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Point of care ultrasonography

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https://www.readbyqxmd.com/read/28521523/sepsis-in-internal-medicine-wards-current-knowledge-uncertainties-and-new-approaches-for-management-optimization
#1
Vincenzo Zaccone, Alberto Tosoni, Giovanna Passaro, Carla Vallone, Michele Impagnatiello, Domenica Donatella Li Puma, Salvatore De Cosmo, Raffaele Landolfi, Antonio Mirijello
Sepsis represents a global health problem in terms of morbidity, mortality, social and economic costs. Although usually managed in Intensive Care Units, sepsis showed an increased prevalence among Internal Medicine wards in the last decade. This is substantially due to the ageing of population and to multi-morbidity. These characteristics represent both a risk factor for sepsis and a relative contra-indication for the admission to Intensive Care Units. Although there is a lack of literature on the management of sepsis in Internal Medicine, the outcome of these patients seems to be gradually improving...
May 18, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28509686/accuracy-of-point-of-care-ultrasonography-for-pediatric-ankle-sprain-injuries
#2
Sarah Jones, Keith Colaco, Jason Fischer, Jennifer Stimec, Charisse Kwan, Kathy Boutis
OBJECTIVES: In children with radiograph fracture-negative lateral ankle injuries, the main objective of this pilot study was to explore the accuracy, sensitivity, and specificity of point-of-care ultrasound (POCUS) performed by a pediatric emergency physician in diagnosing anterior talofibular ligament injuries, radiographically occult distal fibular fractures, and effusions compared with reference standard magnetic resonance imaging (MRI). METHODS: This was a prospective cohort pilot study...
May 15, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28491266/point-of-care-ultrasonography-pocus-in-hemophilia-a-a-commentary-on-current-status-and-its-potential-role-for-improving-prophylaxis-management-in-severe-hemophilia-a
#3
REVIEW
Suchitra S Acharya, Brittny Rule, Omar McMillan, Thomas J Humphries
In patients with severe hemophilia A, recurrent bleeding into joints results in increased morbidity and reduced quality of life. Prophylaxis using replacement factor products, especially when initiated early, has established benefits in terms of reducing joint bleeds and preserving joint function. Poor adherence to prophylactic regimens is a common cause for breakthrough bleeds and resultant arthropathy. Improving prophylaxis management, especially in the transitional age group, is a challenge. Here, we discuss the current status of ultrasonography (US) in hemophilia A, challenges in its wider implementation, and the potential for use of point-of-care US (POCUS) as an adjunct in the routine management of patients with hemophilia following prophylaxis regimens...
April 2017: Therapeutic Advances in Hematology
https://www.readbyqxmd.com/read/28488556/-treating-physicians-can-perform-simple-ultrasounds-triage-ultrasonography-should-be-reserved-for-radiologists
#4
R R van Rijn, J B C M Puylaert
We feel that, in trained hands, point-of-care ultrasonography by non-radiologists is of value to patient care. However, more extensive ultrasonography, i.e., triage ultrasonography, requires a skill set and a clinical environment that can currently only be provided by radiologists.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28466618/point-of-care-ultrasound-in-a-department-of-pediatric-and-adolescent-surgery
#5
Efrat Avinadav, Anastasia Almog, Dragan Kravarusic, Emanuelle Seguier, Inbal Samuk, Adrianna Nika, Enrique Freud
BACKGROUND: Point-of-care ultrasound (POCUS) is becoming a common tool for routine use in emergency medicine, anesthesiology and intensive care for diagnostic and interventional purposes. When a portable ultrasound device became available for the department of Pediatric and Adolescent Surgery at the Schneider's Children Medical Center of Israel, we added POCUS assessments to the physician's daily rounds. POCUS is performed by pediatric surgeons trained in basic ultrasonography skills...
