May 2023: Symptom: Shortness of Breath Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less Christine Butts, MD, cared for a 45-year-old woman who presented with shortness of breath and tachycardia, but her exam was unremarkable. What does this apical four-chamber view reveal about her diagnosis? Watch the video, and read more in her column this month at http://bit.ly/SpeedSound. Play Favorite
April 2023: Symptoms: Anterior Abdominal Wall Pain and Swelling Video 2 Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less This patient who Christine Butts, MD, treated had an area of erythema with moderate induration and tenderness on palpation, but no fluctuance. Watch this video to see another view of the affected area with multiple locules of air within the deeper muscular layers of the abdominal wall. Read more in her column this month at http://bit.ly/SpeedSound. Play Favorite
April 2023: Symptoms: Anterior Abdominal Wall Pain and Swelling Video 1 Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less Christine Butts, MD, cared for a 35-year-old man with pain and swelling to his anterior abdominal wall. Watch this video to see the ultrasound findings: thickened subcutaneous tissue with loss of normal architecture, and read more in her column this month at http://bit.ly/SpeedSound. Play Favorite
March 2023: Chest and Back Pain and Confusion Creator: Christine Butts, MD Duration: 0:01 Emergency Medicine News Show More Show Less Christine Butts, MD, cared for a patient who had been in a motor vehicle collision and was experiencing pain and confusion. A FAST exam was performed, and a parasternal long axis image of the heart showed the injury in this video: http://bit.ly/VideosSound. Read more in her column this month at http://bit.ly/SpeedSound. Play Favorite
February 2023: A Modest Aortic Dissection Proposal: More Ultrasound is Better Creator: Duration: 0:04 Emergency Medicine News Show More Show Less Huafu Chen, MD; Sahrish Ekram, MD; Joseph S. Colla, MD; & Christopher Parker, DO, advocate for using more ultrasonographic views to diagnose rare but deadly conditions, such as acute aortic dissection. This video demonstrates an ultrasound-guided central venous catheter procedure showing an incidental finding of right common carotid artery dissection. Read more in their article at https://bit.ly/Feb28EMNenews. Play Favorite
February 2023: A Modest Aortic Dissection Proposal: More Ultrasound is Better Creator: Duration: 0:03 Emergency Medicine News Show More Show Less Huafu Chen, MD; Sahrish Ekram, MD; Joseph S. Colla, MD; & Christopher Parker, DO, advocate for using more ultrasonographic views to diagnose rare but deadly conditions, such as acute aortic dissection. This video demonstrates a bedside ultrasound of the aortic arch showing Stanford type A dissection using the suprasternal view. Read more in their article at https://bit.ly/Feb28EMNenews. Play Favorite
January 2023: Always Look for the Rib Shadow Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less Christine Butts, MD, teaches you how to use ultrasound to diagnose a large amount of subcutaneous air. Watch these videos and read more in her column at http://bit.ly/SpeedSound. Play Favorite
January 2023: Always Look for the Rib Shadow Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less Christine Butts, MD, teaches you how to use ultrasound to diagnose a large amount of subcutaneous air. Watch these videos and read more in her column at http://bit.ly/SpeedSound. Play Favorite
August 2022: The Speed of Sound: The WES Sign Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less Christine Butts, MD, shows a cross-section of the gallbladder that demonstrates the WES sign in this video. Read more in her column at http://bit.ly/SpeedSound. Play Favorite
July 2022: The Speed of Sound: A Supraclavicular-Infraclavicular Subclavian Showdown Creator: Christine Butts, MD Duration: 0:09 Emergency Medicine News Show More Show Less Christine Butts, MD, demonstrates the in-plane (long-axis) visualization of a needle entering the subclavian vein in the supraclavicular approach. Read more in her column at http://bit.ly/SpeedSound Play Favorite
June 2022: The Speed of Sound: Hip Fracture Nerve Blocks Are Simple with Ultrasound Creator: Christine Butts, MD Duration: 0:07 Emergency Medicine News Show More Show Less Hip fracture pain management can be challenging, often requiring large doses of narcotics, which can be a problem in older patients. If you’ve been reluctant to try nerve blocks for hip fractures, ultrasound can help. Watch this video of the target area, where the femoral artery and vein are seen initially, but moving the transducer laterally reveals the femoral nerve and iliacus muscle. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
