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Emergency department ultrasound

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https://www.readbyqxmd.com/read/28816891/computed-tomography-use-plateaus-among-children-with-emergency-visits-for-abdominal-pain
#1
Jahan Fahimi, Aaron E Kornblith, Hemal Kanzaria, Andrew Herring, Ralph C Wang
OBJECTIVES: Abdominal pain is a common pediatric complaint to emergency departments (EDs), and clinicians often rely on imaging for diagnosis. Studies have demonstrated an increase in computed tomography (CT) in this population. Following emphasis on radiation reduction by researchers and organizations, this study evaluates recent national trends in CT use among pediatric patients presenting to EDs with abdominal pain. METHODS: This is a cross-sectional analysis of ED patients 18 years or younger with chief complaint of abdominal pain in the National Hospital Ambulatory Medical Care Survey from 2008 to 2011...
August 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28807445/the-accuracy-of-emergency-physician-performed-ultrasonography-as-a-diagnostic-tool-for-lateral-malleolar-fracture
#2
Pinar Ozturk, Ersin Aksay, Nese Colak Oray, Basak Bayram, Onur Basci, Duygu Tokgoz
OBJECTIVE: Many studies in the literature related to the investigation of the sensitivity and specificity of ultrasound examinations in lateral malleolar fractures is limited. The aim of this study is to investigate the sensitivity and specificity of ultrasound examinations performed by emergency physicians in fractures who are presented to the emergency department with blunt lateral malleolar trauma. METHOD: Patients over 18years of age who were admitted to the ED with lateral malleolar tenderness were enrolled to this study with convenience sampling...
August 7, 2017: American Journal of 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
#3
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
#4
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/28797559/utilization-of-ultrasound-for-the-evaluation-of-small-bowel-obstruction-a-systematic-review-and-meta-analysis
#5
Michael Gottlieb, Gary D Peksa, Ananda Vishnu Pandurangadu, Damali Nakitende, Sukhjit Takhar, Raghu R Seethala
INTRODUCTION: Small bowel obstruction (SBO) is a common presentation to the Emergency Department (ED). While computed tomography (CT) is frequently utilized to confirm the diagnosis, this modality is expensive, exposes patients to radiation, may lead to time delays, and is not universally available. This study aimed to determine the test characteristics of ultrasound for the diagnosis of SBO. METHODS: PubMed, CINAHL, Scopus, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were assessed for prospective trials evaluating the accuracy of ultrasound for the detection of SBO...
July 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28796651/ultrasound-assisted-reduction-of-displaced-and-shortened-fractures-by-pediatric-emergency-physicians
#6
Eric Scheier, Uri Balla
Pediatric emergency physicians at Kaplan Medical Center regularly reduce forearm fractures under point-of-care ultrasound guidance in the pediatric emergency department. We present 3 children who arrived at our department with shortened, angulated forearm fractures within the span of a single week. We report on the successful reduction of these fractures under point-of-care ultrasound and on the maintenance of anatomic alignment at follow-up 1 week postreduction.
August 7, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28793278/mixed-adenoneuroendocrine-carcinoma-derived-from-the-cystic-duct-a-case-report
#7
Yu-Ki Takemoto, Tomoyuki Abe, Hironobu Amano, Keiji Hanada, Akihito Okazaki, Tomoyuki Minami, Tsuyoshi Kobayashi, Masahiro Nakahara, Shuji Yonehara, Hideki Ohdan, Toshio Noriyuki
INTRODUCTION: Mixed adenoneuroendocrine carcinomas (MANECs) derived from cystic duct are extremely rare. PRESENTATION OF CASE: An 80-year-old woman was admitted to the department of surgery, Onomichi general hospital with abnormal liver function and jaundice. Enhanced abdominal computed tomography (CT) detected a well-enhanced papillary tumor in the cystic duct, which protruded into the common bile duct. The intrahepatic bile duct was dilated due to tumor obstruction...
