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Pediatric emergency ultrasound

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https://www.readbyqxmd.com/read/29786021/developing-and-implementing-a-global-emergency-medicine-course-lessons-learned-from-rwanda
#1
Sojung Yi, Olivier Félix Umuhire, Doris Uwamahoro, Mindi Guptill, Giles N Cattermole
Background: There is a growing demand by medical trainees for meaningful, short-term global emergency medicine (EM) experiences. EM programs in high-income countries (HICs) have forged opportunities for their trainees to access this experience in low-and middle-income countries (LMICs). However, few programs in LMICs have created and managed such courses. As more LMICs establish EM programs, these settings are ideal for developing courses beneficial for all participants. We describe our experience of creating and implementing a short-term global EM course in Rwanda...
September 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/29784474/point-of-care-ultrasound-differentiation-of-lung-consolidation-and-normal-thymus-in-pediatric-patients-an-educational-case-series
#2
Cynthia A Gravel, Richard G Bachur
BACKGROUND: There is a growing body of evidence to support the utility of lung point-of-care ultrasound (POCUS) in pediatric patients with multiple pulmonary pathologies, particularly pneumonia. As we increase our use of lung POCUS for pediatric patients with respiratory complaints, we must be mindful of the normal anatomy and sonographic findings within the pediatric chest and aware of how to distinguish normal findings (e.g., thymus) from pathologic findings (e.g., consolidation). CASE REPORTS: We report four cases of pediatric patients who presented to the Emergency Department with respiratory complaints for which POCUS was able to distinguish lung consolidation and normal thymus in the anterior chest...
May 18, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29760840/clinical-ultrasound-is-safe-and-highly-specific-for-acute-appendicitis-in-moderate-to-high-pre-test-probability-patients
#3
Daniel Corson-Knowles, Frances M Russell
Introduction: Clinical ultrasound (CUS) is highly specific for the diagnosis of acute appendicitis but is operator-dependent. The goal of this study was to determine if a heterogeneous group of emergency physicians (EP) could diagnose acute appendicitis on CUS in patients with a moderate to high pre-test probability. Methods: This was a prospective, observational study of a convenience sample of adult and pediatric patients with suspected appendicitis. Sonographers received a structured, 20-minute CUS training on appendicitis prior to patient enrollment...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29754963/predictors-of-a-drainable-suppurative-adenitis-among-children-presenting-with-cervical-adenopathy
#4
Amir A Kimia, Tiffany F Rudloe, Nadine Aprahamian, Jennifer McNamara, David Roberson, Assaf Landschaft, Jennifer Vaughn, Marvin B Harper
OBJECTIVES: We sought to identify predictors for a drainable suppurative adenitis [DSA] among patients presenting with acute cervical lymphadenitis. METHODS: A retrospective cross sectional study of all patients admitted to an urban pediatric tertiary care emergency department over a 15 year period. Otherwise healthy patients who underwent imaging for an evaluation of cervical lymphadenitis were included. Cases were identified using a text-search module followed by manual review...
May 5, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29746359/evaluation-of-a-focused-cardiac-ultrasound-protocol-in-a-pediatric-emergency-department
#5
Antonio Riera, Bevin Weeks, Beth L Emerson, Lei Chen
OBJECTIVES: The objective of this study was to evaluate the implementation of a focused cardiac ultrasound (FoCUS) protocol in a pediatric emergency department (PED). METHODS: We conducted a cross-sectional, observational, quality improvement project in a PED of an urban tertiary care children's hospital. A FoCUS protocol was collaboratively developed by pediatric cardiology and pediatric emergency medicine. This included a reference document with definitions, indications, image acquisition guidelines, and interpretation expectations...
May 9, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29738103/bedside-sonography-performed-by-emergency-physicians-to-detect-appendicitis-in-children
#6
Marie Nicole, Marie Pier Desjardins, Jocelyn Gravel
OBJECTIVE: The aim of this study was to evaluate the ability of emergency physicians with various levels of Point of Care Ultrasound (POCUS) experience to detect appendicitis with POCUS among children visiting a pediatric Emergency Department (ED). METHODS: A prospective cohort study was conducted in an urban, tertiary care pediatric ED. Children aged 2 to 18 years old who presented with acute abdominal pain suggesting appendicitis were included. Patients were excluded if they had a history of appendectomy, hemodynamic instability requiring resuscitation, or were transferred with proven diagnosis of appendicitis...
May 8, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29716799/emergency-and-critical-care-applications-for-contrast-enhanced-ultrasound
#7
REVIEW
Tobias Kummer, Laura Oh, Mary Beth Phelan, Robert D Huang, Jason T Nomura, Srikar Adhikari
INTRODUCTION: Contrast-enhanced ultrasound (CEUS) using intravascular microbubbles has potential to revolutionize point-of-care ultrasonography by expanding the use of ultrasonography into clinical scenarios previously reserved for computed tomography (CT), magnetic resonance imaging, or angiography. METHODS: We performed a literature search and report clinical experience to provide an introduction to CEUS and describe its current applications for point-of-care indications...