May 2022: The Speed of Sound: Making an Endocarditis Diagnosis in Opioid Users Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less A 25-year-old woman who used heroin presented with a fever and malaise that she had had for a week (COVID negative). Endocarditis is on the rise from opioid use, and this video demonstrates right ventricular inflow view with a mobile vegetation on the tricuspid valve that can be helpful in diagnosing it. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
March 2022: The Speed of Sound: Diagnosing Asteroid Hyalosis Video 2 Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Show More Show Less A 55-year-old man presented with a complaint of right eye pain after he struck his head on a doorway. Ultrasound demonstrated this uncommon condition that EPs should consider to avoid misdiagnosis. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
March 2022: The Speed of Sound: Diagnosing Asteroid Hyalosi Video 1 Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less A 55-year-old man presented with a complaint of right eye pain after he struck his head on a doorway. Ultrasound demonstrated this uncommon condition that EPs should consider to avoid misdiagnosis. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
November 2021: The Speed of Sound: How to Assess Volume Status with VExUS Creator: Christine Butts, MD Duration: 0:15 Emergency Medicine News Show More Show Less Dr. Butts explains how a handful of ultrasound measurements can estimate the degree of venous congestion at the organ level. This video shows how the hepatic veins can sometimes be found from the position used to examine the IVC. If they are not seen in this view, they can also often be found from a right flank approach. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
July 2021, Video 2: The Speed of Sound: Diagnosing COVID-19 with Ultrasound Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less This video shows a patient with interstitial syndrome and COVID-19 pneumonia. Note the presence of B-lines that seem to appear and disappear, consistent with patchy areas of involvement. Also note the irregular pleural line, caused by subpleural consolidations. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
July 2021, Video 1: The Speed of Sound: Diagnosing COVID-19 with Ultrasound Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less This video shows a normal air-filled lung. Contrast it with video 2, which shows interstitial syndrome and COVID-19 pneumonia. Note in this one how the A-lines are visible as the lung slides back and forth. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
June 2021, Video 1: The Speed of Sound: Pneumothorax: Ultrasound Makes the Diagnosis Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less This video demonstrates the “slide sign” in which the visceral and parietal pleural layers slide past each other. Christine Butts, MD, says also note the comet tails, the short vertical lines emanating from the pleural layers that appear and disappear with movement. Read more in her column at http://bit.ly/SpeedSound. Play Favorite
June 2021, Video 2: The Speed of Sound: Pneumothorax: Ultrasound Makes the Diagnosis Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Show More Show Less This video shows a lack of sliding, says Christine Butts, MD. Note also the absence of comet tails because the visceral pleura is not visible here. Read more in her column at http://bit.ly/SpeedSound. Play Favorite
June 2021, Video 3: The Speed of Sound: Pneumothorax: Ultrasound Makes the Diagnosis Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Show More Show Less his video shows a lung point, the transition between normal lung sliding and pneumothorax. Christine Butts, MD, says note the sliding motion on the left of the image and the lack of sliding on the right. Read more in her column at http://bit.ly/SpeedSound. Play Favorite
March 2021: The Speed of Sound: A Telltale Wink Identifies Acute PE Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Show More Show Less This video shows the apical four-chamber view where the RV and LV are the same size. But Christine Butts, MD, and Shawn Sethi, DO, say the RV should be no larger than two-thirds the size of the LV, and the arrow indicates the area in which McConnell’s sign occurs. Read more in their column at http://bit.ly/SpeedSound. Play Favorite
February 2021: Speed of Sound: Rethink Probe Position to Find Occult Pneumothoraces-Video 1 of 3 Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less Christine Butts, MD, says a high-frequency transducer is typically used to evaluate the pleura when looking for a pneumothorax. When the visceral and parietal pleura are in contact, they can be seen to slide against each other as the patient breathes in and out, as seen in this video showing lung sliding in the absence of a pneumothorax. Note the rib, with shadowing on the left of the image. Read more in her column at http://bit.ly/SpeedSound. Play Favorite
