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Ultrasound in Emergency Medicine

Lindsay A Taylor, Michael J Vitto, Michael Joyce, Jordan Tozer, David P Evans
BACKGROUND: Traditional landmark thoracostomy technique has a known complication rate up to 30%. The goal of this study is to determine whether novice providers could more accurately identify the appropriate intercostal site for thoracostomy by ultrasound guidance. METHODS: 33 emergency medicine residents and medical students volunteered to participate in this study during routine thoracostomy tube education. A healthy volunteer was used as the standardized patient for this study...
October 15, 2018: Critical Ultrasound Journal
Fionnuala Mone, Elizabeth Quinlan-Jones, Mark D Kilby
Advances in prenatal genomics have enabled the assessment of not only the sub-microscopic structure of chromosomes using chromosomal microarray analysis, but also the detection of "pathogenic variants" to the resolution of a single base pair with the use of next generation sequencing. Research is emerging on the additional prenatal diagnostic yield that exome sequencing offers when structural fetal anomalies are detected on ultrasound examination, in particular the identification of monogenic abnormalities defining prognosis and recurrence of anomalies...
October 6, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Liana Pleş, Cătălina Alexandrescu, Cringu Antoniu Ionescu, Cristian Andrei Arvătescu, Simona Vladareanu, Marius Alexandru Moga
The primary objective was to assess the utility of routine 3-dimensional (3D) ultrasound in the evaluation of infertile women and to estimate the prevalence of uterine anomalies before the use of assisted reproductive technology (ART), using the European Society of Human Reproduction and Embryology and the European Society for Gynaecological Endoscopy classification system. A second objective was to assess the effect of uterine anomalies on the pregnancy rate in patients who underwent assisted reproductive techniques...
October 2018: Medicine (Baltimore)
M Milkau, T Noll, F Sayk
Point-of-care ultrasound is a fundamental part of diagnostic and therapeutic management in emergency and intensive care medicine. The availability of high-resolution mobile ultrasound systems allows high-quality imaging at the bedside of the patient. Point-of-care ultrasound is not a comprehensive differential diagnostic abdominal ultrasound examination. Rather, the aim of the method is to integrate easily detectable sonographic findings into the clinical context. From this, the necessary diagnostic or therapeutic procedures are derived...
October 9, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Juergen Braun, Xenofon Baraliakos, Martin Fruth
Large-vessel vasculitis is the most common form of primary vasculitis comprising cranial and large-vessel giant cell arteritis, Takayasu's arteritis and idiopathic aortitis. Prompt diagnosis and treatment of large-vessel vasculitis are important to prevent potentially serious emergencies such as visual loss, vascular stenosis and aneurysm formation. Temporal artery biopsy has long been the standard for diagnosing GCA - an invasive technique that lacks sensitivity compared to a clinical diagnosis that relies on a combination of clinical symptoms, elevated serum inflammatory markers and imaging findings...
September 2018: Clinical and Experimental Rheumatology
David L Driskell, J Barton Gillum, Jonathan D Monti, Aaron Cronin
Objective: The study's primary objective was to determine army medics' accuracy performing bedside ultrasound (US) to detect radiolucent foreign bodies (FBs) in a soft-tissue hand model. Secondary objectives included the assessment of US stand-off pad effects on soft-tissue FB detection rates and assess established FB detectable lower limit size of 2 mm. Methods: Prospective, single blinded, observational study of US-naïve Army medics' abilities utilizing bedside US to detect wooden FBs in a chicken thigh model with or without an US stand-off pad...
July 2018: Journal of Medical Ultrasound
C Tesch
Focused sonography of the musculoskeletal system in the emergency room should be done for time-effective and symptom-oriented detection of suspected findings. Analogous to other point-of-care ultrasound in emergency medicine, it is by definition not a complete ultrasound examination of the respective organ (e.g., shoulder, elbow). It allows detection of important findings (luxation, effusion, fracture or rupture) with good to excellent diagnostic accuracy. Afterwards computed tomography, magnetic resonance imaging or complete sonographic examination (according to the guidelines of the working group Bewegungsorgane der Deutschen Gesellschaft für Ultraschall in der Medizin, which are identical to those of the working group Orthopädie und Unfallchirurgie) should be added as clinically required...
