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: 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. 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. 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 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)
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 August 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, 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: 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. 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. 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 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)
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 August 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, 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. 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!
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. 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: 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. 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: 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. 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
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. 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
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.
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. 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
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
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
EMGuideWire's Radiology Reading Room: PneumoniaSean 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 Pneumonia and is brought to you by Elissabeth Hagler, MD and Tom Shuman, MD. Guest Editor is Michael Leonard, MD, Infectious Disease specialist.
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. 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.
EMGuideWire's Radiology Reading Room: COVID 19 Chest X-raysSean 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 Claire Milam, MD and Alyssa Thomas, MD. It has special guest editor, Infectious Disease Specialist, Catherine Passeretti, MD.
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. 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. 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 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!
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. 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: 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. 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: 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. 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
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. 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
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.
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. 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
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
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
EMGuideWire's Radiology Reading Room: PneumoniaSean 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 Pneumonia and is brought to you by Elissabeth Hagler, MD and Tom Shuman, MD. Guest Editor is Michael Leonard, MD, Infectious Disease specialist.
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. 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.
EMGuideWire's Radiology Reading Room: COVID 19 Chest X-raysSean 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 Claire Milam, MD and Alyssa Thomas, MD. It has special guest editor, Infectious Disease Specialist, Catherine Passeretti, MD.
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. 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. 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
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
Drs. Lorenzen and Barlock’s CMC X-Ray Mastery Project: October 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:
- Lobar Pneumonia
- Necrotizing Pneumonina
- PCP Pneumonia with Pneumatocele
- Pneumothorax
- Pleural Effusion
- Parapneumonic Effusion
- Aortic Transection
- Lung Mass
- ARDS
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)
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
Diagnostic imaging in COVID 19 pts in intensive care unitsmansoor masjedi
In the era of COVID19 , early diagnosis , ruling out other differential diagnosis , determination of its severity , monitoring the course of the disease , prediction of outcome and response to treatment are so important . CT scan and ultrasound could help physicians in this way . This presentation is part of an international webinar discussing this entity .
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
EMGuideWire's Radiology Reading Room: Spontaneous PneumothoraxSean 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 Spontaneous Pneumothorax and is brought to you by Elizabeth Olson, MD, and Janet Lorenz, NP.
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
Similar to Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery: May Cases (20)
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
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.
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
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
Drs. Penzler, Ricker, and Ahmad’s CMC Abdominal Imaging Mastery Project: June...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:
● Abdominal Wall Hematoma
● Walled Off Necrosis Of The Pancreas
● Acute Aortic Thrombosis
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.
This presentation provides an introduction to quantitative trait loci (QTL) analysis and marker-assisted selection (MAS) in plant breeding. The presentation begins by explaining the type of quantitative traits. The process of QTL analysis, including the use of molecular genetic markers and statistical methods, is discussed. Practical examples demonstrating the power of MAS are provided, such as its use in improving crop traits in plant breeding programs. Overall, this presentation offers a comprehensive overview of these important genomics-based approaches that are transforming modern agriculture.
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.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
CLASS 11 CBSE B.St Project AIDS TO TRADE - INSURANCE
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery: May 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
May 2020
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.
5. HPI: 3-year-old previously
healthy male presented with
respiratory distress in the
setting fever and cough.
Pulmonary exam showed tight
lungs, decreased movement to
bases and increased work of
breathing with diffuse
retractions and tachypnea.
6. HPI: 3-year-old previously
healthy male presented with
respiratory distress in the
setting fever and cough.
Pulmonary exam showed tight
lungs, decreased movement to
bases and increased work of
breathing with diffuse
retractions and tachypnea.
Pneumomediastinum
Dx: Pneumomediastinum due to
viral bronchiolitis
10. HPI: 4-year-old female
admitted for MRSA sepsis with
ARDS from hip septic arthritis
and osteomyelitis. Patient
intubated and on oscillator
with acute episode of
desaturation which persisted
despite bagging. Vital signs:
HR: 118
BP: 70/42
SpO2 on 100% FiO2: 61%
11. HPI: 4-year-old female
admitted for MRSA sepsis with
ARDS from hip septic arthritis
and osteomyelitis. Patient
intubated and on oscillator
with acute episode of
desaturation.
