 3 day old born at full term presented for hypoxia. Initial
O2 saturations noted to be 75-80% however these
decreased to 65-70%
No murmurs noted on physical exam. PGE-1 was initiated
which resulted in improvement in O2 saturations.
33. 3 month old female presented with
abnormal prenatal echocardiogram.
Oxygen saturations reported to be in
the high 80s-low 90s. No reported
issues with feeding difficulties or
increased work of breathing, however
parents did note that the child
occasionally turns blue when she cries.
Physical exam notable for high pitched
grade 2-3/6 crescendo-decrescendo
systolic murmur at the mid to upper
left sternal border.
34. 1 day old male born at 37 + 6 weeks
gestational age via stat c-section for
fetal bradycardia presented for
respiratory distress. Initial APGARs 4
and 8. Immediately after birth the
patient was noted to be in respiratory
distress initially requiring PPV and
later requiring intubation. An
echocardiogram was obtained and the
patient was started on PGE-1
Physical exam notable for grade 2/6
harsh systolic ejection murmur at the
left upper sternal boarder.
35. 6 week old female who presented for abnormal prenatal
echocardiogram. O2 sats noted to be in the mid 80s since
birth. She has been steadily gaining weight and has had
no difficulty breathing, cyanosis, or sweating with feeds.
Physical exam notable for a 2/6 systolic ejection murmur
at the left upper sternal boarder
37. Tetralogy of Fallot
Symptoms vary depending on the degree of
right ventricular outflow obstruction. The
degree of right ventricular outflow tract
obstruction is progressive over time and
worsens with exertion.
• P – Pulmonary stenosis
• R – Right ventricular hypertrophy
• O – Overriding Aorta
• V – Ventricular Septal Defect
38. Tet Spells
• AKA Hypercyanotic spells
• These “spells” do not only occur in patients
with Tetralogy of Fallot. They can occur in any
cyanotic heart lesions with a VSD and
decreased pulmonary blood flow
• Spells occur due to decreased pulmonary blood
flow, which may be caused by either decreased
systemic vascular resistance or increased
pulmonary vascular resistance
• Remember that decreased afterload/preload leads
to decreased systemic vascular resistance and thus
these factors also contribute to “spells”
• Hypoxia increases pulmonary vascular
resistance, which then further perpetuates the
problem
https://pedemmorsels.com/hypercyanotic-spells/
39. Tet Spells
• Spells are often precipitated by:
• Crying
• Defecation
• Feeding
• Treatment of Spells
• Calm the child
• Knees to chest position to increase preload and
systemic vascular resistance
• Medications
• Oxygen – decreases PVR
• Analgesic – morphine, ketamine to decrease PVR
• Fluid – Improves preload
• Beta Blockers – Propranolol and esmolol are thought to
decrease infundibular obstruction as well as decreasing
heart rate leading to greater diastolic filling
• Phenylephrine – increases SVR. Avoid epinephrine and
isoproterenol as these decrease SVR
• Fever
• Dehydration
• Tachycardia
Increasing SVR and decreasing PVR
decreases the right to left shunting
which limits the flow of de-oxygenated
blood into systemic circulation.
https://pedemmorsels.com/hypercyanotic-spells/
Drawing depicts the pattern of blood flow (arrows) with
the characteristic ventricular septal defect (1),
infundibular pulmonary stenosis (2), overriding aorta
(3), and right ventricular hypertrophy (4). The oxygen-
rich blood in the left side of the heart (5) mixes with
oxygen-poor blood in the right side of the heart (6)
before it proceeds to the aorta (7).
40. Chest X-Ray Characteristics
• The heart has the shape of a wooden shoe or boot, which is due to uplifting of the cardiac apex because of right
ventricular hypertrophy and concavity of the main pulmonary artery
• The shadow of the pulmonary arterial trunk is almost invariably absent, and blood flow to the lungs is usually
reduced
• The right ventricular infundibulum often forms a slight bulge in the upper left heart border, while the middle left
heart border is usually concave
• Approximately 25% of those affected by tetralogy of Fallot have a right-sided aortic arch
• The most common imaging finding is an upturned cardiac apex. This deformity becomes more pronounced as the
right ventricular outflow tract obstruction becomes more severe
Ferguson E, Krishnamurthy R, Oldham S. Classic Imaging Signs of Congenital Cardiovascular Abnormalities. Radiographics 2007; 27: 1323-1334