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Ultrasound in ED

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https://www.readbyqxmd.com/read/28092120/pediatric-peritonsillar-abscess-outcomes-and-cost-savings-from-using-transcervical-ultrasound
#1
Zhen Huang, William Vintzileos, Heather Gordish-Dressman, Anjum Bandarkar, Brian K Reilly
OBJECTIVES: 1) To analyze clinical outcomes of children stratified by ultrasound into three diagnoses: acute tonsillitis, peritonsillar phlegmon, and abscess; and 2) To compare clinical outcomes and financial impact between children who underwent ultrasound protocol to those who did not. STUDY DESIGN: Retrospective analysis between two cohorts: ultrasound protocol group and control group. METHODS: Children with peritonsillar abscess (PTA) diagnosed in the emergency department (ED) were enrolled during a 2-year period for transcervical ultrasound evaluation of bilateral tonsillar fossae...
January 16, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28072673/the-use-of-ultrasound-measured-optic-nerve-sheath-diameter-to-predict-ventriculoperitoneal-shunt-failure-in-children
#2
Sophia D Lin, Kimberly R Kahne, Amira El Sherif, Kevin Mennitt, David Kessler, Mary J Ward, Shari L Platt
OBJECTIVE: The goal of this study was to assess the accuracy of ultrasound-measured optic nerve sheath diameter (ONSD) as a screen for ventriculoperitoneal shunt failure. METHODS: We prospectively enrolled a convenience sample of children presenting to the ED with suspected shunt failure. The ONSD was measured by ultrasound and compared with computed tomography/magnetic resonance imaging (CT/MRI) and neurosurgical impression. We defined shunt failure on ultrasound as an ONSD greater than 4...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28063721/point-of-care-lung-ultrasound-of-children-with-acute-asthma-exacerbations-in-the-pediatric-emergency-department
#3
Samantha Dankoff, Patricia Li, Adam J Shapiro, Terry Varshney, Alexander S Dubrovsky
OBJECTIVES: Primary objective was to characterize lung ultrasound findings in children with asthma presenting with respiratory distress to the emergency department (ED). Secondary objectives included correlating these findings with patients' clinical course in the ED. METHODS: Eligible patients 2-17years of age, underwent a lung ultrasound by the study sonographer between November 2014 to December 2015. Positive lung ultrasound was defined as the presence of ≥1 of the following findings: ≥3 B-lines per intercostal space, consolidation and/or pleural abnormalities...
December 26, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28046001/the-diagnosis-and-management-of-patients-with-renal-colic-across-a-sample-of-us-hospitals-high-ct-utilization-despite-low-rates-of-admission-and-inpatient-urologic-intervention
#4
Elizabeth M Schoenfeld, Penelope S Pekow, Meng-Shiou Shieh, Charles D Scales, Tara Lagu, Peter K Lindenauer
OBJECTIVES: Symptomatic ureterolithiasis (renal colic) is a common Emergency Department (ED) complaint. Variation in practice surrounding the diagnosis and management of suspected renal colic could have substantial implications for both quality and cost of care as well as patient radiation burden. Previous literature has suggested that CT scanning has increased with no improvements in outcome, owing at least partially to the spontaneous passage of kidney stones in the majority of patients...
2017: PloS One
https://www.readbyqxmd.com/read/28038826/using-color-flow-detection-of-air-insufflation-to-improve-accuracy-in-verifying-nasogastric-tube-position
#5
Kin Wa Wong, Hok Hang Chan, Chi Pang Wong, Ming Yin Chan, Jeffrey Cheuk Wai Chau, Tai Wai Wong
OBJECTIVES: Previous studies have shown that ultrasonography (USG), as an alternative to radiography, has a good accuracy in confirming nasogastric tube (NGT) position. Color flow detection of air insufflation is a novel approach in verifying NGT position. In our study, we aimed at evaluating its sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy in confirming the NGT position, as compared with 2-dimensional (2D) USG. METHODS: The study was conducted on adult patients over a period of 38months in an emergency department in Hong Kong...
December 21, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27986838/a-randomised-experiment-comparing-low-cost-ultrasound-gel-alternative-with-commercial-gel
#6
Christine Riguzzi, Allison Binkowski, Mike Butterfield, Farhad Sani, Nathan Teismann, Jahan Fahimi
OBJECTIVE: Point-of-care ultrasound is a portable, relatively low-cost imaging modality with great potential utility in low-resource settings. However, commercially produced ultrasound gel is often cost-prohibitive and unavailable. We investigated whether images obtained using an alternative cornstarch-based gel would be of comparable quality with those using commercial gel. METHODS: This was a blinded, randomised, cross-over study comparing commercially produced ultrasound gel with home-made cornstarch-based gel...
December 16, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27943410/number-of-weeks-rotating-in-the-emergency-department-has-a-greater-effect-on-ultrasound-milestone-competency-than-a-dedicated-ultrasound-rotation
#7
Courtney M Smalley, Molly Thiessen, Richard Byyny, Alyrene Dorey, Bryan McNair, John L Kendall
OBJECTIVES: Ultrasound (US) is vital to modern emergency medicine (EM). Across residencies, there is marked variability in US training. The "goal-directed focused US" part of the Milestones Project states that trainees must correctly acquire and interpret images to achieve a level 3 milestone. Standardized methods by which programs teach these skills have not been established. Our goal was to determine whether residents could achieve level 3 with or without a dedicated US rotation. METHODS: Thirty-three first- and second-year residents were assigned to control (no rotation) and intervention (US rotation) groups...
