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Emergency department ultrasound

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https://www.readbyqxmd.com/read/29349680/ultrasound-evaluation-of-the-airway-in-the-ed-a-feasibility-study
#1
Elizabeth A Hall, Ibrahim Showaihi, Frances S Shofer, Nova L Panebianco, Anthony J Dean
BACKGROUND: Recognition of the difficult airway is a critical element of emergency practice. Mallampati score and body mass index (BMI) are not always predictive and they may be unavailable in critically ill patients. Ultrasonography provides high-resolution images that are rapidly obtainable, mobile, and non-invasive. Studies have shown correlation of ultrasound measurements with difficult laryngoscopy; however, none have been performed in the Emergency Department (ED) using a consistent scanning protocol...
January 18, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29346232/use-of-point-of-care-ultrasound-to-guide-pediatric-gastrostomy-tube-replacement-in-the-emergency-department
#2
Toby C Myatt, Anthony J Medak, Samuel H F Lam
The presentation of a pediatric patient to the emergency department for a malfunctioning or dislodged gastrostomy tube (G-tube) is not uncommon. As such, these tubes are often replaced at the bedside. Improper placement can result in a number of complications, including perforation, fistula tract formation, peritonitis, and sepsis. The current criterion standard method to confirm proper G-tube placement is contrast-enhanced radiography. However, point-of-care ultrasound may be an alternative method to guide and confirm pediatric G-tube replacement in the emergency department...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29343245/an-unusual-case-of-symptomatic-deep-vein-thrombosis-and-pulmonary-embolism-after-arthroscopic-meniscus-surgery
#3
Chao-Hua Fang, Hua Liu, Jun-Hui Zhang, Shi-Gui Yan
BACKGROUND: Although thrombosis complication is rare after arthroscopic meniscus surgery, deep vein thrombosis and pulmonary embolism can be fatal. The associated risk factors and whether anticoagulant prevention after arthroscopic knee surgery is necessary have not reach consensus. Here we present a case of deep vein thrombosis and pulmonary embolism after a common arthroscopic meniscectomy. CASE PRESENTATION: The patient had no risk factors except ipsilateral leg varicose veins...
January 17, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29342466/deep-vein-thrombosis-a-rare-cause-of-acute-testicular-pain-case-report-literature-review
#4
Adrián Amador Robayna, Jonathan Rodríguez Talavera, Begoña Ballesta Martínez, Javier Falcón Barroso, Almudena Carrión Valencia, Nuria Orribo Morales, Melania Santacruz Pérez, Jesús Monllor Gisbert
INTRODUCTION: Thrombosis is defined as the formation of a clot in a blood vessel that obstructs the flow of blood to the peripheral tissues. The incidence of thromboembolic disease ranges from 0.7 to 1.2% within urology. CASE REPORT: A 40-year-old warehouse worker male presented to the emergency department with worsening of a month's lasting scrotal pain. Physical examination showed the presence of an enlarged and painful left testicle with no other findings. Right testicle, penis and abdominal examination showed no abnormalities whatsoever...
January 17, 2018: Urologia Internationalis
https://www.readbyqxmd.com/read/29340508/-space-time-and-power-in-hospital-health-care-contributions-based-on-the-ethnography-of-an-obstetric-center
#5
María Guadalupe García, María Laura Recoder, Susana Margulies
This paper presents the results of an ethnographic study of an obstetric center within a hospital of Greater Buenos Aires and an analysis of the spatio-temporal dimension of hospital care. The fieldwork, carried out between 2007 and 2011, followed the everyday dynamics of the hospital and included observation in the obstetrics unit (waiting areas, the obstetric center where births and emergencies receive care, and the ambulatory care, ultrasound, and hospitalization rooms, among others) as well as spaces such as the appointments and statistics offices, the office of social services, the central hall, the pharmacy, and hallway waiting areas...