July 13, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28777271/point-of-care-ultrasound-in-acute-neonatal-ascites
#8
Sriram Ramgopal, Stefan Scholz, Jennifer R Marin
We present a 4-week-old neonate with acute onset of bloody stools and abdominal distention. Point-of-care ultrasound performed in the emergency department allowed for rapid diagnosis of a large amount of free intra-abdominal fluid, which together with the physical findings, prompted emergent operative exploration revealing chylous ascites. Although no areas of active volvulus were identified intraoperatively, findings in the case were suggestive of small bowel volvulus and deemed as the most likely etiology for this patient's presentation...
August 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28774767/variation-in-the-evaluation-of-testicular-conditions-across-united-states-pediatric-emergency-departments
#9
Lois K Lee, Michael C Monuteaux, Joel D Hudgins, John J Porter, Susan C Lipsett, Florence Bourgeois, Bartley G Cilento, Mark I Neuman
OBJECTIVES: To explore the variation in diagnostic testing and management for males diagnosed with three testicular conditions (testicular torsion, appendix testis torsion, epididymitis/orchitis) using a large pediatric health care database. Diagnostic testing is frequently used in evaluation of the acute scrotum; however, there is likely variability in the use of these tests in the emergency department setting. METHODS: We conducted a cross-sectional study of males with the diagnoses of testicular torsion, appendix testis torsion, and epididymitis/orchitis...
July 26, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28763407/point-of-care-ultrasound-diagnosis-of-multiple-mandibular-fractures-in-an-adolescent-presenting-to-the-pediatric-emergency-department
#10
Nathan Zapolsky, Ivan Joseph Zapolsky, Czer Anthoney Lim
We present a case of an adolescent patient with multiple mandibular fractures diagnosed by point-of-care ultrasound in the pediatric emergency department. Sonographic findings consistent with fracture were identified in our patient, and early consultation expedited interdepartmental coordination and disposition. The role of ultrasound in identifying various traumatic orthopedic and maxillofacial injuries is discussed.
August 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28756934/postoperative-anticholinergic-poisoning-concealed-complications-of-a-commonly-used-medication
#11
Xiao Chi Zhang, Natalija Farrell, Thomas Haronian, Jason Hack
BACKGROUND: Scopolamine is a potent anticholinergic compound used commonly for the prevention of postoperative nausea and vomiting. Scopolamine can cause atypical anticholinergic syndromes due to its prominent central antimuscarinic effects. CASE REPORT: A 47-year-old female presented to the emergency department (ED) 20 h after hospital discharge for a right-knee meniscectomy, with altered mental status (AMS) and dystonic extremity movements that began 12 h after her procedure...
July 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28756363/torsion-of-huge-wandering-accessory-spleen-case-report-and-review-of-literature
#12
Salah Termos, Ahmad Redha, Riad Zbibo, Abdulla Alduwaisan, Majd AlKabbani, Nidal Elyousif, Mohammad Alali
INTRODUCTION: Accessory spleens are found in 10-15% of the population, and are even more prevalent in patients with hematological disorders (Rudowski, 1985). It infrequently may become symptomatic due to torsion, spontaneous rupture or hemorrhage which may lead to death. Torsion of an accessory spleen is extremely rare, and requires prompt medical attention [2] (Coote et al., 1999). PRESENTATION OF CASE: We report the case of a 27-year-old Mediterranean lady with thalassemia trait, who presented to the emergency department with an acute surgical abdomen due to torsion of a giant accessory spleen, measuring 13cm...
July 22, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28754527/ultrasound-use-during-cardiopulmonary-resuscitation-is-associated-with-delays-in-chest-compressions
#13
Maite A Huis In 't Veld, Michael G Allison, David S Bostick, Kiondra R Fisher, Olga G Goloubeva, Michael D Witting, Michael E Winters
AIM: High-quality chest compressions are a critical component of the resuscitation of patients in cardiopulmonary arrest. Point-of-care ultrasound (POCUS) is used frequently during emergency department (ED) resuscitations, but there has been limited research assessing its benefits and harms during the delivery of cardiopulmonary resuscitation (CPR). We hypothesized that use of POCUS during cardiac arrest resuscitation adversely affects high-quality CPR by lengthening the duration of pulse checks beyond the current cardiopulmonary resuscitation guidelines recommendation of 10s...