April 22, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29696826/lung-ultrasound-compared-to-chest-x-ray-for-diagnosis-of-pediatric-pneumonia-a-meta-analysis
#8
REVIEW
Daniel S Balk, Christine Lee, Jesse Schafer, Jeremy Welwarth, John Hardin, Victor Novack, Shaked Yarza, Beatrice Hoffmann
OBJECTIVE: Although a clinical diagnosis, the standard initial imaging modality for patients with concern for pediatric community acquired pneumonia (pCAP) is a chest x-ray (CXR), which has a relatively high false negative rate, exposes patients to ionizing radiation, and may not be available in resource limited settings. The primary objective of this meta-analysis is to evaluate the accuracy of lung ultrasound (LUS) compared to CXR for the diagnosis of pCAP. METHODS: Data were collected via a systematic review of PubMed, EMBASE, and Web of Science with dates up to August 2017...
April 26, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29681446/reduction-of-radiography-with-point-of-care-elbow-ultrasonography-for-elbow-trauma-in-children
#9
Julia Tokarski, Jeffrey R Avner, Joni E Rabiner
OBJECTIVES: To determine whether point-of-care elbow ultrasound (US), with history and physical examination, can decrease radiography for patients with elbow trauma. Secondary outcomes included evaluation of pediatric emergency department (PED) length of stay (LOS) and test performance characteristics. STUDY DESIGN: This was a prospective study of patients up to age 21 years with elbow trauma necessitating radiography. After clinical examination and before radiography, pediatric emergency physicians performed elbow ultrasonography of the posterior fat pad and determined whether radiography was required...
April 19, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29645365/pre-procedural-ultrasound-for-infant-lumbar-puncture-a-randomized-clinical-trial
#10
David Kessler, Vartan Pahalyants, Joshua Kriger, Gerald Behr, Peter Dayan
BACKGROUND: Our purpose was to determine the potential effect of pre-procedural ultrasound to increase lumbar puncture (LP) success compared with standard palpation method. Further, we assessed feasibility of and clinician satisfaction with a standardized ultrasound protocol. METHODS: This prospective, two-arm, parallel group randomized trial was conducted in a single-center pediatric emergency department. We compared pre-procedural ultrasound vs. palpation method on success with infant LPs...
April 12, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29615193/does-the-implementation-of-a-pediatric-appendicitis-pathway-promoting-ultrasound-work-outside-of-a-children-s-hospital
#11
Emily Kobayashi, Bennett Johnson, Kathleen Goetz, James Scanlan, Robert Weinsheimer
BACKGROUND: Efficacy of care pathways for pediatric appendicitis is well established in children's hospitals, but not in community Emergency Departments (EDs). METHODS: A diagnostic pathway combining the Pediatric Appendicitis Score (PAS) with selective ultrasound was implemented. The charts of 2201 pediatric patients seen at four general EDs before and after implementation were retrospectively reviewed, identifying 611 children seriously considered for appendicitis...
March 17, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29578644/point-of-care-diaphragm-ultrasound-in-infants-with-bronchiolitis-a-prospective-study
#12
Danilo Buonsenso, Maria C Supino, Emanuele Giglioni, Massimo Battaglia, Alessia Mesturino, Simona Scateni, Barbara Scialanga, Antonino Reale, Anna M C Musolino
BACKGROUND: Bronchiolitis is the most common reason for hospitalization of children worldwide. Many scoring systems have been developed to quantify respiratory distress and predict outcome, but none of them have been validated. We hypothesized that the ultrasound evaluation of the diaphragm could quantify respiratory distress and therefore we correlated the ultrasound diaphragm parameters with outcome. METHODS: Prospective study of infants with bronchiolitis (1-12 months) evaluated in a pediatric emergency department...
March 26, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29570940/lung-ultrasound-in-diagnosis-and-follow-up-of-community-acquired-pneumonia-in-infants-younger-than-1-year-old
#13
Ahmed Omran, Samah Eesai, Mostafa Ibrahim, Sonya El-Sharkawy
BACKGROUND: Pneumonia is still a leading cause of illness and death in infants worldwide. Lung ultrasound (LUS) is emerging as an extremely valuable non-ionizing radiation diagnostic tool in diagnosis and follow up of multiple paediatric pulmonary diseases. OBJECTIVE: To assess the applicability of LUS in diagnosis and follow up of community acquired pneumonia (CAP) in Egyptian infants younger than 1-year old. METHODS: LUS and chest X-ray (CXR) were performed in 50 infants presented with clinical symptoms and signs suggestive of CAP within the first 6 hours of admission in our inpatient department, then follow up LUS was performed 5 days after admission...
