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Emergency department ultrasound

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https://www.readbyqxmd.com/read/28441243/emergency-point-of-care-ultrasound-diagnosis-of-retained-soft-tissue-foreign-bodies-in-the-pediatric-emergency-department
#1
Terry Varshney, Charisse W Kwan, Jason W Fischer, Alyssa Abo
The presence of a foreign body (FB), its depth and size, is often indeterminate by clinical examination. Conventional imaging such as a radiograph can fail to visualize soft tissue FBs. We present 2 cases where point-of-care ultrasound was used to detect previously unidentified FBs.
April 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28435503/ultrasound-guided-radial-artery-compression-to-assess-blood-pressure
#2
Leonard Bunting, Andrew Butki, Ashley Sullivan
INTRODUCTION: We proposed using compression sonography to observe the coaptation and collapse of the radial artery as a surrogate for automated cuff blood pressures (BP). We hypothesize that the pressure required to achieve coaptation and complete collapse of the artery would correlate to the diastolic and systolic BP, respectively. This pilot study was to assess the feasibility of ultrasound-guided radial artery compression (URAC) for BP measurement and compare patient comfort levels during automated cuff with URAC measurements...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435500/skin-to-intramuscular-compartment-thigh-measurement-by-ultrasound-in-pediatric-population
#3
Myto Duong, Albert Botchway, Jonathan Dela Cruz, Richard Austin, Kevin McDaniel, Cassie Jaeger
INTRODUCTION: Pediatric obesity threatens the efficacy of medications given intramuscularly. In anaphylactic patients, epinephrine auto-injector needle lengths are potentially too short to reach the muscle compartment in patients with elevated body habitus. The objective of the study was to determine needle-length requirements for intramuscular injections in pediatric patients. METHODS: We used ultrasound to measure the distance from skin to muscle compartment of the thigh in 200 pediatric patients of various weight and body mass index who presented to the emergency department...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28430713/a-national-survey-of-neonatologists-barriers-and-prerequisites-to-introduce-point-of-care-ultrasound-in-neonatal-icus
#4
Hussnain S Mirza, Gregory Logsdon, Anoop Pulickal, Mark Stephens, Rajan Wadhawan
Point-of-care (POC) ultrasound refers to the use of portable imaging. Although POC ultrasound is widely available to the neonatologists in Australia and Europe, neonatologists in the United States report limited availability. Our objective was to seek the US neonatologists' perception of barriers and prerequisites in adopting POC ultrasound in neonatal intensive care units. An online survey link was sent via e-mail to 3000 neonatologists included in the database maintained by the American Academy of Pediatrics...
April 20, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/28419618/correspondence-response-to-letter-to-the-editor-ultrasound-assisted-lumbar-puncture-on-infants-in-the-pediatric-emergency-department
#5
Michael Gorn
We would like to thank our reader for his/her interest in our work and continuing support of point-of-care ultrasound in pediatric emergency medicine. Our study was conducted at a large academic emergency department with pediatrics and emergency medicine residents, nurse practitioners who function at or above the level of a senior resident (PGY-3 and 4), and pediatric emergency fellows who function as attending physicians. As a routine, all initial lumbar puncture (LP) attempts are made by learners. This article is protected by copyright...
