The Ring of Fire algorithm is a visual and interactive mnemonic designed mainly for junior residents who take call in the emergency department. It provides a simple, innovative, and organized approach to the radiologic management of emergencies during early pregnancy. Emphasis is placed on how to exclude the diagnosis of ectopic pregnancy.
As a play on words of the commonly described sonographic sign, the Ring of Fire algorithm is a set of six, sequential questions displayed along a ring that the user must address in order to exclude an ectopic pregnancy. The idea is to “escape” the Ring of Fire with answers that direct one away from the center of the ring where the diagnosis of ectopic pregnancy is located. However, if the answers continue to direct one along the ring of clinical and radiologic questions, concern for ectopic pregnancy should increase as the user progresses further. Links to clinical pearls are included at their respective points along the ring in order to build on this foundation.
Ring of Fire Algorithm
The Importance of Excluding Ectopic in Early Pregnancy Emergencies
True Gestational Sac vs. Pseudosac
Adnexal Ring of Fire
Quantitative B-hCG and the Importance of Doubling Time
Ectopic Pregnancy
Non-ectopic early pregnancy emergencies
Conclusion
Griggs, M,
George, V,
The Ring of Fire: A New Approach to Excluding Ectopic Pregnancy for Junior Residents Taking Call in the Emergency Department. Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL.
http://archive.rsna.org/2014/14001784.html
