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

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

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

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Coding in the Community

Coding in the Community

Coding patients in the community setting is difficult given constraints of man power, specialists, equipment, and other resources. Knowing how to code a patient well in the community is a skill all EM practitioners should master. In this post we review the priorities and pitfalls of coding in the community, with our guest Salim Rezaie.

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Feature Film(s) - Pediatric Point of Care Ultrasound in the Emergency Department

Feature Film(s) - Pediatric Point of Care Ultrasound in the Emergency Department

Dr. Rachel Rempell is a pediatric emergency medicine physician in Boston, Massachusetts and is affiliated with Boston Children's Hospital. She is board certified in pediatrics, pediatric emergency medicine and completed an ultrasound fellowship with a focus on pediatrics.  We were fortunate to have her as a guest speaker for our grand rounds where she gave us a tour of the current landscape of pediatric point of care ultrasound in emergency medicine. 

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