April 17, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28416252/hydroceles-not-just-for-men
#6
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/28414684/who-shot-the-cannonballs-extensive-lung-metastases-in-a-39-year-old-man
#7
D Sommerhalder, J Blondin
CASE: A 39 year-old man presented to the emergency department complaining of a cough of 2 months in duration. He also complained of weight loss of 20 pounds in two months and night sweats over the same period. An x-ray of the chest was performed and revealed innumerable lung nodules and masses. Computed tomography of the chest and abdomen were subsequently performed which confirmed the masses, but imaging did not reveal an obvious primary source. A testicular exam was performed but no obvious abnormalities were noted...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414680/a-rare-cause-of-abdominal-pain
#8
E M Dauchy, M Modica, N Masri
CASE: A 54 year old woman with hypothyroidism presented with right flank pain that began acutely one week prior to presentation. She was told initially she had a urinary tract infection and treatment resulted in mild symptomatic improvement. The pain returned and she presented to another Emergency Department (ED); and was told the pain was due to constipation. She returned to the ED the next day when her pain worsened and her labs were notable for WBC of 19,000/uL, BUN/Cr of 28/0.75 mg/dL, AST of 31 U/L, ALT of 92 U/L and total bilirubin of 0...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28412493/the-clinical-impact-and-prevalence-of-emergency-point-of-care-ultrasound-a-prospective-multicentre-study
#9
Xavier Bobbia, Laurent Zieleskiewicz, Christophe Pradeilles, Chloé Hudson, Laurent Muller, Pierre Géraud Claret, Marc Leone, Jean-Emmanuel de La Coussaye
OBJECTIVE: The main objectives of our study were to evaluate the prevalence of emergency point-of-care ultrasound (POCUS) use and to assess the impact of POCUS on: diagnostic, therapeutic, patient-orientation and imaging practices. METHODS: This was a one-day, prospective, observational study carried out across multiple centres. Fifty emergency departments (EDs) recorded all POCUS performed over a 24h period. The prevalence of POCUS was defined as the number of POCUS/number of patients seen in all units...
April 12, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28410544/does-respiratory-variation-in-inferior-vena-cava-diameter-predict-fluid-responsiveness-a-systematic-review-and-meta-analysis
#10
Elliot Long, Ed Oakley, Trevor Duke, Franz E Babl
BACKGROUND: The aim of fluid resuscitation is to increase stroke volume, yet this effect is observed in only 50% of patients. Prediction of fluid responsiveness may allow fluid resuscitation to be administered to those most likely to benefit. The aim of this study was to systematically review the test characteristics of respiratory variation in inferior vena cava (IVC) diameter as a predictor of fluid responsiveness in patients with acute circulatory failure. METHODS: Electronic searches combined with reference review of identified studies...
May 2017: Shock
https://www.readbyqxmd.com/read/28383844/-point-of-care-ultrasound-in-emergency-department-a-case-report-of-acute-dyspnea-during-pregnancy
#11
L Marissiaux, M Gensburger, A Tromba, B Duysinx, P Meunier, V D'Orio, A Ghuysen
On the basis of the case report of a pregnant woman with acute pleuritis, this article describes the diagnostic modalities of dyspnea during pregnancy. The utility and effectiveness of bedside ultrasound examination by the emergency physician («POCUS») are reviewed in view of recent literature data. The ultrasound in this case is considered to be the extension of physical examination aiming at providing answers with immediate clinical relevance.
July 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28377943/expert-evaluation-of-a-chicken-tissue-based-model-for-teaching-ultrasound-guided-central-venous-catheter-insertion
#12
Akiva Nachshon, John D Mitchell, Ariel Mueller, Valerie M Banner-Goodspeed, Jakob I McSparron
BACKGROUND: Ultrasound-guided central venous catheterization (CVC) is a commonly performed procedure which carries significant risks for complications. Current models used for simulation-based teaching are expensive and may not replicate tissue feel and ultrasound qualities of human tissues. We aimed to evaluate a tissue model composed of chicken breast and balloons and compare it to a commercially available mannequin. METHODS: Forty attending physicians from four departments with extensive CVC experience were enrolled...
January 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/28376563/the-effect-of-access-to-electronic-health-records-on-throughput-efficiency-and-imaging-utilization-in-the-emergency-department
#13
Matthew M Knepper, Edward M Castillo, Theodore C Chan, David A Guss
STUDY OBJECTIVE: To evaluate whether the availability of Electronic Health Records (EHRs) reduces throughput time and utilization of advanced imaging for patients in an academic ED. DATA SOURCES: All patients arriving at an academic Emergency Department (ED) via ambulance between June 1, 2011, and June 4, 2012, were included in the study. This accounted for 9,970 unique ambulance patient visits. STUDY DESIGN: Retrospective noninterventional analysis of patients in an academic ED...
April 4, 2017: Health Services Research
https://www.readbyqxmd.com/read/28372830/air-and-its-sonographic-appearance-understanding-the-artifacts
#14
Simran Buttar, Denrick Cooper, Patrick Olivieri, Michael Barca, Aaran B Drake, Melvin Ku, Gabriel Rose, Sebastian D Siadecki, Turandot Saul
BACKGROUND: Although air has traditionally been considered a barrier to sonographic imaging, when encountered in unusual settings it can serve as an important indicator of various pathologic states as well. Clinician recognition and thorough understanding of the characteristic pattern of artifacts generated by air are critical for making a number of important diagnoses. CASE SERIES: We present five emergency department cases in which air was visualized in a pathologic location...