March 23, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29520998/does-respiratory-variation-of-inferior-vena-cava-diameter-predict-fluid-responsiveness-in-spontaneously-ventilating-children-with-sepsis
#14
Elliot Long, Trevor Duke, Ed Oakley, Adam O'Brien, Bennett Sheridan, Franz E Babl
OBJECTIVE: The intent of fluid bolus therapy (FBT) is to increase cardiac output and tissue perfusion, yet only 50% of septic children are fluid responsive. We evaluated respiratory variation of inferior vena cava (IVC) diameter as a predictor of fluid responsiveness. METHODS: A prospective observational study in the ED of The Royal Children's Hospital, Melbourne, Australia. Patients were spontaneously ventilating children treated with FBT for sepsis-induced acute circulatory failure...
March 8, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29494462/point-of-care-ultrasound-to-identify-congenital-heart-disease-in-the-pediatric-emergency-department
#15
Daniel Rosenfield, Jason W Fischer, Charisse W Kwan
The first presentation of congenital heart disease can be a diagnostic challenge in the emergency department. We report on 2 cases where point-of-care ultrasound identified gross cardiac abnormalities in 2 children and expedited disposition and downstream care.
March 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29461427/educational-effectiveness-of-an-easily-made-new-simulator-model-for-ultrasound-guided-vascular-access-and-foreign-body-management-procedures-on-pediatric-patients
#16
Ikwan Chang, Young Ho Kwak, Do Kyun Kim, Jin Hee Lee, Jae Yun Jung, Hyuksool Kwon, Jin Hee Jung, Bongjin Lee, So Hyun Paek
OBJECTIVES: This study aimed to introduce an easily made chicken breast simulator for ultrasound (US)-guided vascular access, foreign body (FB) detection, and hydrodissection in pediatric patients and to validate the effectiveness for training using this phantom tissue model. METHODS: The authors made the tissue phantom simulator using a chicken breast and rubber tourniquet for vascular access and fragments of a tongue blade and steel clip for FB detection and hydrodissection using a very simple method...
February 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29438126/sonographic-evaluation-and-monitoring-of-pneumoperitoneum-after-air-enema-reduction-for-intussusception
#17
Amy Z Zhou, Amy Toporowski, James W Tsung
Abdominal radiography and computed tomography scans are standard tests to diagnose pneumoperitoneum. With the growing availability of point-of-care ultrasound, pneumoperitoneum may be diagnosed in settings without easy access to radiography or computed tomography, such as in overcrowded emergency departments or resource-poor environments. The use of point-of-care ultrasound to diagnose or monitor pneumoperitoneum has been described in adult but not pediatric patients. We present a case of point-of-care ultrasound detection of pneumoperitoneum and monitoring for tension pneumoperitoneum, after failed air enema reduction for intussusception in an infant...
February 12, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29429201/-survey-on-the-prevalence-of-continuous-blood-purification-in-chinese-pediatric-critical-care
#18
X Yang, S Y Qian, Y M Zhu, X Xu, C F Liu, F Xu, X X Ren, Y Wang, Y C Zhang, G P Lu
Objective: To investigate the current application status of continuous blood purification (CBP) technology and equipment in pediatric intensive care unit (PICU) in China. Methods: A cross-sectional survey was conducted to understand the current popularization of CBP technology and equipment, the management of CBP equipment and consumables, and the application of CBP in different diseases. A questionnaire named Application Status of Continuous Blood Purification Technology was applied. Children's hospitals and polyclinic hospitals with the pediatric qualification (pediatric emergency or critical care unit members of Chinese Medical Association and Chinese Medical Doctor Association) were selected...
February 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29427374/economic-analysis-of-diagnostic-imaging-in-pediatric-patients-with-suspected-appendicitis
#19
Anupam B Kharbanda, Eric W Christensen, Nanette C Dudley, Lalit Bajaj, Michelle D Stevenson, Charles G Macias, Manoj K Mittal, Richard G Bachur, Jonathan E Bennett, Kelly Sinclair, Brianna McMichael, Peter S Dayan
OBJECTIVE: The use of computed tomography (CT) and ultrasound (US) in patients with acute abdominal pain has substantial variation across pediatric emergency departments (EDs). This study compares the cost of diagnosing and treating suspected appendicitis across a multicenter network of children's hospitals. METHODS: This study is a secondary analysis using deidentified data of a prospective, observational study of patients with suspected appendicitis at nine pediatric EDs...
February 10, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29381908/long-term-changes-in-computed-tomography-and-ultrasound-utilization-in-a-pediatric-emergency-department
#20
Ikwan Chang, Jae Yun Jung, Young Ho Kwak, Do Kyun Kim, Jin Hee Lee, Jin Hee Jung, Hyuksool Kwon, So Hyun Paek, Joong Wan Park
OBJECTIVE: Many studies have proposed reducing unnecessary use of computed tomography (CT), and ongoing studies in pediatric populations are aiming to decrease radiation dosages whenever possible. We aimed to evaluate the long-term changes in the utilization patterns of CT and ultrasound (US) in pediatric emergency departments (PEDs). METHODS: This retrospective study reviewed the electronic medical data of patients who underwent CT and/or US in the PED of a tertiary referral hospital from 2000 to 2014...
March 2018: Clinical and Experimental Emergency Medicine
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