February 2021: Speed of Sound: Rethink Probe Position to Find Occult Pneumothoraces-Video 2 of 3 Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Show More Show Less Christine Butts, MD, says when air is present between the visceral and parietal pleura, as in a pneumothorax, the visceral pleura is obscured by the air, and only the static, nonsliding parietal pleura is seen. Read more in her column at http://bit.ly/SpeedSound. Play Favorite
February 2021: Speed of Sound: Rethink Probe Position to Find Occult Pneumothoraces-Video 3 of 3 Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Show More Show Less Christine Butts, MD, says the finding of a lung point, or the point at which the parietal and visceral pleural layers come back together (and the pneumothorax stops), can be demonstrated to confirm further that the lack of sliding is caused by a pneumothorax, not another process. Note the sliding on the left side of the image, which disappears on the right. Read more in her column at http://bit.ly/SpeedSound. Play Favorite
November 2020: Speed of Sound: Confirming that Shoulder Relocation ‘Clunk’ Creator: Christine Butts, MD Duration: 0:05 Emergency Medicine News Show More Show Less Christine Butts, MD, says almost nothing is more satisfying than that “clunk” as the humeral head pops back into place and your follow-up x-ray shows that all is right with the world. Watch this video of a normal shoulder joint in motion with ultrasound where you can see the normal position of the humeral head within the glenoid and the motion when internally and externally rotating the arm. Then read more in her column at http://bit.ly/SpeedSound. Play Favorite
October 2020, Video 1 of 2: Speed of Sound: #Echofirst Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Show More Show Less Christine Butts, MD, says always put #echofirst to make the right diagnosis. Judge the cardiac function for yourself in this video of the parasternal long axis view of the heart at normal speed, and read more in her column at http://bit.ly/SpeedSound. Play Favorite
October 2020, Video 2 of 2: Speed of Sound: #Echofirst Creator: Christine Butts, MD Duration: 0:07 Emergency Medicine News Show More Show Less hristine Butts, MD, says always put #echofirst to make the right diagnosis. Judge the cardiac function for yourself in this video of parasternal long axis view of the heart at half speed. Look closely at the left ventricle; does the myocardium thicken in systole and does the chamber size decrease by a third? Read more in her column at http://bit.ly/SpeedSound. Play Favorite
August 2020, Video 1: Speed of Sound: Tracing COVID-19 by ‘Light Beams’ in the Lungs Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less Christine Butts, MD, writes this month about using ultrasound to diagnose COVID-19, noting that the A lines in this video indicate a normally aerated lung. Compare it with video 2, and read more in her column at http://bit.ly/SpeedSound. Play Favorite
August 2020, Video 2: Speed of Sound: Tracing COVID-19 by ‘Light Beams’ in the Lungs Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less Christine Butts, MD, demonstrates the “light beam” effect, where the B lines appear and disappear, which can help diagnose COVID-19. Read more in her column at http://bit.ly/SpeedSound. Play Favorite
July 2020, Video 1: Speed of Sound: Upper-Extremity Vein Ultrasound Is Easier than You Think Creator: Christine Butts, MD Duration: 0:10 Emergency Medicine News Show More Show Less Christine Butts, MD, notes that upper-extremity ultrasounds are not commonly ordered, but is easy to perform at the bedside. In this video, she demonstrates tracing the internal jugular to the subclavian vein. Read more in her column at http://bit.ly/SpeedSound. Play Favorite
July 2020, Video 2: Speed of Sound: Upper-Extremity Vein Ultrasound Is Easier than You Think Creator: Christine Butts, MD Duration: 0:03 Emergency Medicine News Show More Show Less Christine Butts, MD, notes that upper-extremity ultrasounds are not commonly ordered, but are easy to perform at the bedside. In this video, she shows the cephalic vein branching off the subclavian vein on the left side of the image with the subclavian artery on the right. Read more in her column at http://bit.ly/SpeedSound. Play Favorite
July 2020, Video 3: Speed of Sound: Upper-Extremity Vein Ultrasound Is Easier than You Think Creator: Christine Butts, MD Duration: 0:26 Emergency Medicine News Show More Show Less Christine Butts, MD, notes that upper-extremity ultrasounds are not commonly ordered, but are easy to perform at the bedside In this video, she traces the basilic vein (begins in the middle of the image and transitions toward the left) as it travels proximally. The brachial vein can be seen on the right of the image to wrap around the brachial artery before joining the basilic vein at the end of the video. Read more in her column at http://bit.ly/SpeedSound. Play Favorite