Mediastinal Shift
Left Sided Pneumothorax
Dx: Tension Pneumothorax
Deep Sulcus Sign
12. Spontaneous
Pneumothorax• Etiology:
• May be primary or secondary
• 94% occur in patients >10yrs old, 80% in males
• Presentation:
• Presentation is often delayed
• Most patients presents with acute onset chest pain or shortness of breath
• Activities which increase intrathoracic pressure increase symptoms
• Diagnosis:
• Ultrasound: ~90% sensitive (may be higher based on operator)
• Supine CXR: ~50% sensitive
• Erect CXR: has increased sensitivity (~90%)
• Management: 100% O2 therapy is recommended for PTX less than 15-20%
Dotson K, Timm N, Gittelman M. Is Spontaneous Pneumothorax Really a Pediatric Problem? A National Perspective. Pediatric Emer Care 2012; 28(4): 340-344.
Dotson K, Johnson LH. Pediatric Spontaneous Pneumothorax. Pediatric Emer Care 2012; 28(7): 715-723.
From: Pediatric EM
Morsels™
13. Spontaneous
Pneumothorax
Dotson K, Timm N, Gittelman M. Is Spontaneous Pneumothorax Really a Pediatric Problem? A National Perspective. Pediatric Emer Care 2012; 28(4): 340-344.
Dotson K, Johnson LH. Pediatric Spontaneous Pneumothorax. Pediatric Emer Care 2012; 28(7): 715-723.
Secondary Spontaneous Pneumothorax
Chronic Lung Pathology
Asthma
Cystic Fibrosis
Emphysema
Connective Tissue Disorder
Marfan Syndrome
Ehlers-Danlos Syndrome
Lupus
Infection
Malignancy
Foreign Body
Congenital Malformation
Catamenial (associated with menses)
From: Pediatric EM
Morsels™
14. HPI: 13-year-old previously
healthy female presented for
evaluation of intermittent
chest tightness x 1 month with
three days of cough.
Respiratory rate 22, SpO2 97%
on room air but speaking in 2-
3-word sentences
Dx: Spontaneous Pneumothorax
16. Patients spontaneous pneumothorax thought to be secondary to apical
blebs. Underwent bilateral apical blebectomy with mechanical
pleurodesis after recovery from her initial PTX
But that’s not the end of her
story….
17. Patient returned 2 years later
with shortness of breath and
cough without shortness of
breath. SpO2 100% on room air,
heart rate 109
Dx: Recurrent Pneumothorax
20. Patient returned from CT scan
and chest tube reconnected to
wall suction. Patient in no
respiratory distress and
endorsing improvement of her
shortness of breath.
Dx: Resolution of
Pneumothorax
21. Patient underwent R video assisted thoracoscopic surgery with
bulbectomy, pleurectomy and pleurodesis during this hospitalization.
But that’s not the end of her
story….
22. Patient returned 1 month later
with recurrent shortness of
breath and right sided chest
pain. Patient in no respiratory
distress. SpO2 100% on room
air with mild tachypnea and
tachycardia.
Dx: Recurrent Pneumothorax
23. Patient had another pigtail thoracostomy preformed and was admitted
for recurrent pneumothorax. She underwent talc pleurodesis and was
seen by genetics for evaluation for possible connective tissue disorder
given recurrent pneumothoraces.
But that’s not the end of her
story….
24. Patient returned 6 months later
after acute onset of L upper
back pain and shortness of
breath when bending over. She
was again noted to be mildly
tachycardic and tachypnea, but
breathing comfortably with
SpO2 100% on room air
Dx: Left Sided Pneumothorax
Given the patient was breathing
comfortably on room air without
vital sign abnormality she was
discharged home.
25. Patient returned 1 year later
with recurrent shortness of
breath and left sided chest
pain. Patient again in no
respiratory distress. SpO2 100%
on room air with mild
tachypnea and tachycardia.