July 2017: Salud Colectiva
https://www.readbyqxmd.com/read/29337338/goda-resultat-n%C3%A3-r-akutl%C3%A3-kare-diagnostiserade-djup-ventrombos-dvt-diagnostik-kan-utf%C3%A3-ras-med-ultraljud-p%C3%A3-akuten-enligt-pilotstudie-vid-lasarettet-i-ystad
#6
David Nygren, Caroline Hård Af Segerstad, Catarina Ellehuus Hilmersson, Johan Elf, Ekelund Ulf, Jakob Lundager Forberg
Good outcomes when emergency physicians diagnosed deep vein thrombosis Deep vein thrombosis of the lower limb is best diagnosed with ultrasound. Internationally, several studies have shown promising and often equal results when emergency physicians have been compared with radiologists in diagnosing thrombosis. Our results confirm these findings in a non-academic hospital and for the first time in a Swedish setting. Our findings form the basis for a multi-centre study on new diagnostic routines in patients with suspected proximal deep vein thrombosis in the emergency department, potentially resulting in faster and more resource-effective management...
January 15, 2018: Läkartidningen
https://www.readbyqxmd.com/read/29336754/predictors-and-outcomes-of-nondiagnostic-ultrasound-for-acute-appendicitis-in-children
#7
Richard Sola, Blair A Wormer, William E Anderson, Thomas M Schmelzer, Graham H Cosper
Ultrasound assessments of children with possible acute appendicitis (AA) are often nondiagnostic. We aimed to identify the predictors of nondiagnostic ultrasound and to investigate the outcomes. A retrospective review was conducted on children aged 4 to 17 years evaluated in 2013 for AA with ultrasound at a tertiary hospital pediatric emergency department. Demographics, clinical data, and outcomes were analyzed. Of 528 children, 194 (36.7%) had diagnostic ultrasounds and 334 (63.3%) had nondiagnostic ultrasounds...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29330983/ultrasound-and-supine-chest-radiograph-in-road-traffic-accident-patients-a-reliable-and-convenient-way-to-diagnose-pleural-effusion
#8
Uzma Mumtaz, Zainab Zahur, Muhammad Ali Raza, Madiha Mumtaz
BACKGROUND: Portable bed side ultrasound and supine chest radiograph of 80 traumatic patients excluding very clinically unstable patients who subsequently underwent CT scan chest was done for traumatic effusion showing that ultrasound had a higher sensitivity than CXR, 88.23% and 77.94%, respectively, and a similar specificity of 100% and 100%, respectively. Objective of the study is to compare the diagnostic accuracy of high resolution ultrasound and supine chest x-ray in detection of pleural effusion in road traffic accident patients keeping plain CT chest as gold standard...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29328792/identification-and-management-of-nontraumatic-splenic-rupture
#9
Samanthi De Silva
A 43-year old previously fit and well gentleman presented to the emergency department (ED) with a two day history of worsening epigastric pain. He had had coryzal symptoms the preceding week but had no other past medical history. He was haemodynamically stable at presentation and an ultrasound scan (US) performed in the ED could not definitively rule out intra-abdominal fluid. In view of his tender abdomen on examination and a haemoglobin level of 9.2g/dL, a computerised tomography (CT) scan was performed and revealed extensive high-density fluid within the peritoneal cavity, raising the possibility of a concealed bleed but no obvious source was identified by the scan...
December 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29322942/purulent-pericarditis-an-unusual-complication-of-pneumococcal-pneumonia-a-case-report
#10
Ghizlane Zoulati, Ramatou Yèya Maïga, Rachid Kerzaz, Ghita Yahyaoui, Mustapha Harandou, Mustapha Mahmoud
Purulent pericarditis has become rare since the advent of antibiotics. Among the involved germs, S. pneumoniae remains the most implicated pathogen to evoke in principle, especially that prescription of systematic antibiotics for any febrile condition can considerably mask the clinical picture. A 36-year-old pregnant woman was visiting the emergency department for dyspnea and flu-like syndrom that had been going on for a week. The chest X-ray showed a white lung on the left and the transthoracic ultrasound revealed a pericardial effusion, resulting in pericardial drainage and pleural puncture that allows the evacuation of a purulent fluid...
