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Emergency sonography

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https://www.readbyqxmd.com/read/29740831/do-emergency-physicians-rely-on-point-of-care-ultrasound-for-clinical-decision-making-without-additional-confirmatory-testing
#1
Mohamad Moussa, Julie M Stausmire
PURPOSE: It is unknown if Emergency Physicians (EPs) rely solely on Emergency Medicine performed Point-Of-Care Ultrasound (EM-POCUS) for clinical decision making or if they proceed to subsequent "gold standard" studies for confirmatory diagnosis. METHODS: After Institutional Review Board approval, an online survey was distributed by the Ohio Chapter of the American College of Emergency Physicians to its members. RESULTS: The most common EM-POCUS procedures used without confirmatory testing were: determination of cardiac activity during cardiac arrest (81...
May 8, 2018: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29738103/bedside-sonography-performed-by-emergency-physicians-to-detect-appendicitis-in-children
#2
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/29736195/chest-ultrasonography-in-modern-day-extreme-settings-from-military-setting-and-natural-disasters-to-space-flights-and-extreme-sports
#3
REVIEW
Francesco Feletti, Viviana Mucci, Andrea Aliverti
Chest ultrasonography (CU) is a noninvasive imaging technique able to provide an immediate diagnosis of the underlying aetiology of acute respiratory failure and traumatic chest injuries. Given the great technologies, it is now possible to perform accurate CU in remote and adverse environments including the combat field, extreme sport settings, and environmental disasters, as well as during space missions. Today, the usage of CU in the extreme emergency setting is more likely to occur, as this technique proved to be a fast diagnostic tool to assist resuscitation manoeuvres and interventional procedures in many cases...
2018: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/29732520/sonographic-evaluation-of-peripheral-nerve-pathology-in-the-emergency-setting
#4
Shane Mallon, Vladimir Starcevic, Matthew Rheinboldt, Andrew Petraszko
High-resolution sonography has a growing role in both the diagnosis and management of traumatic and atraumatic peripheral nerve pathology. Sonography not only affords a cost-effective and time-efficient approach to interrogating long segments of peripheral nerves but also possesses unique advantages in terms of its dynamic, real-time nature with few clinical contraindications and limitations. In this review, we will initially discuss imaging techniques and characteristics of normal neural sonohistology, then address specific features and pitfalls pertaining to the spectrum of post-traumatic peripheral nerve injury...
May 7, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29727515/microv-technology-to-improve-transcranial-color-coded-doppler-examinations
#5
Giovanni Malferrari, Giuseppe Pulito, Attilia Maria Pizzini, Nicola Carraro, Giorgio Meneghetti, Enzo Sanzaro, Patrizio Prati, Antonio Siniscalchi, Daniela Monaco
The purpose of this review is to provide an update on technology related to Transcranial Color Coded Doppler Examinations. Microvascularization (MicroV) is an emerging Power Doppler technology which can allow visualization of low and weak blood flows even at high depths, thus providing a suitable technique for transcranial ultrasound analysis. With MicroV, reconstruction of the vessel shape can be improved, without any overestimation. Furthermore, by analyzing the Doppler signal, MicroV allows a global image of the Circle of Willis...
May 4, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/29697685/-ruptures-of-popliteal-artery-aneurysms
#6
I P Mikhaylov, V N Lavrenov, G A Isaev, L S Kokov, E Yu Trofimova
AIM: To improve diagnosis and surgical outcomes in patients with ruptured popliteal artery aneurysm. MATERIAL AND METHODS: Eight patients with ruptured popliteal artery aneurysm have undergone surgery for the period from 1999 to 2015 at the Vascular Surgery Department of Sklifosovsky Research Institute for Emergency Care. Incidence of rupture was 2.9% from total number of popliteal artery aneurysm. 7 patients with rupture had signs of lower limb ischemia (acute form grade I in 2 (25%) cases, grade IIA in 1 (12...
2018: Khirurgiia
https://www.readbyqxmd.com/read/29696124/diagnostic-value-of-sonography-for-confirmation-of-endotracheal-intubation-in-the-emergency-department
#7
Farzad Rahmani, Zahra Parsian, Kavous Shahsavarinia, Mahboob Pouraghaei, Sohrab Negargar, Robab Mehdizadeh Esfanjani, Hassan Soleimanpour
Background: Intubation and maintaining airway are crucial in the management of critically ill patients in the emergency department. Correct tracheal intubation should be confirmed by the physician, otherwise oesophageal intubation could lead to hypoxia with detrimental consequences and even death. Sonography can be used to determine proper placement of the tracheal tube. Methods: In this study, 75 patients, with an indication of intubation and age older than 18 years entered the study...