November 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28464459/accuracy-of-point-of-care-ultrasonography-for-diagnosing-acute-appendicitis-a-systematic-review-and-meta-analysis
#6
Matthew J Fields, Joshua Davis, Carl Alsup, Amanda Bates, Arthur Au, Srikar Adhikari, Isaac Farrell
INTRODUCTION: The use of ultrasonography to diagnose appendicitis has become increasingly common over recent years and is well-established. More recently, point of care ultrasonography (POCUS) has also been studied for the diagnosis of appendicitis, which may also prove a valuable diagnostic tool. The purpose of this study is through systematic review and meta-analysis to identify the test characteristics of POCUS, specifically ultrasonography performed by a non-radiologist physician, in accurately diagnosing acute appendicitis in patients of any age...
May 2, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28447145/-recommendations-for-education-in-ultrasound-in-medical-intensive-care-and-emergency-medicine-position-paper-of-dgiin-degum-and-dgk
#7
G Michels, H Zinke, M Möckel, D Hempel, C Busche, U Janssens, S Kluge, R Riessen, M Buerke, M Kelm, R S von Bardeleben, F Knebel, H-J Busch
Point-of-care ultrasound in acute care medicine is a prerequisite for diagnosis and therapy monitoring of critically ill patients. There is currently no uniform education strategy for medical intensive care and emergency medicine. As part of the basic level, the trainee takes theoretical and clinical training covering abdominal and thoracic ultrasonography and focused cardiovascular ultrasound. In a second step, special knowledge and skills can be acquired at an expert level. This two-stage concept is intended to guarantee quality assurance in ultrasound education in medical intensive care and emergency medicine...
May 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28443388/utilization-of-thoracic-ultrasound-for-confirmation-of-central-venous-catheter-placement-and-exclusion-of-pneumothorax-a-novel-technique-in-real-time-application
#8
Dileep Raman, Manish Sharma, Ajit Moghekar, Xiaofeng Wang, Umur Hatipoğlu
AIM: To evaluate the safety and utility of ultrasonography as a tool to confirm central venous catheter (CVC) position and to exclude insertion-related pneumothorax in place of chest radiography (CXR) in a tertiary medical intensive care unit (ICU). METHODS: We randomized 60 consecutive medical ICU patients to conventional or ultrasound groups for CVC placement. Both groups had CVCs inserted under ultrasound guidance. The intervention group underwent real-time transthoracic echocardiography to assist in catheter positioning and chest ultrasonography for exclusion of pneumothorax...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28435502/inferior-vena-cava-measurement-with-ultrasound-what-is-the-best-view-and-best-mode
#9
Nathan M Finnerty, Ashish R Panchal, Creagh Boulger, Amar Vira, Jason J Bischof, Christopher Amick, David P Way, David P Bahner
INTRODUCTION: Intravascular volume status is an important clinical consideration in the management of the critically ill. Point-of-care ultrasonography (POCUS) has gained popularity as a non-invasive means of intravascular volume assessment via examination of the inferior vena cava (IVC). However, there are limited data comparing different acquisition techniques for IVC measurement by POCUS. The goal of this evaluation was to determine the reliability of three IVC acquisition techniques for volume assessment: sub-xiphoid transabdominal long axis (LA), transabdominal short axis (SA), and right lateral transabdominal coronal long axis (CLA) (aka "rescue view")...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28431818/the-comparison-of-point-of-care-ultrasonography-and-radiography-in-the-diagnosis-of-tibia-and-fibula-fractures
#10
Nalan Kozaci, Mehmet Oguzhan Ay, Mustafa Avci, Sadullah Turhan, Eda Donertas, Ahmet Celik, Ertan Ararat, Emrah Akgun
OBJECTIVE: We aimed to compare the efficacy of Point-of-care ultrasonography (POCUS) with radiography in the diagnosis of tibia fracture (TF) and fibula fracture (FF), and determation of fracture characteristics. METHODS: Patients aged 5-55 years who were admitted to ED due to low-energy, simple extremity trauma, who had a suspected TF and FF on physical examination were included in this prospective study. One physician performed POCUS examination. Other physician evaluated the radiography images...
