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Emergency department ultrasound

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https://www.readbyqxmd.com/read/28926507/point-of-care-ultrasound-could-streamline-the-emergency-department-workflow-of-clinically-nonspecific-intussusception
#1
Jung Heon Kim, Jeong-Yong Lee, Jae Hyun Kwon, Hyung-Rae Cho, Jong Seung Lee, Jeong-Min Ryu
OBJECTIVES: The aim of this study was to evaluate whether point-of-care ultrasound (POCUS) for intussusception screening streamlines the workflow of clinically nonspecific intussusception (CNI), an intussusception presenting with only 1 manifestation of the classic triad, and/or vomiting. METHODS: We reviewed 274 consecutive children with intussusception, aged 6 years or younger, who visited a tertiary care hospital emergency department between May 2012 and April 2016...
September 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28923679/inguinal-hernia-containing-urinary-bladder-a-case-report
#2
Milena Taskovska, Jurij Janež
INTRODUCTION: Inguinal bladder hernia is rare condition found in about 1-5% of inguinal hernias. The condition is usually diagnosed intraoperatively. Patients rarely have symptoms regarding urinary tract. The best management is surgical, open surgical technique is preferred over laparoscopic. Possible urinary tract damage during surgery should be recognized and resolved. CASE PRESENTATION: The following paper presents case of inguinal bladder hernia in 82-year old Caucasian male...
September 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28916590/us-emergency-department-trends-in-imaging-for-pediatric-nontraumatic-abdominal-pain
#3
Lauren M Niles, Monika K Goyal, Gia M Badolato, James M Chamberlain, Joanna S Cohen
OBJECTIVES: To describe national emergency department (ED) trends in computed tomography (CT) and ultrasound imaging for the evaluation of pediatric nontraumatic abdominal pain from 2007 through 2014. METHODS: We used data from the National Hospital Ambulatory Medical Care Survey to measure trends in CT and ultrasound use among children with nontraumatic abdominal pain. We performed multivariable logistic regression to measure the strength of the association of ED type (pediatric versus general ED) with CT and ultrasound use adjusting for potential confounding variables...
September 15, 2017: Pediatrics
https://www.readbyqxmd.com/read/28914343/image-guided-percutaneous-removal-of-ballistic-foreign-bodies-secondary-to-air-gun-injuries
#4
Jacob L Rothermund, Andrew J Rabe, Nicholas A Zumberge, James W Murakami, Patrick S Warren, Mark J Hogan
BACKGROUND: Ballistic injuries with retained foreign bodies from air guns is a relatively common problem, particularly in children and adolescents. If not removed in a timely fashion, the foreign bodies can result in complications, including pain and infection. Diagnostic methods to identify the presence of the foreign body run the entire gamut of radiology, particularly radiography, ultrasound (US) and computed tomography (CT). Removal of the foreign bodies can be performed by primary care, emergency, surgical, and radiologic clinicians, with or without imaging guidance...
September 15, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28914285/hospital-medicine-point-of-care-ultrasound-credentialing-an-example-protocol
#5
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/28912821/thyrotoxicosis-and-choledocholithiasis-masquerading-as-thyroid-storm
#6
Christian L Horn, Patricia A Short
A 26-year-old female, thirteen months postpartum, presented to the emergency department for four weeks of epigastric abdominal pain, pruritus, new onset jaundice, and 11.3 kgs (25 lbs) unintentional weight loss. On examination, she was afebrile, tachycardic, alert, and oriented and had jaundice with scleral icterus. Labs were significant for undetectable TSH, FT4 that was too high to measure, and elevated total bilirubin, direct bilirubin, alkaline phosphatase, and transaminases. Abdominal ultrasound revealed cholelithiasis without biliary ductal dilation...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28900525/a-case-of-legionella-pneumophila-evaluated-with-ct-and-ultrasound
#7
Alessio D'Angelo, Chiara De Simone, Marco Pagnottella, Stefano Rossi, Raffaele Pepe, Giacomo Ruggieri, Giulio Cocco, Cosima Schiavone
A 36-year-old man was admitted to the emergency department of "SS Annunziata" hospital in Chieti complaining of a sharp chest pain arisen some hours before admission. On examination, the patient looked sweaty; his vital signs showed tachycardia and augmented breath rate; sinus tachycardia and normal ventricular repolarization were observed on ECG, and no abnormalities were observed in the echoscan of the hearth. According to the clinical and electrocardiographic findings, and to previous episode of DVT in anamnesis, a thorax CT scan was performed in order to rule out pulmonary embolism...
