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Ultrasound and emergency medicine

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https://www.readbyqxmd.com/read/28927978/approaching-zero-implications-of-a-computed-tomography-reduction-program-for-pediatric-appendicitis-evaluation
#1
K Tinsley Anderson, Marisa Bartz-Kurycki, Mary T Austin, Akemi Kawaguchi, Susan D John, Lillian S Kao, KuoJen Tsao
PURPOSE: Because of awareness of iatrogenic radiation exposure, there is a national trend of diminishing computed tomography (CT) use for pediatric suspected appendicitis. The purpose of this study was to evaluate the effects of a CT reduction program for evaluation of appendicitis. METHODS: A multidisciplinary group (emergency medicine, radiology, and surgery) at a children's hospital developed a reduction program which included: ultrasound (U/S) first (2012), magnetic resonance imaging (MRI) second (2014), and standardized U/S reports (2016)...
September 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28914285/hospital-medicine-point-of-care-ultrasound-credentialing-an-example-protocol
#2
Benji K Mathews, Michael Zwank
Though the use of point-of-care ultrasound (POCUS) has increased over the last decade, formal hospital credentialing for POCUS may still be a challenge for hospitalists. This document details the Hospital Medicine Department Ultrasound Credentialing Policy from Regions Hospital, which is part of the HealthPartners organization in Saint Paul, Minnesota. National organizations from internal medicine and hospital medicine (HM) have not published recommended guidelines for POCUS credentialing. Revised guidelines for POCUS have been published by the American College of Emergency Physicians, though these are not likely intended to guide hospitalists when working with credentialing committees and medical boards...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28898139/point-of-care-ultrasound-its-growing-application-in-hospital-medicine
#3
Aidan Kingwill, Graham Barker, Adrian Wong
Point-of-care ultrasound is emerging as an important adjunct to the clinical examination. Ultrasonography has long been seen as a modality for experts but this is changing and it is hoped that, with appropriate training, point-of-care ultrasound will become a modern-day diagnostic necessity.
September 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28877363/establishing-an-ultrasound-curriculum-in-undergraduate-medical-education-how-much-time-does-it-take
#4
Yonaton Siegel-Richman, John Kendall
OBJECTIVES: Over the years, the use of ultrasound in the medical profession has become a common occurrence. As a result, many medical schools are considering an ultrasound curriculum for first- and second-year medical students. The question posed by many of these programs is how much time and effort are required to establish such a curriculum. We at the University of Colorado School of Medicine sought to quantify the resources and time required. METHODS: We conducted a cohort study that analyzed the time spent teaching, as well as the types of instructors (eg, faculty, resident, and peer student) that contributed to our ultrasound curriculum...
September 6, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28859628/assessment-of-thoracic-ultrasound-in-complementary-diagnosis-and-in-follow-up-of-community-acquired-pneumonia-cap
#5
Maria D'Amato, Gaetano Rea, Vincenzo Carnevale, Maria Arcangela Grimaldi, Anna Rita Saponara, Eric Rosenthal, Michele Maria Maggi, Lucia Dimitri, Marco Sperandeo
BACKGROUND: Chest X-ray (CXR) is the primary diagnostic tool for community-acquired pneumonia (CAP). Some authors recently proposed that thoracic ultrasound (TUS) could valuably flank or even reliably substitute CXR in the diagnosis and follow-up of CAP. We investigated the clinical utility of TUS in a large sample of patients with CAP, to challenge the hypothesis that it may be a substitute for CXR. METHODS: Out of 645 consecutive patients with a CXR-confirmed CAP diagnosed in the emergency room of our hospital over a three-years period, 510 were subsequently admitted to our department of Internal Medicine...
August 31, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28845599/paediatric-emergency-medicine-point-of-care-ultrasound-fundamental-or-fad
#6
Peter J Snelling, Mark Tessaro
No abstract text is available yet for this article.
August 28, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28833896/prospective-validation-of-a-clinical-score-for-males-presenting-with-an-acute-scrotum
#7
Lillian C Frohlich, Niloufar Paydar-Darian, Bartley G Cilento, Lois K Lee
OBJECTIVE: To validate the Testicular Workup for Ischemia and Suspected Torsion (TWIST) score among pediatric emergency medicine providers for the evaluation of pediatric males presenting with testicular pain and swelling (acute scrotum). METHODS: We conducted a prospective cohort study of males 3 months to 18 years old presenting with an acute scrotum. History and physical examination findings, including components of the TWIST score (hard testicle, absent cremasteric reflex, nausea/vomiting, and high riding testicle) as well as diagnostic results (ultrasound, urine, sexually transmitted infection (STI) testing) were recorded...