December 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29694987/-improved-diagnostics-and-therapeutic-decision-making-in-traumatic-peripheral-nerve-lesions-using-mr-neurography
#8
Konstantin D Bergmeister, Philipp Schönle, Arne Hendrik Böcker, Moritz Kronlage, Tim Godel, Simeon Daeschler, Martin Bendszus, Ulrich Kneser, Leila Harhaus, Daniel Schwarz
INTRODUCTION: The correct diagnosis of peripheral nerve injuries is essential for choosing the correct treatment in nerve surgery. Especially, nerve defects require early diagnosis to provide quick surgical reconstruction and prevent long-term disabilities. Recent developments in MR-neurography provide surgeons with a diagnostic tool delivering precise information on the structure and possibly function of nerves. Here we describe a series of cases, that benefited from preoperative MR-neurography to identify the correct type of injury...
April 25, 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/29693940/the-peas-protocol-an-airway-ultrasound-technique
#9
Akihiro Suzuki
In the past ultrasound identification of the airway structure was rather difficult However, recent advancement of the high frequency linear type transducer allows us to visualize airway structure easily. Accordingly, now we have difficult airway society guideline 2015. resuscitation guideline 2015, and Australia and New Zealand Intensive Care Society guidelines for percutaneous dilatational tracheostomy which recommend use of ultrasound in airway management Airway ultrasound is an emerging technique for all physicians, and the author introduces perioperative evaluation of the airway via sonography, the PEAS protocol...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29688110/a-mixed-methods-evaluation-of-a-multidisciplinary-point-of-care-ultrasound-program
#10
Andrew Smith, Michael Parsons, Tia Renouf, Sarah Boyd, Peter Rogers
BACKGROUND: Point of Care Ultrasound (PoCUS) is well established within emergency medicine, however, the availability of formal training for other clinical disciplines is limited. Memorial University has established a cost-efficient, multidisciplinary PoCUS training program focusing on training residents' discipline-specific ultrasound skills. This study evaluates the skills, knowledge, and attitudes of residents who participated in the program. METHODS: Analysis was conducted using a mixed-methods, sequential exploratory approach...
April 24, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29662732/institutional-review-of-hemorrhagic-pelvic-emergencies-effectively-managed-with-percutaneous-arterial-embolization
#11
Muhammad Azeemuddin, Raza Sayani, Nauman Turab, Syed M Mustahsan, Mohammad Hasan, Dawar B Khan, Fatima Mubarak
OBJECTIVE: Our aim was to review the results of pelvic arterial embolization (PAE) performed in the interventional radiology suite. METHOD: The data of all patients in whom pelvic angioembolization was performed was collected from July 2011 to June 2017. Procedures were performed by an experienced interventional radiologist. The clinical and laboratory data, as well as the outcome data, were obtained from the medical records of our hospital. The following parameters were collected for each patient, including the age, gender, presenting symptoms, site of bleeding, catheters used for embolization, material used for embolization, previous computed tomography (CT) scan and/or focused assessment with sonography for trauma (FAST) ultrasound, average hemoglobin before the procedure, and patient clinical status on discharge...
February 15, 2018: Curēus
https://www.readbyqxmd.com/read/29644294/isolated-right-atrial-appendage-rupture-following-blunt-chest-trauma
#12
Rakesh Hegde, Nathan Lafayette, Michael Sywak, Gregory Ricketts, Jorge Otero, Scott Kurtzman, Zhongqiu Zhang
Background: Right sided tears or rupture are the most common injury to the heart after blunt chest trauma. The majority of these injuries are to the thin walled atrium. Reports of localized right atrial appendage rupture are rare. The classical features of Beck's triad are unreliable in the trauma bay. With the advent of EFAST (Focused assessment with sonography for trauma extended to thorax), Beck's triad should be considered but not used as the primary clinical tool for diagnosis of cardiac tamponade [1]...
February 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29644270/importance-of-the-capability-for-complete-resuscitative-treatment-combining-surgery-and-interventional-radiology-for-potentially-lethal-multiple-injuries-a-case-report
#13
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
Background: Recently, trauma management has been complicated owing to the introduction of damage-control strategies and interventional radiology. Here, we discuss important aspects regarding survival of patients with severe trauma. Case presentation: A 74-year-old Japanese woman experienced a traffic accident on a highway. On arrival, paramedics were unable to measure her blood pressure, and her condition deteriorated. The patient was immediately transferred to our hospital in a physician-staffed emergency helicopter, during which she was administered emergency blood transfusions...
October 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29616352/efast-for-the-diagnosis-of-a-perioperative-complication-during-percutaneous-nephrolithotomy
#14
Achyut Sharma, Prajjwal Bhattarai, Apurb Sharma
A 29-year-old patient with normal preanesthetic evaluation was planned for percutaneous nephrolithotomy (PCNL) for right nephrolithiasis with right pyelolithiasis. Surgery was performed under general anesthesia with endotracheal intubation with muscle relaxation. At the conclusion of surgery, when the patient was turned over to supine position, tense abdomen was noted. Immediately extended focused assessment with sonography in trauma (eFAST) was done in which both right and left quadrants of abdomen including pericardial and suprapubic region, right and left thoracic, and both lung basis were examined...