June 2020, Video 1: Speed of Sound: Ultrasound a Potential Tool for Detecting COVID-19 Creator: Christine Butts, MD Duration: 0:03 Emergency Medicine News Show More Show Less Christine Butts, MD, writes that many diagnostic tools EPs typically rely on are not practical due to the risk of contamination and the high volume of patients. Instead, turn to ultrasound, which can help diagnose lung and heart findings. This video shows a low-frequency image of normal, air-filled lungs. The pleural line is seen just deep to the rib. Note the repeating horizontal lines, which are A lines. Read more in her column at http://bit.ly/SpeedSound, and watch this video. Play Favorite
June 2020, Video 2: Speed of Sound: Ultrasound a Potential Tool for Detecting COVID-19 Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Show More Show Less Christine Butts, MD, writes that many diagnostic tools EPs typically rely on are not practical due to the risk of contamination and the high volume of patients. Instead, turn to ultrasound, which can help diagnose lung and heart findings. This video shows a low-frequency image of the lungs demonstrating thick, confluent B lines deep to the ribs. Note the more irregular appearance of the pleura. Read more in her column at http://bit.ly/SpeedSound, and watch this video. Play Favorite
June 2020, Video 3: Speed of Sound: Ultrasound a Potential Tool for Detecting COVID-19 Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less Christine Butts, MD, writes that many diagnostic tools EPs typically rely on are not practical due to the risk of contamination and the high volume of patients. Instead, turn to ultrasound, which can help diagnose lung and heart findings. This video shows a high-frequency image of a subpleural consolidation. Note the interruption to the solid pleural line and an irregular hypoechoic area. Read more in her column at http://bit.ly/SpeedSound, and watch this video. Play Favorite
May 2020: Speed of Sound: An Indicator of PE Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less Christine Butts, MD, says a small LV shows promise as an indicator of PE during pulse checks in cardiac arrest. Read more in her column at http://bit.ly/SpeedSound, and watch this video taken just after initial ROSC, and note that the contraction overall appears disorganized and irregular. Play Favorite
February 2020: Speed of Sound: Can Early Systolic Notching Diagnose PE? Creator: Christine Butts, MD Duration: 0:05 Emergency Medicine News Show More Show Less Christine Butts, MD, looks at the pros and cons of early systolic notching to rule in or out massive or submassive PE at the bedside. Read more in her column at http://bit.ly/SpeedSound, and watch this video to see a parasternal short axis view of the base of the heart. Play Favorite
Speed of Sound: POCUS Is Not a Magic Bullet - Video 1 Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Show More Show Less Christine Butts, MD, says POCUS is meant to augment clinical decision-making, not be a treatment in and of itself. The history, exam, and most importantly, clinical judgment are the bedrock of caring for patients. A case in point in these videos: Assessing for RV enlargement and pericardial fluid. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound, and watch these videos to see. Play Favorite
Speed of Sound: POCUS Is Not a Magic Bullet - Video 2 Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Show More Show Less Christine Butts, MD, says POCUS is meant to augment clinical decision-making, not be a treatment in and of itself. The history, exam, and most importantly, clinical judgment are the bedrock of caring for patients. A case in point in these videos: Assessing for RV enlargement and pericardial fluid. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound, and watch these videos to see. Play Favorite
Speed of Sound: A Good Starting Point to Assess for RV Enlargement and Pericardial Fluid Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Show More Show Less Christine Butts, MD, says the subxiphoid view of the heart gets a lot of love from scanning protocols such as the FAST exam, but a good parasternal long axis view can also yield a large amount of helpful info in just a few seconds. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound, and watch this video to see her perform the ultrasound. Play Favorite
Speed of Sound: Diagnosing Endocarditis, Video 1 of 2 Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Show More Show Less Christine Butts, MD, explains how to diagnose endocarditis with ultrasound. The parasternal long axis view demonstrating mitral regurgitation (blue jet in left atrium) demonstrates mobile vegetation on the anterior leaflet in this video. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