Dx: Recurrent Left
Pneumothorax
26. Admitted for observation.
Repeat CXR 1 day later showed
increase in size of PTX and thus
she underwent thoracoscopy,
lysis of pleural adhesions,
apical blebectomy and creation
of pleural tent
Dx: Recurrent Left
Pneumothorax
27. Patient discharged in stable condition approximately 6 days after her
surgery.
But that’s not the end of her
story….
28. Patient represented 2 days
after discharge with recurrent
shortness of breath and left
sided chest pain. Again vital
signs stable other than mild
tachycardia.
Dx: Recurrent Left
Pneumothorax
29. Patient admitted to the surgical service for observation and underwent
tube thoracostomy for her recurrent L sided pneumothorax. Chest tube
removed on hospital day 3 and discharged home in stable condition
But that’s not the end of her
story….
30. Patient represented 1 month
later with left sided chest pain.
Vital signs all within normal
limits.
Dx: Recurrent Left
Pneumothorax
Last but not least…
31. Patient admitted to the surgical service for observation and underwent
repeat CXR with resolution of pneumothorax and discharge in stable
condition the next day
She continues to have no known etiology for her recurrent
pneumothoraces.
32. Recurrent PTX
• Recurrence rates in the pediatric population is estimated at
approximately 61%
• Management of recurrent PTX is controversial and often at the
discretion of the managing surgical service
• In a retrospective study of patients with primary spontaneous
pneumothorax, 92 patients required thoroscopic surgery1
• Surgical indications included failed non-operative management (32.7%),
recurrent ipsilateral PTX (36.4%)
• Bulla was identified in 91.8% of cases
• Authors concluded that early thoracoscopic mechanical pleurodesis and
stapled bullectomy after thoracostomy tube insertion could be offered as a
primary option for management of large PSP in pediatric population, since
most of these patients had bulla identified as the culprit of the disease.
• Another retrospective study analyzed the 36 patients admitted for
spontaneous pneumothorax2
• VATS was preformed in 14 of these patients for persistent air leak (57%) and
recurrent pneumothorax (43%)
• Patients undergoing surgery had longer hospitalizations, but lower recurrence
rates
• Authors concluded that VATS is successful, efficient, and safe method of
treatment for spontaneous pneumothorax, due to its significantly lower rate
of recurrence in comparison with chest tube insertion.
1. Yeung F, et al. “Surgical Intervention for Primary Spontaneous Pneumothorax in Pediatric Population: When and Why?”. Journal of Laparoendosc Adv Surg Tech 2017;27(8):841-844
2. Pogorelic Z, et al. “Management of the Pediatric Spontaneous Pneumothorax: The Role of Video Assisted Thoracoscopic Surgery. J Laparoendosc Adv Surg Tech 2020
33. HPI: 2-month-old previously
healthy male presented to the
emergency department in
respiratory distress. Noted to
have increased work of
breathing with hypoxia,
requiring 10L by HFNC to
maintain oxygen saturations
Rightward shift of mediastinal
structures
Extensive left sided airspace
opacity
Dx: Consolidation vs atelectasis
vs large pleural effusion
34. What can we use in this unstable patient to further classify the airspace
opacity?
Ultrasound!!!
35. HPI: 2-month-old previously healthy male presented to the
emergency department in respiratory distress with left sided
consolidation on CXR. Ultrasound used to further differentiate.
Spleen
Diaphragm
Lung tissue
floating in fluid
Dx: Pleural Effusion
36. HPI: 2-month-old previously
healthy male presented to the
emergency department in
respiratory distress. Noted to
have a large left pleural
effusion. Chest tube placed
with exudative pleural effusion.
Patchy consolidation on L with
resolution of L pleural effusion
Dx: Parapneumonic effusion
37. Pediatric Chest Tube Recommendations
• Consider what is it you have to drain
• Acute blood or air can easily be drained with a pigtail
catheter
• If it is expected to be viscous, you may need a small
caliber thoracostomy tube, however Chien-Heng found no
difference between drainage and hospitalization days
when using a pigtail catheter versus thoracostomy tube
for drainage of parapneumonic effusion1
• Be nice – anesthetize and sedate if needed
• Be safe – Use a flexible tipped guidewire and US for
guidance
• Aim high – above 6th intercostal space
1. Lin, Chien-Heng, et al. “Comparison of Pigtail Catheter with Chest Tube for
Drainage of Parapneumonic Effusion in Children.” Pediatrics and
Neonatology, U.S. National Library of Medicine, Dec. 2011,
www.ncbi.nlm.nih.gov/pubmed/22192262.