January 11, 2018: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/29321112/the-evaluation-and-management-of-urolithiasis-in-the-emergency-department-a-review-of-the-literature
#11
REVIEW
Michael Gottlieb, Brit Long, Alex Koyfman
BACKGROUND: Urolithiasis is a common condition in the U.S. Patients frequently present to the emergency department (ED) for care, including analgesia and treatments to facilitate stone passage. OBJECTIVE: With the new evidence concerning the evaluation and treatment of urolithiasis, this review summarizes current literature regarding the ED management of urolithiasis. DISCUSSION: Urolithiasis occurs primarily through supersaturation of urine and commonly presents with flank pain, hematuria, and nausea/vomiting...
January 5, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29310984/comparison-of-sonographic-inferior-vena-cava-and-aorta-indexes-during-fluid-administered-in-children
#12
Yun Ang Choi, Hyuksool Kwon, Jin Hee Lee, Jae Yun Jung, Yoo Jin Choi
OBJECTIVES: This prospective, observational study evaluated changes in ultrasound measurements of the inferior vena caval index (IVCI), the aorta diameter/IVC diameter index (Ao/IVCD), and the aorta area/IVC area index (Ao/IVCA) during fluid administration in children requiring intravenous fluid administration. METHODS: Children who presented to the pediatric emergency department with symptoms of dehydration were enrolled between May 2015 and February 2016. The maximum diameter of the aorta, from inner wall to inner wall, and the long and short axis diameters of IVC were measured using a convex array transducer in the transverse view...
January 4, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29310702/mondor-s-disease-a-rare-cause-of-chest-pain-a-case-report
#13
Navaneethakrishnan Suganthan, Vithiya Ratnasamy
BACKGROUND: Chest pain is one of the common presenting symptoms encountered in an emergency department. Prompt history taking and careful clinical examination do help to differentiate cardiac chest pain from other causes. Mondor's disease is a rare cause of chest pain which is often underdiagnosed due to lack of awareness. Mondor's disease is a condition characterized by thrombophlebitis of the superficial veins of breast and anterior chest wall. The diagnosis is often made clinically...
January 9, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29309713/routine-preoperative-venous-doppler-screening-is-not-effective-in-preventing-thromboembolic-events-after-total-joint-arthroplasty
#14
Morteza Meftah, Peter B White, Ahmed Siddiqi, Vinayak S Perake, Ira H Kirschenbaum
Despite advances in thromboprophylaxis, the relationship between preexisting deep venous thromboses (DVTs) and postoperative thromboembolic complications is not fully established. The aim of this study was to assess the utility of selective and nonselective preoperative lower extremity venous Doppler screening protocols as tools in reducing the incidence of thromboembolic events (DVT/pulmonary embolism [PE]) after total joint arthroplasty. In the 2-year period from August 2013 to August 2015, a total of 455 consecutive elective primary total joint arthroplasties were identified from the authors' database...
January 8, 2018: Orthopedics
https://www.readbyqxmd.com/read/29307034/emergency-department-imaging-of-pediatric-trauma-patients-during-combat-operations-in-iraq-and-afghanistan
#15
Jason F Naylor, Michael D April, Jamie L Roper, Guyon J Hill, Paul Clark, Steven G Schauer
BACKGROUND: Military hospitals in Iraq and Afghanistan treated children with traumatic injuries during the recent conflicts. Diagnostic imaging is an integral component of trauma management; however, few published data exist on its use in the wartime pediatric population. OBJECTIVE: The authors describe the emergency department (ED) utilization of radiology resources for pediatric trauma patients in Iraq and Afghanistan. MATERIALS AND METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric patients admitted to military fixed-facility hospitals in Iraq and Afghanistan from January 2007 to January 2016...