Speed of Sound: Diagnosing Endocarditis, Video 2 of 2 Creator: Christine Butts, MD Duration: 0:02 Emergency Medicine News Show More Show Less Christine Butts, MD, explains how to diagnose endocarditis with ultrasound. This video shows the right ventricular inflow view with the left ventricle seen to the left with right atrium, ventricle, and tricuspid valve on the right. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
Speed of Sound: Vaginal Bleeding in Early Pregnancy, Video 1 of 2 Creator: Christine Butts, MD Duration: 0:02 Emergency Medicine News Show More Show Less Christine Butts, MD, asks you to diagnose a pregnant woman with vaginal bleeding and cramping using ultrasound. This video gives a hint about what is going on. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
Speed of Sound: Vaginal Bleeding in Early Pregnancy, Video 2 of 2 Creator: Christine Butts, MD Duration: 0:02 Emergency Medicine News Show More Show Less Christine Butts, MD, asks you to diagnose a pregnant woman with vaginal bleeding and cramping using ultrasound. A video of that test reveals a clue to the diagnosis. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
Speed of Sound, The FAST Files: Location Matters in Pericardial Effusions, Video 1 of 2 Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Show More Show Less Christine Butts, MD, opens her FAST Files again to show how important location is in diagnosing pericardial effusions. This video shows the subxiphoid view and how nothing appears between the liver and heart. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
Speed of Sound, The FAST Files: Location Matters in Pericardial Effusions, Video 2 of 2 Creator: Christine Butts, MD Duration: 0:14 Emergency Medicine News Show More Show Less Christine Butts, MD, opens her FAST Files again to show how important location is in diagnosing pericardial effusions. This video shows a hypoechoic area between the heart and pericardium, an important clue. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
Speed of Sound, Ultrasound Beats Other Imaging in Diagnosing Pneumonia, Video 2 of 2 Creator: Christine Butts, MD Duration: 0:03 Emergency Medicine News Show More Show Less Christine Butts, MD, notes that chest x-rays are known to have significant deficiencies in diagnosing pneumonia because the radiographic appearance of infection lags behind the onset of symptoms, sometimes by several days. The answer? Ultrasound, of course! Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
Speed of Sound, Ultrasound Beats Other Imaging in Diagnosing Pneumonia, Video 1 of 2 Creator: Christine Butts, MD Duration: 0:03 Emergency Medicine News Show More Show Less Christine Butts, MD, says why wonder when you can know? No need to speculate about a diagnosis when you can know for sure with ultrasound. A case in point: Ultrasound is better than chest c-rays for diagnosing pneumonia. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
Speed of Sound, The FAST Files: The Signs of Injury You Don’t Expect, Video 3 of 3 Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less This video from Christine Butts, MD, shows the sagittal view of the right upper quadrant. The liver is seen on the left of the image, with a hypoechoic area (C) in the hepatorenal space. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
Speed of Sound, The FAST Files: The Signs of Injury You Don’t Expect, Video 2 of 3 Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less This video from Christine Butts, MD, shows the transverse view of the pelvis. The bladder is seen anteriorly as a well-defined anechoic area, with a circular, hypoechoic, complex collection deep to it. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
Speed of Sound, The FAST Files: The Signs of Injury You Don’t Expect, Video 1 of 3 Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less Christine Butts, MD, has reviewed more than 9,000 ultrasound scans in her career and has seen many interesting cases, a lot of great diagnoses, and several significant mistakes in that time. Most of them were a result of misinterpretation of the images on screen, and these videos offer great ultrasound pearls. This video shows the sagittal view of the pelvis. The bladder is seen on the left, with a large complex collection extending to the right. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
Speed of Sound, In Defense of the IVC, Video 2 Creator: Christine Butts, MD Duration: 0:05 Emergency Medicine News Show More Show Less Christine Butts, MD, notes that the IVC can show fluid status. This video shows the same IVC seen in Video 1 after a fluid bolus. Note that it has increased in size. Watch this video of the IVC before the patient received hydrations, and read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