Pediatric EM Morsles – PigTail Catheter
38. HPI: 11-month-old previously
healthy female presented with
respiratory distress in the
setting of RSV bronchiolitis
progressive to septic shock,
ARDS and pulmonary
hemorrhage. CXR upon
admission to our facility.
39. HPI: 11-month-old previously
healthy female presented with
respiratory distress in the
setting of RSV bronchiolitis
progressive to septic shock,
ARDS and pulmonary
hemorrhage. CXR upon
admission to our facility.
RUL opacification consistent
with pulmonary hemorrhage
Extensive bilateral ground glass
opacities
Small, bilateral pleural effusions
40. Patient developed worsening
respiratory distress with SpO2
in the 80s while on 100% FiO2
with hypotension requiring
pressor support and decision
was made to proceed with
ECMO. CXR obtained at the
time of ECMO cannulation.
Extensive bilateral pulmonary
opacities
42. Pediatric ARDS: Management Basics
Cheifetz, IM. “Pediatric ARDS”. Resp Care. 2017;62(6):718-731
• Tidal Volume:
• 3– 6 mL/kg predicted body weight for patients with poor respiratory system compliance
• 5–8 mL/kg ideal body weight (physiologic range) for patients with better preserved respiratory
compliance
• Plateau Pressure: 28 cm H2O, allowing for slightly higher plateau pressures (29 –32 cm
H2O) for patients with increased chest wall elastance
• PEEP: Titrate to avoid alveolar collapse at end expiration
• moderately elevated levels of PEEP (10 – 15 cm H2O) should be titrated in patients with severe
PARDS to the observed oxygenation and hemodynamic response
• PEEP levels > 15 cm H2O may be needed for severe PARDS with attention paid to limiting the
peak airway pressure
• Recruitment Strategies: No convincing data. Recommend Careful recruitment
maneuvers by slow, incremental and decremental PEEP steps in an attempt to improve
severe oxygenation failure
• Gas Exchange
• Permissive hypoxemia
• Mild PARDS with PEEP <10 cm H2O, the SpO2 goal should generally be 92–97%.
• Severe PARDS with PEEP >10 cm H2O, SpO2 of 88 –92% “should be considered” after PEEP has been
optimized with recommendation to monitor central venous saturation when SpO2 <92%
• Permissive hypercapnia with goal pH 7.15 – 7.30
43. Pediatric ARDS: Management with HFOV
1. Cheifetz, IM. “Pediatric ARDS”. Resp Care. 2017;62(6):718-731
2. Young D, Lamb SE, Shah S, MacKenzie I, Tunnicliffe W, Lall R, et al. High-frequency oscillation for acute respiratory distress syndrome. N Engl J Med 2013;368(9):806-813
3. Ferguson ND, Cook DJ, Guyatt GH, Mehta S, Hand L, Austin P, et al. High-frequency oscillation in early acute respiratory distress syndrome. N Engl J Med 2013;368(9):795-805
4. Bateman ST, Borasino S, Asaro LA, Cheifetz IM, Diane S, Wypij D, Curley MAQ, RESTORE Study Investigators. Early high frequency oscillatory ventilation in pediatric acute respiratory failure: a propensity score analysis. Am J Respir
Crit Care Med 2016;193(5):495-503
• High-Frequency Oscillatory Ventilation (HFOV) theoretically provides a
lung-protective ventilation strategy by preventing atelectrauma and
maintaining airway recruitment via a constant applied airway pressure
and preventing volutrauma by avoiding alveolar overdistention via the
delivery of VT less than anatomic dead space
• Two adult RCTs have evaluated the differences between HFOV and lung-
protective conventional ventilation in adults with early moderate to
severe ARDS.