April 13, 2017: Injury
https://www.readbyqxmd.com/read/28416252/hydroceles-not-just-for-men
#11
Danielle Biggs, Amy Patwa, Steve Gohsler
BACKGROUND: Hydroceles develop in females through the canal of Nuck. This canal is formed when the processes vaginalis fails to obliterate during development. The canal of Nuck can lead to the formation of not only hydroceles, but hernias as well. Although physicians typically think of hydroceles occurring in males, on rare occasions, they do occur in females because of this defect. They are often mistaken for incarcerated hernias, making ultrasound an excellent tool to distinguish between them and guide further treatment...
April 14, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28376073/point-of-care-ultrasound-diagnosis-of-traumatic-abdominal-wall-hernia
#12
Lori B Bjork, Shawna D Bellew, Tobias Kummer
Traumatic abdominal wall hernias due to blunt abdominal trauma in pediatric patients can pose a diagnostic challenge because of spontaneous hernia reduction. Ultrasonography may be superior to computed tomography for this indication in some cases because of the ability to dynamically and repeatedly assess the area of injury. Herniation can be induced or exaggerated via Valsalva maneuvers, which can facilitate its detection during dynamic assessment. We present the case of a 3-year-old boy who sustained blunt abdominal trauma, with a resultant abdominal wall hernia that was diagnosed using point-of-care ultrasound imaging...
May 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28376070/diagnosis-of-ingested-foreign-body-in-the-stomach-by-point-of-care-ultrasound-in-the-upright-and-slightly-forward-tilting-position-bowing-position
#13
Motoyoshi Yamamoto, Toru Koyama, Masahiro Agata, Kenjiro Ouchi, Takayuki Kotoku, Yuta Mizuno
We report a case involving accidental ingestion of a marble that was detected by point-of-care ultrasonography of the abdomen with the patient in the upright and slightly forward tilting position, which we term the "bowing position." Using this position for abdominal ultrasonography may be more useful than the usual supine position for such patients.
May 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28366285/a-review-of-hemodynamic-monitoring-techniques-methods-and-devices-for-the-emergency-physician
#14
Abdullah E Laher, Matthew J Watermeyer, Sean K Buchanan, Nicole Dippenaar, Nelly Clotilde Tchouambou Simo, Feroza Motara, Muhammed Moolla
The emergency department (ED) is frequently the doorway to the intensive care unit (ICU) for a significant number of critically ill patients presenting to the hospital. Hemodynamic monitoring (HDM) which is a key component in the effective management of the critically ill patient presenting to the ED, is primarily concerned with assessing the performance of the cardiovascular system and determining the correct therapeutic intervention to optimise end-organ oxygen delivery. The spectrum of hemodynamic monitoring ranges from simple clinical assessment and routine bedside monitoring to point of care ultrasonography and various invasive monitoring devices...
March 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28357139/effect-of-focused-bedside-ultrasonography-in-hypotensive-patients-on-the-clinical-decision-of-emergency-physicians
#15
M Ikbal Sasmaz, Faruk Gungor, Ramazan Guven, K Can Akyol, Nalan Kozaci, Mustafa Kesapli
We assessed the effect of focused point of care ultrasound (POCUS) used for critical nontraumatic hypotensive patients presenting to the emergency department of our hospital on the clinical decisions of the physicians and whether it led to the modification of the treatment modality. This prospective clinical study was conducted at the Emergency Department of Antalya Training and Research Hospital. Nontraumatic patients aged 18 and older who presented to our emergency department and whose systolic blood pressure was <100 mmHg or shock index (heart rate/systolic blood pressure) was >1 were included in the study...