April 3, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29581925/isolated-renal-laceration-on-point-of-care-ultrasound
#15
Madeline M Grade, Cori Poffenberger, Viveta Lobo
We report a renal laceration identified on a point-of-care ultrasound (POCUS) performed in the emergency department on a 58-year-old female presenting after blunt trauma. Emergency workup demonstrated a right flank abrasion with tenderness to palpation, hematuria, and decreasing hematocrit. A Focused Assessment with Sonography in Trauma (FAST) exam, performed as part of the intake trauma protocol, identified positive intraperitoneal fluid in the right upper quadrant. A computed tomography (CT) scan established a diagnosis of isolated right renal hematoma arising from a Grade IV laceration, with no collecting duct involvement...
January 25, 2018: Curēus
https://www.readbyqxmd.com/read/29560289/use-of-focused-assessment-with-sonography-in-trauma-examination-skills-in-the-evaluation-of-non-trauma-patients
#16
Parisa P Javedani, Gregory S Metzger, Jeremy R Oulton, Srikar Adhikari
Study objectives Although the focused assessment with sonography in trauma (FAST) examination was initially developed for rapid evaluation of trauma patients, the basic skillset required to perform a FAST examination provides valuable information that may alter a non-trauma patient's clinical course. The objective of this study was to determine the utility of the FAST examination in the emergency department management of non-trauma patients. Methods Cases in which the FAST examination was used to direct care in non-trauma patients were retrospectively reviewed...
January 16, 2018: Curēus
https://www.readbyqxmd.com/read/29560074/comparison-of-static-versus-dynamic-ultrasound-for-the-detection-of-endotracheal-intubation
#17
Michael Gottlieb, Damali Nakitende, Tina Sundaram, Anthony Serici, Shital Shah, John Bailitz
Introduction: In the emergency department setting, it is essential to rapidly and accurately confirm correct endotracheal tube (ETT) placement. Ultrasound is an increasingly studied modality for identifying ETT location. However, there has been significant variation in techniques between studies, with some using the dynamic technique, while others use a static approach. This study compared the static and dynamic techniques to determine which was more accurate for ETT identification. Methods: We performed this study in a cadaver lab using three different cadavers to represent variations in neck circumference...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29530355/evaluation-for-occult-sepsis-incorporating-nirs-and-emergency-sonography
#18
Natalie Yu Yi Ng, Hannah Hui En Ang, Jacqueline Chieh Ling Tan, Weng Hoe Ho, Win Sen Kuan, Mui Teng Chua
PURPOSE: We aim to determine whether the combination of regional tissue oxygen saturation (StO2 ) measurement using near-infrared spectroscopy (NIRS), inferior vena cava (IVC) collapsibility and ejection fraction (EF) is able to detect occult sepsis. METHODS: We included adult patients in the emergency department with at least one of the following: fever; any one component of the quick sepsis-related organ function assessment (SOFA) score; heart rate≥100 beats per minute; or white cell count <4...
February 27, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29503836/emergency-department-bedside-ultrasonography-for-diagnosis-of-acute-cholecystitis-a-diagnostic-accuracy-study
#19
Babak Shekarchi, Seyed Zia Hejripour Rafsanjani, Nima Shekar Riz Fomani, Mojtaba Chahardoli
Introduction: Using bedside ultrasound in diagnosing acute cholecystitis in the emergency department (ED) can save time, help the decision making process and allocate resources wisely. This study aimed to evaluate the diagnostic accuracy of bedside right upper quadrant (RUQ) ultrasonography in detection of acute cholecystitis. Method: In this diagnostic accuracy study, patients presenting to ED, suffering from RUQ pain in favor of acute cholecystitis underwent RUQ ultrasonography in emergency and radiology departments and interrater agreement between reports was calculated...
2018: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/29487770/point-of-care-ultrasound-diagnosis-of-upper-gastrointestinal-bleeding
#20
Robert P Jamplis, Lucas Friedman, Srikar Adhikari
A 28-year-old male was brought to the emergency department by the Emergency medical services (EMS) after being found unconscious and unresponsive. Upon arrival, he was hypotensive, intubated with a Glasgow Coma Scale (GCS) 3T, without the signs of trauma or the evidence of bleeding. A focused assessment with sonography in trauma (FAST), point-of-care ultrasound (POCUS) was performed, obscuring part of the spleen from the distended stomach, which was filled with the heterogeneous contents, with the internal movement being identified...
December 17, 2017: Curēus
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