July 25, 2017: Resuscitation
https://www.readbyqxmd.com/read/28752731/cardiac-imaging-in-patients-with-dyspnea
#14
Pierfranco Dellavesa, Federico Nardi
Acute dyspnea is a frequent cause of access to the Discharge Department (DEA); Differentiation between cardiogenic and respiratory causes does not always seem simple and certain, causing a delay in initiating targeted therapies and prolonging the Patient's stay in the emergency department. The basic elements for the diagnosis remain the history and the objective examination, supplemented by the execution of an electrocardiogram, a determination of blood parameters and the execution of a chest X-ray. The limits of radiological semeiotics, related to a low sensitivity to high specificity, promote other methods available to the physician of First Aid...
July 27, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28745844/emergency-department-management-of-priapism-digest
#15
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/28731535/ultrasound-guided-drainage-for-pediatric-soft-tissue-abscesses-decreases-clinical-failure-rates-compared-to-drainage-without-ultrasound-a-retrospective-study
#16
Romolo Joseph Gaspari, Alexandra Sanseverino
OBJECTIVES: Soft tissue abscesses are common in the pediatric emergency department (ED). Ultrasound (US) can be used to both diagnose soft tissue abscesses as well as guide drainage. We hypothesized that clinical failure rates would be less in pediatric patients with suspected skin abscesses when evaluated with US. METHODS: We performed a retrospective review of suspected pediatric skin abscesses at 4 EDs over a 22-month period. Cases were identified through electronic medical record descriptions, discharge diagnoses, and US database records...
July 21, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28729007/the-feasibility-of-point-of-care-ankle-ultrasound-examination-in-patients-with-recurrent-ankle-sprain-and-chronic-ankle-instability-comparison-with-magnetic-resonance-imaging
#17
Sun Hwa Lee, Seong Jong Yun
OBJECTIVE: To evaluate the feasibility of point-of-care ankle ultrasound compared with magnetic resonance imaging (MRI) for diagnosing major ligaments and Achilles tendon injuries in patients with recurrent ankle sprain and chronic instability, and to evaluate inter-observer reliability between an emergency physician and a musculoskeletal radiology fellow. MATERIAL AND METHODS: A prospective cross-sectional study was conducted in an emergency department. Patients with recurrent ankle sprain and chronic instability were recruited...
July 13, 2017: Injury
https://www.readbyqxmd.com/read/28724473/imagessecondary-cardiac-cancer-mimicking-inferior-st-elevation-myocardial-infarction-diagnosed-using-point-of-care-ultrasound-in-the-emergency-department
#18
Taft Micks, Patricia Kousaie, Aaron Guinn
No abstract text is available yet for this article.
July 20, 2017: CJEM
https://www.readbyqxmd.com/read/28719480/a-rare-pediatric-case-of-posttraumatic-pseudoaneurysm-case-report-and-literature-review
#19
Ada Gu, April J Kam
Posttraumatic pseudoaneurysms are extremely rare in pediatric populations. In many cases, pseudoaneurysms may be confused with abscesses, epidermoid cysts, arteriovenous fistula, foreign objects, and ganglion cysts, as well as tumors. They are associated with distinguishing findings of "pulsatile mass, a palpable thrill, and an audible to-and-fro murmur" (1), which can be confirmed by various imaging techniques. In this report, we describe the case of a 4-year-old boy who presented to the pediatric emergency department 3 weeks after falling and subsequently getting cut by glass...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28714490/current-diagnostic-approach-and-initial-treatment-patterns-for-renal-colic-in-emergency-department
#20
R Shrestha, Y Bista, A Khan
BACKGROUND: Renal colic is a common clinical presentation in emergency. The goal of this study was to describe the epidemiology, current diagnostic and treatment strategies of ureteric colic in our emergency department. METHODS: This is a retrospective study performed over a six months period of patients with clinically suspected renal colic. Data collected included age, sex, urine analysis, ultrasound studies regarding size, site of the stone and presence of hydronephrosis...
January 2017: Journal of Nepal Health Research Council
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