August 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28803375/lung-ultrasound-in-internal-medicine-efficiently-drives-the-management-of-patients-with-heart-failure-and-speeds-up-the-discharge-time
#8
Chiara Mozzini, Marco Di Dio Perna, Giancarlo Pesce, Ulisse Garbin, Anna Maria Fratta Pasini, Andrea Ticinesi, Antonio Nouvenne, Tiziana Meschi, Alder Casadei, Maurizio Soresi, Luciano Cominacini
Lung ultrasound (LUS) is a valid tool for the assessment of heart failure (HF) through the quantification of the B-lines. This study in HF patients aims to evaluate if LUS: (1) can accelerate the discharge time; (2) can efficiently drive diuretic therapy dosage; and (3) may have better performance compared to the amino-terminal portion of B type natriuretic peptide (NT-proBNP) levels in monitoring HF recovery. A consecutive sample of 120 HF patients was admitted from the Emergency Department (ED) to the Internal Medicine Department (Verona University Hospital)...
August 12, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28802868/development-and-implementation-of-an-ultrasound-guided-peripheral-intravenous-catheter-program-for-emergency-nurses
#9
Courtney Edwards, Jodi Jones
PROBLEM: Emergency medical care often necessitates placement of peripheral intravenous (PIV) catheters. When traditional methods for obtaining PIV access are not successful, ultrasound guidance is a rescue technique for peripheral vascular placement that improves the quality of patient care. METHODS: The aim of this training program was to develop a process where emergency nurses would be competent to perform ultrasound guided PIV to improve the quality of patient care delivered while reducing throughput time...
August 9, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28793969/lung-ultrasound-in-internal-medicine-a-bedside-help-to-increase-accuracy-in-the-diagnosis-of-dyspnea
#10
Tiziano Perrone, Alessia Maggi, Carmelo Sgarlata, Ilaria Palumbo, Elisa Mossolani, Sara Ferrari, Ariel Melloul, Roberta Mussinelli, Michele Boldrini, Ambra Raimondi, Aderville Cabassi, Francesco Salinaro, Stefano Perlini
BACKGROUND: Dyspnea is one of the most frequent causes of admission in Internal Medicine wards, leading to a sizeable utilization of medical resources. STUDY DESIGN AND METHODS: The role of bedside lung ultrasound (LUS) was evaluated in 130 consecutive patients (age: 81±9years), in whom blindly collected LUS results were compared with data obtained by clinical examination, medical history, blood analysis, and chest X-ray. Dyspnea etiology was classified as "cardiac" (n=80), "respiratory" (n=36) or "mixed" (n=14), according to the discharge diagnosis (congestive heart failure either alone [n=80] or associated with pneumonia [n=14], pneumonia [n=24], and obstructive disventilatory syndrome [n=12])...
August 6, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28780235/dilated-right-coronary-sinus-identified-on-point-of-care-ultrasound
#11
Damali Nakitende, Michael Gottlieb
Point-of-care cardiac ultrasound (POCUS) is a common application in Emergency Medicine. Here we present a case of an incidentally discovered dilated right coronary sinus on ultrasound. This case involved a 55-year-old female who presented with chest pain, shortness of breath, and lightheadedness. Her initial presentation was concerning for congestive heart failure (CHF) exacerbation. A bedside ultrasound was performed to assess cardiac function, where a dilated right coronary sinus was discovered. The right coronary sinus is the vein that serves as the venous return for the coronary system...
July 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28777270/point-of-care-ultrasound-identification-of-an-abdominal-hernia
#12
Michael Alfonzo, Anna von Reinhart, Antonio Riera
Pediatric emergency medicine physicians may be able to use point-of-care ultrasound (POCUS) as a tool to evaluate abdominal wall masses. We present a case of a 2-month-old infant with a lower abdominal mass identified as a hernia sac by POCUS. It was initially thought to represent a Spigelian-type abdominal wall hernia but subsequently determined to be an unusual presentation of an inguinal hernia with testicular entrapment. We review each of these diagnoses in addition to relevant POCUS findings.
August 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28745844/emergency-department-management-of-priapism-digest
#13
Gregory S Podolej, Christine Babcock, Jeremy Kim
Priapism is a genitourinary emergency that demands a thorough, time-sensitive evaluation. There are 3 types of priapism: ischemic, nonischemic, and recurrent ischemic priapism; ischemic priapism accounts for 95% of cases. Ischemic priapism must be treated within 4 to 6 hours to minimize morbidity, including impotence. The diagnosis of ischemic priapism relies heavily on the history and physical examination and may be facilitated by penile blood gas analysis and penile ultrasound. This issue reviews current evidence regarding emergency department treatment of ischemic priapism using a stepwise approach that begins with aspiration of cavernosal blood, cold saline irrigation, and penile injection with sympathomimetic agents...