October 2, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Jesper Weile, Jacob Brix, Anders Broens Moellekaer
BACKGROUND: Point-of-care ultrasound (PoCUS) is spreading throughout Emergency Medicine, Critical Care and Pre-hospital Care. However, there is an underlying inherited conflict with the established specialties performing comprehensive examinations. It has been stated that PoCUS is disruptive innovation. If this is true the definition might open up for a new perspective on differentiating comprehensive ultrasound from PoCUS. PoCUS in the light of disruptive innovation is a different perspective on ultrasound that has not before been academically scrutinized...
October 1, 2018: Critical Ultrasound Journal
Terrell Caffery, Tonya Jagneaux, Glenn N Jones, Erik Stopa, Nathan Freeman, Cara Cantelli Quin, Ann C Long, Lauren Zatarain, Mandi W Musso
Background: Obtaining central venous cannulation of the internal jugular vein is an important skill for physicians to master. To our knowledge, no studies to date have examined residents' preferences or the safety of the oblique approach compared to other approaches. This study compared medical residents' preferences for and performance of ultrasound-guided central venous access using the transverse, longitudinal, and oblique approaches. Methods: Emergency medicine and internal medicine residents (n = 72) at an urban community hospital participated in a central venous access course...
2018: Ochsner Journal
Lucio Brugioni, Marco Barchetti, Giovanni Tazzioli, Roberta Gelmini, Massimo Girardis, Marcello Bianchini, Filippo Schepis, Matteo Nicolini, Giovanni Pinelli, Pietro Martella, Marco Barozzi, Francesca Mori, Serena Scarabottini, Andrea Righetti, Mirco Ravazzini, Elisabetta Bertellini
BACKGROUND: In patients with difficult peripheral venous access, alternative techniques require expertise and are invasive, expensive, and prone to serious adverse events. This brought us to designing a new venous catheter (JLB® Deltamed, Inc.) for the cannulation of medium and large bore veins; it is echogenic, and available in different lengths (60 / 70 / 80 mm) and Gauges (14 / 16 / 17 / 18). METHODS: We led a multi-center observational convenience sampling study to evaluate safety and effectiveness of JLB...
September 25, 2018: Journal of Vascular Access
Azif Safarulla, Walter Kuhn, Matthew Lyon, Rebecca J Etheridge, Brian Stansfield, Graciela Best, Amy Thompson, Emily Masoumy, Jatinder Bhatia
The use of point-of-care sonography in clinical settings such as emergency medicine and intensive care units has increased, but adoption in neonatology has been slow. Unlike the focused assessment with sonography for trauma scan used in adults, a quick bedside scan to rapidly evaluate an acutely deteriorating neonate does not exist. The objective of our article is to introduce a focused bedside ultrasound scan that is easy to learn, rapidly performed, and relatively inexpensive.© 2018 by the American Institute of Ultrasound in Medicine...
September 23, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Muritala A Asafa, Rahman A Bolarinwa, Omotayo A Eluwole, Bolanle O Ibitoye, Adesoji M Adegoke, Oluwadare Ogunlade
BACKGROUND: The use of electrocardiogram for sex verification in adults is an emerging concept in medicine. It is feasible through the utilization of Ogunlade Sex Determination Electrocardiographic Score. The aim of this study was to use an electrocardiogram to verify the sex of a woman with primary amenorrhea. CASE PRESENTATION: We report a case of a 36-year-old woman of Yoruba ethnicity who presented with primary amenorrhea. A physical examination revealed a woman with a feminine appearance characterized by long plaited hair and well-developed breasts...
September 17, 2018: Journal of Medical Case Reports
Mohamad Iqhbal, Julina M Noor, Nur A Karim, Izzat Ismail, Halim Sanib, Mohd A Mokhtar, Safreeda S F Salim
The use of ultrasonography in acute and critical care medicine is becoming increasingly common. However, use of an airway ultrasound as an adjunct to determine the type of intervention needed and assess complications is not common practice. We report a 56-year-old male who presented to the Emergency Department of the Sungai Buloh Hospital, Selangor, Malaysia, in 2015 with hoarseness, stridor and impending respiratory failure. A point-of-care ultrasound performed to assess the neck and vocal cords indicated a heterogeneous echogenic mass in the larynx, thus ruling out a cricothyroidotomy...