Speed of Sound, In Defense of the IVC, Video 1 Creator: Christine Butts, MD Duration: 0:05 Emergency Medicine News Show More Show Less Ultrasound assessment of the IVC has fallen out of favor, but Christine Butts, MD, said it’s not time to give up on the IVC. Watch this video of the IVC in almost full collapse during respiration before the patient received hydration, and read more in Dr. Butts’ column at http://bit.ly/SpeedSound. Play Favorite
The Speed of Sound-March 2017: A New Measure to Single Out High-Risk PE Patients Creator: Christine Butts, MD Duration: 0:02 Emergency Medicine News Show More Show Less Read Dr. Christine Butts’ article, “A New Measure to Single Out High-Risk PE Patients,” in the March 2017 issue, and then watch this video that shows step 1 of the TAPSE measurement. Play Favorite
The Speed of Sound - March 2017: A New Measure to Single Out High-Risk PE Patients Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Show More Show Less Read Dr. Christine Butts’ article, “A New Measure to Single Out High-Risk PE Patients,” in the March 2017 issue, and then watch this video that shows step 2 of the TAPSE measurement. Play Favorite
The Speed of Sound: Assessing Tendons Creator: Christine Butts, MD Duration: 0:01 Emergency Medicine News Show More Show Less Dr. Christine Butts provides tips and tricks for assessing tendons using ultrasound, as shown in this video of anisotropy. Read her May 2016 column at http://emn.online/SoundEMN, and then watch this video. Play Favorite
The Speed of Sound-May 2015: Creator: Christine Butts, MD Duration: 0:05 Emergency Medicine News Show More Show Less Read Dr. Christine Butts’ article, “Ultrasound Critical in Saving Patient with Aortic Dissection,” in the May 2015 issue, and then watch this video that shows a transverse image of the aorta, seen just superficial to the vertebral body on the patient's left. An intimal flap can be seen as a hyperechoic lucency within the lumen of the aorta. Play Favorite
The Speed of Sound-May 2015: Creator: Christine Butts, MD Duration: 0:05 Emergency Medicine News Show More Show Less Read Dr. Christine Butts’ article, “Ultrasound Critical in Saving Patient with Aortic Dissection,” in the May 2015 issue, and then watch this video that shows an intimal flap vacillating with each heartbeat within the lumen of the aorta. Play Favorite
The Speed of Sound-July 2014: RADiUS to the Rescue for Patients with SOB Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Show More Show Less Read Dr. Christine Butts’ article, “RADiUS to the Rescue for Patients with SOB,” in the July issue, and then watch this video that shows that the patient has normal lung sliding bilaterally, ruling out a pneumothorax. Play Favorite
The Speed of Sound-July 2014: RADiUS to the Rescue for Patients with SOB Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less Read Dr. Christine Butts’ article, “RADiUS to the Rescue for Patients with SOB,” in the July issue, and then watch this video that shows that the patient’s IVC is enlarged, changing little with respiration. These findings correlate with an elevated central venous pressure. Play Favorite
The Speed of Sound-July 2014: RADiUS to the Rescue for Patients with SOB Creator: Christine Butts, MD Duration: 0:03 Emergency Medicine News Show More Show Less Read Dr. Christine Butts’ article, “RADiUS to the Rescue for Patients with SOB,” in the July issue, and then watch this video that shows that the patient’s overall left ventricular function is severely decreased. Play Favorite
Lack of Lung Sliding with Pneumothorax Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Show More Show Less Read Dr. Butts’ article, “Comet Tails and Lung Sliding: Evaluating for Pneumothorax,” in the December 2013 issue, and then view this video that demonstrates lack of lung sliding associated with a pneumothorax. A rib is seen to the right of the image as the structure casting a large shadow. Just beneath the rib, the pleura is seen as a hyperechoic horizontal line. Careful observation reveals that the pleura is not sliding nor are comet tails visible. Play Favorite
Normal Lung Sliding Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Show More Show Less Read Dr. Butts’ article, “Comet Tails and Lung Sliding: Evaluating for Pneumothorax,” in the December 2013 issue, and then view this video that demonstrates a normal “sliding” motion of the pleura back and forth. Comet tail artifacts are also seen to appear and disappear, emanating from the pleural border. The combination of the presence of sliding and comet tail artifacts virtually excludes a pneumothorax. Play Favorite