September 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28899594/delayed-detection-of-spontaneous-bilateral-tubal-ectopic-pregnancies-after-methotrexate-treatment
#8
Nicole E Brown, Shereen A Singer, Joe Suyama
BACKGROUND: Bilateral tubal ectopic pregnancies are a rare subset of ectopic pregnancy that can pose a diagnostic dilemma for clinicians. There is no distinct clinical presentation for bilateral tubal ectopic pregnancies, although they are typically associated with assistive reproductive techniques. In addition, there is no single diagnostic feature to help clinicians delineate bilateral tubal ectopic pregnancies from other types of ectopic pregnancy prior to passing the discriminatory zone (such as heterotopic pregnancy or twin ectopic [two gestational sacs in one tube])...
September 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28875864/pulmonary-embolism-with-cardiac-arrest-a-stemi-patient-s-unexpected-course
#9
Zoë Piggott, Tomislav Jelic
We describe the successful use and complications of bolus-dose alteplase to treat strongly suspected pulmonary embolism (PE) with cardiac arrest in a patient initially presenting as ST-elevation myocardial infarcation (MI). Case description is followed by a review of the indications, safety, and dosing of systemic thrombolytic therapy for high-risk PE in the emergency department (ED). Diagnostic and therapeutic approach to PE in critically ill patients is also considered, including the potential utility of point-of-care ultrasound (PoCUS) in the ED...
September 6, 2017: CJEM
https://www.readbyqxmd.com/read/28874947/diagnostic-accuracy-of-ultrasound-for-identifying-shoulder-dislocations-and-reductions-a-systematic-review-of-the-literature
#10
REVIEW
Michael Gottlieb, Frances Russell
INTRODUCTION: Patients with shoulder dislocations commonly present to the emergency department. Ultrasound has the potential to save time, radiation exposure, healthcare costs, and possible need for re-sedation. We conducted this systematic review to compare the diagnostic accuracy of ultrasound compared with plain radiography in the assessment of shoulder dislocations. METHODS: We searched PubMed, Scopus, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials for relevant trials...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28871936/xanthoma-like-skin-changes-in-an-elderly-woman-with-a-normal-lipid-profile
#11
Piotr Nockowski, Zdzisław Woźniak, Adam Reich, Joanna Maj
Dear Editor, An 83-year-old woman developed yellow-brownish infiltrates, nodules, and tumors mimicking xanthomas, mostly involving the periorbital and chest area within three months (Figure 1). She had no abnormalities in serum cholesterol or triglycerides levels. A detailed laboratory analysis revealed the presence of mild monoclonal gammopathy with a presence of immunoglobulin G (IgG) kappa light chains; however, according to hematologist consultation, it did not require medical intervention. Imaging assessment and ultrasound examination did not show any specific involvement of internal organs...
July 2017: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/28859628/assessment-of-thoracic-ultrasound-in-complementary-diagnosis-and-in-follow-up-of-community-acquired-pneumonia-cap
#12
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/28857959/ovarian-torsion-in-a-pediatric-patient-the-importance-of-repeat-imaging
#13
Christopher Skappak, Jackie L Thurston, April J Kam
A previously healthy 10-year-old girl presented to the emergency department with a 1-day history of abdominal pain. She was afebrile with an elevated white blood cell count and a negative pelvic ultrasound. The pain resolved while in hospital, and the patient was discharged home. The patient returned 10 days later, and the pain now migrated from the left flank to the subumbilical region. The patient now had an elevated white blood cell count and C-reactive protein. On pelvic ultrasound, the patient had a large midline mass and a normal right ovary...