January 22, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28688814/proceedings-beyond-ultrasound-first-forum-on-improving-the-quality-of-ultrasound-imaging-in-obstetrics-and-gynecology
#14
Beryl R Benacerraf, Katherine K Minton, Carol B Benson, Bryann S Bromley, Brian D Coley, Peter M Doubilet, Wesley Lee, Samuel H Maslak, John S Pellerito, James J Perez, Eric Savitsky, Norman A Scarborough, Joseph Wax, Alfred Z Abuhamad
The Beyond Ultrasound First Forum was conceived to increase awareness that the quality of obstetric and gynecologic ultrasound can be improved, and is inconsistent throughout the country, likely due to multiple factors, including the lack of a standardized curriculum and competency assessment in ultrasound teaching. The forum brought together representatives from many professional associations; the imaging community including radiology, obstetrics and gynecology, and emergency medicine among others; in addition to government agencies, insurers, industry, and others with common interest in obstetric and gynecologic ultrasound...
July 6, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28685812/simulation-based-training-program-with-deliberate-practice-for-ultrasound-guided-jugular-central-venous-catheter-placement
#15
M A Corvetto, J C Pedemonte, D Varas, C Fuentes, F R Altermatt
BACKGROUND: Current evidence supports the utility of simulation training for bedside procedures such as ultrasound-guided jugular central venous catheter (CVC) insertion. However, a standardized methodology to teach procedural skills has not been determined yet. The aim of this study was to evaluate the effectiveness of a simulation-based training program for improving novice technical performance during ultrasound-guided internal jugular CVC placement. METHODS: Postgraduate year 1 (PGY-1) residents from anesthesiology, emergency medicine, cardiology, ICU, and nephrology specialties were trained in four deliberate practice sessions...
October 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28649711/point-of-care-ultrasound-in-general-surgery-residency-training-a-proposal-for-milestones-in-graduate-medical-education-ultrasound
#16
Eliza W Beal, Benjamin R Sigmond, Latifa Sage-Silski, Samantha Lahey, Victor Nguyen, David P Bahner
The use of point-of-care ultrasound (US) in the clinical setting has undergone massive growth, although its incorporation into training and practice is variable. Surgeons are interested in using point-of-care US and can incorporate it effectively into clinical practice. However, the current state of point-of-care US training in general surgery is inadequate. The Accreditation Council for Graduate Medical Education introduced the Milestones Project to evaluate resident and fellow performance. Emergency medicine is the only specialty with a point-of-care US milestone...
June 26, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28646595/point-of-care-ultrasound-work-flow-innovation-impact-on-documentation-and-billing
#17
Matthew J Flannigan, Srikar Adhikari
OBJECTIVES: To evaluate the impact that an innovative automated ultrasound (US) work flow, which allows for bedside performance of examination documentation and order placement, has on point-of-care US billing compared to ordering US examinations through an electronic medical record. METHODS: We conducted a retrospective review of point-of-care US billing data (March 2014-February 2016) for adult and pediatric emergency departments with an emergency medicine residency and a US fellowship...
June 24, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28640133/effectiveness-of-education-in-point-of-care-ultrasound-assisted-physical-examinations-in-an-emergency-department-a-before-and-after-study
#18
Yoo Jin Choi, Jae Yun Jung, Hyuksool Kwon
Implementation of point-of-care ultrasonography (POCUS)-assisted physical examination (PE) in emergency departments (EDs) was conducted in the ED of an urban tertiary teaching hospital. This study examines the effect of POCUS implementation in emergency medicine departments by using a systematic education program on image acquisition to analyze decision making.Educating staff on POCUS involved a technique related to image acquisition and then accurately diagnosing subsequent POCUS results. The quasi-experimental, uncontrolled before-and-after study was performed to evaluate the education effect...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28625217/the-core-emergency-ultrasound-curriculum-project-a-report-from-the-curriculum-working-group-of-the-caep-emergency-ultrasound-committee
#19
Paul Olszynski, Dan Kim, Jordan Chenkin, Louise Rang
Emergency ultrasound (EUS) is now widely considered to be a "skill integral to the practice of emergency medicine." 1 The Canadian Association of Emergency Physicians (CAEP) initially issued a position statement in 1999 supporting the availability of focused ultrasound 24 hours per day in the emergency department (ED). 2.
June 19, 2017: CJEM
https://www.readbyqxmd.com/read/28593003/focused-cardiac-ultrasound-focus-by-emergency-medicine-residents-in-patients-with-suspected-cardiovascular-diseases
#20
Davood Farsi, Skokoufeh Hajsadeghi, Mohammad Javad Hajighanbari, Mani Mofidi, Peyman Hafezimoghadam, Mahdi Rezai, Babak Mahshidfar, Samaneh Abiri, Saeed Abbasi
INTRODUCTION: Few studies have assessed the value and accuracy of focused cardiac ultrasound (FOCUS) performed by emergency physicians. The aim of the present study was to evaluate the diagnostic accuracy of FOCUS performed by emergency medicine residents compared to echocardiography performed by a cardiologist in emergency department (ED) patients suspected of cardiovascular disease. METHODS: The research involved a prospective observational cross-sectional study enrolling patients over 18-years old suspected of having cardiovascular disease who required an echocardiograph...
June 2017: Journal of Ultrasound
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