May 2018: Sultan Qaboos University Medical Journal
Ozgur Bozkurt, Murat Ersel, Funda Karbek Akarca, Sercan Yalcinli, Sadiye Midik, Levent Kucuk
Objective: We evaluated the sensitivity and specificity of bedside ultrasound (US) for determining the success of reduction of displaced distal radius fractures. In addition, we determined the ability of US to diagnose causes of unsuccessful reduction. Methods: In a prospective, double-blind fashion, patients over 18 of age whose acute distal radius fracture was to be reduced were approached for inclusion. The closed reductions were performed by orthopedics residents...
September 2018: Turkish Journal of Emergency Medicine
Keith R Barron, Michael S Wagner, Patrick S Hunt, Victor V Rao, Floyd E Bell, Saaid Abdel-Ghani, David Schrift, Duncan Norton, Paul H Bornemann, Robert Haddad, Richard A Hoppmann
As ultrasound devices become smaller, more portable, and more user friendly, there is now widespread use of this technology by physicians of all specialties, yet there are currently few structured opportunities for ultrasound education outside of emergency and critical care medicine. Anticipating the rising educational demand in the primary care specialties, the University of South Carolina School of Medicine created a primary care ultrasound fellowship in 2011, the first yearlong training program in point-of-care ultrasonography for graduates of internal medicine, medicine-pediatrics, pediatrics, and family medicine residencies...
September 4, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Sinan Karacabey, Erkman Sanri, Bayram Metin, Fatih Erkoc, Sener Yildirim, Yavuz Selim Intepe, Sercan Yalcinli
PURPOSE: Modern lung ultrasound (US) is mainly applied not only in critical care, emergency medicine, and trauma surgery, but also in pulmonary and internal medicine. In some cases, pneumothorax (PTX) distinguishes with bullous diseases. In this study, we aimed to discuss the success of US on detecting PTX versus bullae. METHODS: We performed a prospective blinded study. Patients underwent thorax computed tomography (CT) if bullae or pneumothorax could not be differentiated from the chest radiography...
September 3, 2018: Emergency Radiology
Agnieszka Skrzypek, Tomasz Górecki, Paweł Krawczyk, Mateusz Podolec, Grzegorz Cebula, Konrad Jabłoński, Marta Szeliga, Michał Nowakowski
INTRODUCTION: Peyton's four-step approach is well-known and commonly used in medical education. It is a practical and useful method which is simple to apply. The study presents the implementation of the modified four-step approach method to teach how to perform the emergency echocardiographic assessment according to FATE (Focus-Assessed Transthoracic Echo) protocol. The aim of the study was to determine the feasibility and utility of this method FATE protocol teaching. DESIGN: We collected students' feedback relating to perception of this way of teaching...
August 26, 2018: Echocardiography
Lisa Herzig, Nina de Lacy, George Capone, Jenny Radesky
Andrew is a 17-year-old male with trisomy 21, commonly known as Down syndrome, and accompanying severe intellectual disability who presents to your primary care office with his father for the first time to establish care and assistance with transition. Andrew has a history of a complete atrioventricular canal that was repaired as an infant and poorly controlled infantile spasms. Currently, he struggles with constipation, esophageal strictures, medullary nephrocalcinosis, urinary retention, sleep dysregulation, G-tube dependency, and hip dysplasia...
September 2018: Journal of Developmental and Behavioral Pediatrics: JDBP
K F Alber, M Dachsel, A Gilmore, P Lawrenson, R Matsa, N Smallwood, J Stephens, E Tabiowo, A Walden
Point of care ultrasound (POCUS) in the hands of the non-radiologist has seen a steady growth in popularity amongst emergency, intensive care and acute medical physicians. Increased accessibility to portable, purpose-built ultrasound machines has meant that clinicians often have access to a safe and non-invasive tool to enhance their management of the unwell.
2018: Acute Medicine
Michael Gottlieb, Dallas Holladay, Gary D Peksa
BACKGROUND: Lumbar punctures (LPs) are a common procedure in emergency medicine. However, studies have found that failed procedure rates can be as high as 50%. Ultrasound has been suggested to improve success rates by visually identifying the location and trajectory for the LP procedure. This systematic review and meta-analysis was performed to determine whether the use of ultrasound improved the rate of successful LP performance. METHODS: PubMed, CINAHL, Scopus, LILACS, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and bibliographies of selected articles were assessed for all randomized controlled trials comparing the success rates of ultrasound-assisted LP with landmark-based LP...
August 21, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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