July 3, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28856019/detailed-efsum-recommendations-on-the-scope-of-ultrasound-assessment-in-patients-with-portal-hypertension-considering-the-diagnostic-reference-level
#14
REVIEW
Andrzej Smereczyński, Katarzyna Kołaczyk
An important paper describing the Standards of the Polish Ultrasound Society regarding the assessment of portal and hepatic vasculature was published in the Journal of Ultrasonography. Due to the multiplicity of morphological and hemodynamic data required, the time needed to obtain these data and the legal responsibility of doctors for the results, there seems to be a need to determine a clear range of the assessed parameters depending on the reference level of a given healthcare facility. Therefore, the aim of the paper was to present the EFSUMB recommendations on the range of the evaluated ultrasonographic parameters in portal hypertension depending on the reference level...
June 2017: Journal of Ultrasonography
https://www.readbyqxmd.com/read/28851498/point-of-care-ultrasound-leads-to-diagnostic-shifts-in-patients-with-undifferentiated-hypotension
#15
Hamid Shokoohi, Keith S Boniface, Michelle Zaragoza, Ali Pourmand, James P Earls
OBJECTIVE: To assess the impact of an ultrasound hypotension protocol in identifying life-threatening diagnoses that were missed in the initial evaluation of patients with hypotension and shock. METHODS: A subset of cases from a previously published prospective study of hypotensive patients who presented at the Emergency Department in a single, academic tertiary care hospital is described. An ultrasound-trained emergency physician performed an ultrasound on each patient using a standardized hypotension protocol...
August 26, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28844655/a-missed-diagnosis-of-multiple-intraocular-foreign-bodies-for-21-years
#16
Xubo Yang, Chunling Liu, Longqian Liu, Lanlan Zhang
A 30-year-old patient went to the emergency department because of a chemical burn to the left eye more than 10 days ago by toilet cleanser. Surprisingly, a small piece of glass was found in the inferior anterior chamber in the same eye. The visual acuity was counting fingers. There was conjunctival congestion, corneal oedema and Descemet's membrane striae. And there was also a corneal leukoma around 4 to 5 o'clock. Through repeated questioning he recalled that he was injured by an exploded light bulb around 21 years ago...
August 24, 2017: Contact Lens & Anterior Eye: the Journal of the British Contact Lens Association
https://www.readbyqxmd.com/read/28826982/changes-in-the-availability-of-bedside-ultrasound-practice-in-emergency-rooms-and-pre-hospital-settings-in-france
#17
X Bobbia, M Abou-Badra, N Hansel, P Pes, T Petrovic, P G Claret, J Y Lefrant, J E de la Coussaye
OBJECTIVE: Ensuring the availability of ultrasound devices is the initial step in implementing clinical ultrasound (CUS) in emergency services. In France in 2011, 52% of emergency departments (EDs) and only 9% of mobile intensive care stations (MICS) were equipped with ultrasound devices. The main goal of this study was to determine the movement of these rates since 2011. METHODS: We conducted a cross-sectional, descriptive, multi-centre study in the form of a questionnaire...
August 4, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28819597/case-report-oblique-fracture-of-the-ulnar-sesamoid-bone-of-the-metacarpophalangeal-joint-a-rare-pathology
#18
Dauwe Jan, Van der Cruyssen Fréderic, De Smet Luc
INTRODUCTION: Fractures of the sesamoid bones of the metacarpophalangeal joint (MCPJ) are a rare pathology in hand trauma. Only a few case reports and case series were found in literature. The diagnosis of an ulnar sesamoid bone fracture of the MCPJ is difficult and can pose a differential diagnostic problem with Stener lesions or ulnar collateral ligament (UCL) instability. This pathology is frequently missed with subsequent poor functional outcomes. Correct and early diagnosis is important as this will allow for correct treatment with full recovery of function without sequelae...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28816891/computed-tomography-use-plateaus-among-children-with-emergency-visits-for-abdominal-pain
#19
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
#20
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
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