2017: Emergency Medicine International
https://www.readbyqxmd.com/read/28324786/assessment-of-corrected-flow-time-in-carotid-artery-via-point-of-care-ultrasonography-reference-values-and-the-influential-factors
#16
Hooman Hossein-Nejad, Mohsen Banaie, Seyedhossein Seyedhosseini Davarani, Payam Mohammadinejad
OBJECTIVE: Assessment of Corrected Flow Time (FTc) in carotid artery has been suggested recently as a measure of intravascular volume status. This study aimed to determine the reference values of FTc in carotid artery in a normal population. METHODS: A total number of 142 healthy volunteers (73 females and 69 males) with a mean age of 36.65±10.52years were included. RESULTS: The mean FTc in carotid artery was 325.18±22.15ms(0.5). The mean value of FTc differed significantly between females and males both before and after passive leg raise (PLR) (330...
March 14, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28298944/4-point-ultrasonography-to-confirm-the-correct-position-of-the-nasogastric-tube-in-114-critically-ill-patients
#17
Marianna Zatelli, Norberto Vezzali
PURPOSE: Nasogastric feeding tube is routinely positioned in intensive care units. The complications of misplacement are rare but very dangerous for the patients. The aim of this study is to estimate the diagnostic accuracy of this new technique, 4-point ultrasonography to confirm nasogastric tube placement in intensive care. METHODS: One hundred fourteen critical ill patients monitored in ICU were included. The intensivist provided in real time to perform the exam in four steps: sonography from either the right or left side of the patient's neck to visualize the esophagus, sonography of epigastrium to confirm the passage through the esophagogastric junction and the positioning in antrum, sonography of the fundus...
March 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28284770/point-of-care-ultrasonography-to-assist-in-the-diagnosis-and-management-of-subluxation-of-the-radial-head-in-pediatric-patients-a-case-series
#18
Faruk Güngör, Taylan Kılıç
BACKGROUND: A subluxation of the radial head (SRH) is a clinical condition that commonly occurs in children under 6 years of age. History and physical examination findings typically include a child who presents with an elbow held in extension and with forearm pronation, after having suffered significant longitudinal traction on the arm, or after a fall on an outstretched hand. The diagnosis is often clinically obvious. The injury responds dramatically to closed reduction, and usually no imaging is required...
March 8, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28282364/lung-ultrasound-for-the-regional-anesthesiologist-and-acute-pain-specialist
#19
Stephen C Haskins, Ban C Tsui, Jemiel A Nejim, Christopher L Wu, Jan Boublik
In this article, we discuss the emerging role of lung point-of-care ultrasonography for regional anesthesiologists and pain management specialists. Lung ultrasonography is a well-established clinical tool that is used on a routine basis in emergency rooms and critical care units internationally to evaluate patients with respiratory distress; however, its benefits to the regional anesthesiologist and pain specialist are not as well known and are practiced less frequently. This review article covers the clinical evidence in support of lung point-of-care ultrasonography as a rapid and superior tool to traditional imaging modalities such as chest radiography and fluoroscopy...
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28263791/accuracy-of-point-of-care-focused-echocardiography-in-predicting-outcome-of-resuscitation-in-cardiac-arrest-patients-a-systematic-review-and-meta-analysis
#20
REVIEW
Po-Yang Tsou, Jeantte Kurbedin, Yueh-Sheng Chen, Eric H Chou, Meng-Tse Gabriel Lee, Matthew Chien-Hung Lee, Matthew Huei-Ming Ma, Shyr-Chyr Chen, Chien-Chang Lee
OBJECTIVE: We aim to summarize current evidence on the value of point-of-care (POC) focused echocardiography in the assessment of short-term survival in patients with cardiac arrest. METHODS: PubMed and EMBASE were searched from inception to July 2016 for eligible studies that evaluated the utility of POC echocardiography in patients with cardiac arrest. Modified QUADAS was used to appraise the quality of included studies. A random-effect bivariate model and a hierarchical summary receiving operating curve were used to summarize the performance characteristics of focused echocardiography...
March 2, 2017: Resuscitation
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