January 6, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29306644/increasing-utilization-of-emergency-department-neuroimaging-in-medicare-beneficiaries-from-1994-to-2015
#16
Anand M Prabhakar, Ravi V Gottumukkala, Jennifer Hemingway, Danny R Hughes, Sumir S Patel, Richard Duszak
OBJECTIVE: To assess for changes in emergency department (ED) utilization of neuroimaging in Medicare fee-for-service beneficiaries from 1994 to 2015. METHODS: Using Medicare Physician Supplier Procedure Summary Master Files, annual ED volumes of head computed tomography (CT), magnetic resonance (MR), and carotid duplex ultrasound (CDUS) were assessed from 1994 through 2015. Annual volumes of head CT angiography (CTA), neck CTA, head MR angiography (MRA), and neck MRA studies were assessed from 2001 (first year of unique reporting codes) through 2015...
December 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29306580/comparison-of-the-accuracy-of-emergency-department-performed-point-of-care-ultrasound-pocus-in-the-diagnosis-of-lower-extremity-deep-vein-thrombosis
#17
Jorge Pedraza García, Joaquín Valle Alonso, Pedro Ceballos García, Francisca Rico Rodríguez, Miguel Ángel Aguayo López, María Del Carmen Muñoz-Villanueva
BACKGROUND: Compression ultrasonography is the most effective diagnostic tool in the emergency department (ED) for the diagnosis of deep vein thrombosis (DVT). It has been demonstrated to be highly accurate and cost-effective. OBJECTIVE: The objective of this study was to determine the accuracy of emergency physicians who performed three-point compression ultrasound (US) for suspected above-knee DVT within the context of using Wells score and D-dimer. METHOD: This was a prospective diagnostic test assessment of three-point ultrasound conducted in a district general hospital of patients who presented to the ED with suspected DVT of the lower limb...
January 3, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29304490/inflammatory-lung-edema-correlates-with-echocardiographic-estimation-of-capillary-wedge-pressure-in-newly-diagnosed-septic-patients
#18
Thiago M Santos, Daniel Franci, Carolina M Gontijo-Coutinho, Tatiana Mirabetti Ozahata, Tiago de Araújo Guerra Grangeia, José R Matos-Souza, Marco A Carvalho-Filho
PURPOSE: Lung ultrasound is an accurate and accessible tool to quantify lung edema. Furthermore, left ventricle filling pressures (LVFP) can be assessed with transthoracic echocardiography (TTE) by the E/e' ratio (E/e'). The present study aimed to assess the correlation between E/e' and lung edema quantified by a simplified lung ultrasound score (LUS) in newly admitted septic patients. MATERIALS AND METHODS: In this prospective observational cohort, septic adult patients admitted at the emergency department of a tertiary hospital were included...
December 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29301653/successful-emergency-pain-control-for-posterior-rib-fractures-with-ultrasound-guided-erector-spinae-plane-block
#19
Josh Luftig, Daniel Mantuani, Andrew A Herring, Brittany Dixon, Eben Clattenburg, Arun Nagdev
The Eastern Association for the Surgery of Trauma and Trauma Anesthesiology Society Guidelines recommend prompt and effective multimodal analgesia for rib fractures that combines regional anesthesia (RA) techniques with pharmacotherapy to treat pain, optimize pulmonary function, and reduce opioid related complications. However, RA techniques such as epidurals and paravertebral blocks, are generally underutilized or unavailable for emergency department (ED) patients. The recently described serratus anterior plane block (SAPB) is a promising technique, but failures with posterior rib fractures have been observed...
December 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29298251/bedside-ultrasound-for-the-evaluation-of-epidural-hematoma-after-infant-lumbar-puncture
#20
Matthew P Kusulas, Eric P Eutsler, Andrew D DePiero
BACKGROUND: Unsuccessful lumbar puncture (LP) attempts may lead to epidural hematoma (EH) formation within the spinal canal at the site of needle insertion, which can affect subsequent attempts. We aimed to determine the rate of EH formation after infant LP using bedside ultrasound (US). Furthermore, we aimed to correlate both perceived trauma during LP and cerebral spinal fluid (CSF) red blood cell (RBC) counts with EH formation. METHODS: We enrolled infants younger than 6 months who underwent LP in the emergency department...
January 2, 2018: Pediatric Emergency Care
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