Confirming ET Tube Placement with Ultrasound Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Show More Show Less An indirect method for assessing proper placement of the ET tube is to watch the pleura for the presence of the slide sign. The pleura are easily identified from the anterior chest wall utilizing the high-frequency transducer. The transducer should be placed just inferior to the clavicle in the mid-clavicular line. Pointing the indicator toward the patient’s head will produce an image that is easy to interpret. Once the skin, soft tissue, and ribs have been identified, the pleura will be seen as a hyperechoic (white) line running just deep to the rib. In real time, the pleura slide back and forth with respiration. Play Favorite
The Speed of Sound-March 2013: RADiUS Video 1 Creator: Christine Butts, MD Duration: 0:06 Emergency Medicine News Emergency Medicine News. 36(3):6, March 2014 Show More Show Less Read Dr. Butts’ article, “The RADiUS Focused Cardiac Exam,” in the Breaking News blog, and then view this video that shows the subxiphoid view of a pericardial effusion demonstrating mass effect on the right ventricle (RV). Play Favorite
The Speed of Sound-March 2013: RADiUS Video 2 Creator: Christine Butts, MD Duration: 0:02 Emergency Medicine News Emergency Medicine News. 36(3):6, March 2014 Show More Show Less Read Dr. Butts’ article, “The RADiUS Focused Cardiac Exam,” in the Breaking News blog, and then view this video that shows parasternal long axis image demonstrating normal contractility. Play Favorite
The Speed of Sound-March 2013: RADiUS Video 3 Creator: Christine Butts, MD Duration: 0:04 Emergency Medicine News Emergency Medicine News. 36(3):6, March 2014 Show More Show Less Read Dr. Butts’ article, “The RADiUS Focused Cardiac Exam,” in the Breaking News blog, and then view this video that shows parasternal long axis image demonstrating severely decreased contractility. Play Favorite
The Speed of Sound-March 2013: RADiUS Video 4 Creator: Christine Butts, MD Duration: 0:03 Emergency Medicine News Emergency Medicine News. 36(3):6, March 2014 Show More Show Less Read Dr. Butts’ article, “The RADiUS Focused Cardiac Exam,” in the Breaking News blog, and then view this video that shows parasternal long axis image demonstrating septal bowing, with the septal wall bowing toward the left ventricle. Play Favorite
The Speed of Sound: Video 1. SUPRAclavicular for Subclavian Lines Creator: Christine Butts, MD Duration: 0:11 Emergency Medicine News Show More Show Less Read Dr. Butts’ article, “Think SUPRAclavicular for Subclavian Lines,” in the July 2013 issue, and then view this video that shows the technique to assess the venous anatomy of the neck and to identify the subclavian vein (SCV). The high-frequency transducer should be placed in the transverse orientation just lateral to the trachea. Once the internal jugular (IJ) is identified, it can be followed inferiorly until it is seen to join the SCV. Angling the transducer anteriorly will help to visualize this junction. Play Favorite
The Speed of Sound: Video 2. SUPRAclavicular for Subclavian Lines Creator: Christine Butts, MD Duration: 0:29 Emergency Medicine News Show More Show Less Read Dr. Butts’ article, “Think SUPRAclavicular for Subclavian Lines,” in the July 2013 issue, and then view this video that shows assessment of the venous anatomy as seen under ultrasound. The internal jugular (IJ) vein is seen as the triangular vessel that appears to fluctuate slightly with respiration. As the view progresses inferiorly, the IJ can be seen to join the SCV, which appears tubular in this orientation. Play Favorite
The Speed of Sound: Video 3. SUPRAclavicular for Subclavian Lines Creator: Christine Butts, MD Duration: 0:05 Emergency Medicine News Show More Show Less Read Dr. Butts’ article, “Think SUPRAclavicular for Subclavian Lines,” in the July 2013 issue, and then view this video that shows an “in-plane” approach to a vessel (using a simulator). As the needle is inserted from the end of the transducer, rather than at its mid-point, it traverses the path of the transducer. This enables the entire needle, including the tip, to be visible throughout the procedure, minimizing complications such as arterial puncture or pneumothorax. Play Favorite
Video 2: Identifying Right Ventricular Strain with Bedside ECHO Creator: Christine Butts, MD Duration: 0:03 Emergency Medicine News Show More Show Less Watch the bedside echocardiogram performed on the patient featured in Dr. Christine Butts’ December 2012 column, “Identifying Right Ventricular Strain with Bedside ECHO.” Play Favorite
Video 1: Identifying Right Ventricular Strain with Bedside ECHO Creator: Christine Butts, MD Duration: 0:02 Emergency Medicine News Show More Show Less Watch the bedside echocardiogram performed on the patient featured in Dr. Christine Butts’ December 2012 column, “Identifying Right Ventricular Strain with Bedside ECHO.” Play Favorite