• OSCAR: no significant difference in all cause 30d mortality and in-hospital
mortality between HFOV and control group2
• OSCILLATE studied early use of HFOV in patients with high initial mean airway
pressure to promote lung recruitment and found an increase in mortality with
HFOV as compared with the lung-protective conventional group3
• There are no pediatric RCTs
• Bateman et al published a secondary propensity score analysis of the
353 subjects enrolled in the RESTORE study who were managed with
HFOV and found early application of HFOV was associated with
significantly longer duration of mechanical ventilation and greater use
of sedation and pharmacologic paralysis, but no mortality association
was note4
• Recommendation: HFOV should be considered as an alternative
ventilatory mode for those patients with moderate-to-severe PARDS in
whom plateau airway pressures exceed 28 cm H2O in the absence of
clinical evidence of reduced chest-wall compliance
44. Pediatric ARDS: Adjunct Treatments
Cheifetz, IM. “Pediatric ARDS”. Resp Care. 2017;62(6):718-731
• Other adjunctive treatments which may be considered
in select patient populations but whose routine use is
not recommended include:
• Corticosteroids
• iNO
• Prone positioning
• Exogenous surfactant
• Neuromuscular blockage
45. HPI: 11-year-old previously
healthy male presented to the
emergency department for
evaluation of L hip septic
arthritis. Patient was taken to
the OR by orthopedics.
Postoperatively he was noted
to be progressively more
hypotensive. CXR obtained:
46. HPI: 11-year-old previously
healthy male presented to the
emergency department for
evaluation of L hip septic
arthritis. Patient was taken to
the OR by orthopedics.
Postoperatively he was noted
to be progressively more
hypotensive.
Bilateral nodular patchy airspace
opacities
48. To further narrow down the
differential, CT obtained
Dx: Septic Pulmonary Emboli
Extensive nodular, peribronchial
airspace opacities throughout
both lungs, some of which
demonstrate central cavitation
49. HPI: 4-year-old previously
healthy female presented to
the Emergency Department for
evaluation of five days of fever,
cough, nausea/vomiting.
Vital signs:
HR 170s
BP: 120/63
RR: 55
SpO2: 91%
50. HPI: 4-year-old previously
healthy female presented to
the Emergency Department for
evaluation of five days of fever,
cough, nausea/vomiting
Bilateral patchy airspace
opacities
Dx: ARDS
51. HPI: 6-month-old ex 25wk
premie with chronic lung
disease of prematurity
presented to the Emergency
Department for evaluation of
cough and increasing oxygen
requirements after
hospitalization 2 weeks prior
for viral URI. Vital signs:
HR 180s
BP: 115/89
RR: 52
SpO2: 98% on 0.25L
(on 0.15L at home)
52. HPI: 6-month-old ex 25wk
premie presented to the
Emergency Department for
evaluation of cough and
increasing oxygen
requirements
Bilateral perihilar patchy
airspace opacities
RUL Consolidation
Dx: Viral bronchiolitis with
superimposed RUL PNA
53. Unfortunately, the patient
became progressively more
hypoxic with increased work of
breathing despite significant
HFNC support and the decision
was made to proceed with
intubation. Post intubation CXR
ETT terminates 8mm below
carina
Dx: R Mainstem Intubation
Left lobe atelectasis
54. HPI: 3-year-old male with no
significant past medical history
presented to the emergency
department for evaluation of
GSW to the neck. Vital signs:
HR 180s
BP: 60/40
RR: 22
GCS: 7-8
55. HPI: 3-year-old male with no
significant past medical history
presented to the emergency
department for evaluation of
GSW to the neck. Vital signs:
HR 180s
BP: 60/40
RR: 22
GCS: 7-8
56. HPI: 3-year-old male with no
significant past medical history
presented to the emergency
department for evaluation of
GSW to the neck. Vital signs:
HR 180s
BP: 60/40
RR: 22
GCS: 7-8
Dx: GSW to right chest with
resultant rib fractures and
pulmonary hemorrhage
Right 1st and 2nd posterior rib
fractures
RUL consolidation consistent
with pulmonary hemorrhage
57. Summary Of This Month’s Diagnoses
• Recurrent pneumothorax
• Parapneumonic effusion
• Pediatric ARDS
• Septic pulmonary emboli
• RUL pneumonia
• GSW with pulmonary hemorrhage