March 31, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28368084/neurovascular-ultrasound-in-emergency-settings-diagnostic-and-therapeutic-aspects
#15
REVIEW
T Santos, M Veloso, P Barros
INTRODUCTION: Neurovascular ultrasound is a non-invasive, portable and fast imaging method that, when performed by an experienced neurosonologist, offers reliable and reproducible information on the morphological and hemodynamic status of cervical and intracranial vessels. AIM: To review the available evidence regarding the use of this tool in the approach to acute stroke. DEVELOPMENT: Neurovascular ultrasound can be used in one of two ways: diagnostic and therapeutic...
April 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28366287/whole-body-computed-tomography-versus-selective-radiological-imaging-strategy-in-trauma-an-evidence-based-clinical-review
#16
Brit Long, Michael D April, Shane Summers, Alex Koyfman
BACKGROUND: Trauma patients often present with injuries requiring resuscitation and further evaluation. Many providers advocate for whole body computed tomography (WBCT) for rapid and comprehensive diagnosis of life-threatening injuries. OBJECTIVE: Evaluate the literature concerning mortality effect, emergency department (ED) length of stay, radiation, and incidental findings associated with WBCT. DISCUSSION: Physicians have historically relied upon history and physical examination to diagnose life-threatening injuries in trauma...
March 21, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28363670/using-the-analytic-hierarchy-process-for-prioritizing-imaging-tests-in-diagnosis-of-suspected-appendicitis
#17
Maria Agapova, Brian W Bresnahan, Ken F Linnau, Louis P Garrison, Mitchell Higashi, Larry Kessler, Beth Devine
RATIONALE AND OBJECTIVES: In clinical guideline or criteria development processes, such as those used in developing American College of Radiology Appropriateness Criteria (ACR AC), experts subjectively evaluate benefits and risks associated with imaging tests and make complex decisions about imaging recommendations. The analytic hierarchy process (AHP) decomposes complex decisions into structured smaller decisions, incorporates quantitative evidence and qualitative expert opinion, and promotes structured consensus building...
March 28, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28357139/effect-of-focused-bedside-ultrasonography-in-hypotensive-patients-on-the-clinical-decision-of-emergency-physicians
#18
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/28355246/search-8es-a-novel-point-of-care-ultrasound-protocol-for-patients-with-chest-pain-dyspnea-or-symptomatic-hypotension-in-the-emergency-department
#19
Jung Hwan Ahn, Jin Jeon, Hong-Chuen Toh, Vicki Elizabeth Noble, Jun Su Kim, Young Sik Kim, Han Ho Do, Young Rock Ha
OBJECTIVE: This study was conducted to evaluate a problem-oriented focused torso bedside ultrasound protocol termed "Sonographic Evaluation of Aetiology for Respiratory difficulty, Chest pain, and/or Hypotension" (SEARCH 8Es) for its ability to narrow differential diagnoses and increase physicians' diagnostic confidence, and its diagnostic accuracy, for patients presenting with dyspnea, chest pain, or symptomatic hypotension. METHODS: This single-center prospective observational study was conducted over 12 months in an emergency department and included 308 patients (184 men and 124 women; mean age, 67...
2017: PloS One
https://www.readbyqxmd.com/read/28355138/ultrasound-to-detect-pressure-related-deep-tissue-injuries-in-adults-admitted-via-the-emergency-department-a-prospective-descriptive-pilot-study
#20
Jonathan Scheiner, Karen Farid, Mark Raden, Seleshi Demisse
Stage 4 pressure ulcers (PUs) start with tissue death at the level of the bone, also known as deep tissue injury (DTI). Studies have shown the appearance of DTI on the skin is delayed for several days after the original pressure-related injury to the deep soft tissues. Studies also suggest DTI can be seen using ultrasound (US) technology. A prospective, descriptive, correlational pilot study was conducted to evaluate the use of US technology to detect DTI in the soft tissues that are not visible on the skin upon hospital admission...
March 2017: Ostomy/wound Management
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