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In pediatric patients who have an Alvarado score 6 and below, the absence of free fluid or periappendiceal fat inflammation, when the appendix was not visualized on ultrasound, had a negative predictive value of 99.4% for appendicitis.

Source
Predictive values of indirect ultrasound signs for low risk of acute appendicitis in paediatric patients without visualisation of the appendix on ultrasound. Emerg Med J. 2024 May 10:emermed-2023-213466. doi: 10.1136/emermed-2023-213466. Online ahead of print. PMID: 38729752

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Reliance on landmark guidance for chest tube placement may pose significant safety issues in pediatric patients.

Source
Ultrasound Investigation of the Fifth Intercostal Space Landmark for Chest Tube Thoracostomy Site Selection in Pediatric Patients. Pediatr Emerg Care. 2024 Apr 23. doi: 10.1097/PEC.0000000000003207. Epub ahead of print. PMID: 38713844.

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This was a network meta-analysis of 13 randomized controlled trials comparing 5 different central venous catheterization (CVC) approaches. The supraclavicular subclavian (SupraSCV) demonstrated superior first-attempt success, while artery puncture was similar for all five locations.  

Source
Ultrasound-guided central venous catheterization around the neck: Systematic review and network meta-analysis. Am J Emerg Med. 2024;78:206-214.

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This expert panel from Canada has compiled a list of what they deem to be the most influential POCUS papers with regard to cardiac arrest as well as evaluation of shock. Whether you want to further educate yourself or guide your residents to learn more on the subject, this primer is a great place to start.

Source
POCUS literature primer: key papers on POCUS in cardiac arrest and shock. CJEM. 2023 Nov 23. doi: 10.1007/s43678-023-00611-1. Epub ahead of print.

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In a small, randomized trial, placing an ultrasound-guided central venous catheter (CVC) using 2 planes simultaneously was more likely to be successful on the first attempt and performed more quickly. Both groups had a 100% procedural success rate.

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While it doesn’t have great specificity, the sensitivity of ultrasound makes it a viable first step in making the diagnosis of peritonsillar abscess.

Source
Test characteristics of ultrasound for the diagnosis of peritonsillar abscess: A systematic review and meta-analysis. Acad Emerg Med. 2023 Aug;30(8):859-869. doi: 10.1111/acem.14660. Epub 2023 Jan 30.

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The LUS-ARDS score can make a diagnosis of acute respiratory distress syndrome (ARDS) easier, particularly in patients who can’t have CT scan. The LUS-ARDS score performs similarly to the standard of care (Berlin criteria plus CXR evaluation) in diagnosis of ARDS in ventilated patients.

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Pulling traction on a testicle with torsion is proposed by these authors to help relieve pressure, identify direction of torsion, and to make manual detorsion easier to perform. See figure below for technique.

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Through the use of point-of-care ultrasound (POCUS) Emergency Medicine providers can optimize and tailor pre-intubation resuscitation in critically ill patients. See algorithm below.

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An initial diagnostic workup that includes an E-FAST exam and targeted chest and pelvis x-rays allows clinicians an opportunity to assess and intervene appropriately on the majority of patients prior to WBCT in the setting of blunt trauma.

Source
Appropriateness of Initial Course of Action in the Management of Blunt Trauma Based on a Diagnostic Workup Including an Extended Ultrasonography Scan. JAMA Netw Open. 2022 Dec 1;5(12):e2245432. doi: 10.1001/jamanetworkopen.2022.45432.