December 10, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27904260/sonographic-identification-of-peripheral-nerves-in-the-forearm
#8
Saundra A Jackson, Charlotte Derr, Anthony De Lucia, Marvin Harris, Zuheily Closser, Branko Miladinovic, Rahul Mhaskar, Theresa Jorgensen, Lori Green
BACKGROUND: With the growing utilization of ultrasonography in emergency medicine combined with the concern over adequate pain management in the emergency department (ED), ultrasound guidance for peripheral nerve blockade in ED is an area of increasing interest. The medical literature has multiple reports supporting the use of ultrasound guidance in peripheral nerve blocks. However, to perform a peripheral nerve block, one must first be able to reliably identify the specific nerve before the procedure...
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27904146/the-correlation-between-high-sensitivity-c-reactive-protein-and-erectile-dysfunction-patients-with-hypertension-treated-with-vardenafil
#9
S Azab, H Aoud, N Nabil
We evaluate the correlation between the plasma level of C-reactive protein (CRP) in patients with erectile dysfunction (ED) and hypertension and to set up whether the CRP level affected by the treatment of vardenafil 10 mg orally once daily. A total of 116 male patients with ED and hypertension were enrolled in this prospective study. The patients were divided into two groups, group 1 (ED patients with Not controlled hypertension) and group 2 (ED patients with controlled hypertension). All patients completed the International Index of Erectile Function (IIEF) scores, performed a penile color Doppler ultrasound examination and high sensitivity (hs-CRP) levels...
December 1, 2016: International Journal of Impotence Research
https://www.readbyqxmd.com/read/27899166/pain-management-of-acute-appendicitis-in-canadian-pediatric-emergency-departments
#10
Andrea L Robb, Samina Ali, Naveen Poonai, Graham C Thompson
OBJECTIVES: Children with suspected appendicitis are at risk for suboptimal pain management. We sought to describe pain management patterns for suspected appendicitis across Canadian pediatric emergency departments (PEDs). METHODS: A retrospective medical record review was undertaken at 12 Canadian PEDs. Children ages 3 to 17 years who were admitted to the hospital in February or October 2010 with suspected appendicitis were included. Patients were excluded if partially assessed or treated at another hospital...
November 30, 2016: CJEM
https://www.readbyqxmd.com/read/27898921/using-estrus-detection-patches-to-optimally-time-insemination-improved-pregnancy-risk-in-suckled-beef-cows-enrolled-in-a-fixed-time-artificial-insemination-program
#11
S L Hill, D M Grieger, K C Olson, J R Jaeger, C R Dahlen, G A Bridges, F Dantas, J E Larson, A M Muth-Spurlock, J K Ahola, M C Fischer, G A Perry, E L Larimore, T L Steckler, W D Whittier, J F Currin, J S Stevenson
A multilocation study examined pregnancy risk (PR) after delaying AI in suckled beef cows from 60 to 75 h when estrus had not been detected by 60 h in response to a 7-d CO-Synch + progesterone insert (CIDR) timed AI (TAI) program (d -7: CIDR insert concurrent with an injection of GnRH; d 0: PGF injection and removal of CIDR insert; and GnRH injection at TAI [60 or 75 h after CIDR removal]). A total of 1,611 suckled beef cows at 15 locations in 9 states (CO, IL, KS, MN, MS, MT, ND, SD, and VA) were enrolled...
September 2016: Journal of Animal Science
https://www.readbyqxmd.com/read/27878404/inter-rater-agreement-between-trained-emergency-medicine-residents-and-radiologists-in-the-examination-of-gallbladder-and-common-bile-duct-by-ultrasonography
#12
Javad Seyedhosseini, Azade Nasrelari, Narges Mohammadrezaei, Ehsan Karimialavijeh
STUDY OBJECTIVES: Bedside emergency ultrasonograAmerican Society of Emergency Radiologyphy is a rapid diagnostic tool in the emergency department (ED). Nevertheless, the learning curve for ultrasound (US) training in various indications has to date not been clearly defined. The aim of the present study was to assess how much a short specialized training program in hepatobiliary US might impact the skills of novice emergency medicine residents. METHODS: This was a prospective observational study conducted at a university-affiliated ED from May 2014 to January 2015...
November 22, 2016: Emergency Radiology
https://www.readbyqxmd.com/read/27876328/best-clinical-practice-controversies-in-transient-ischemic-attack-evaluation-and-disposition-in-the-emergency-department
#13
Brit Long, Alex Koyfman
BACKGROUND: Transient ischemic attack (TIA) affects over 200,000 patients annually in the United States, and it precedes approximately 14% to 23% of strokes. Patients are typically admitted for evaluation and management. OBJECTIVE: This review investigates the controversies of emergency department (ED) evaluation of TIA, including imaging, clinical risk scores, rapid diagnostic protocols, and disposition. DISCUSSION: TIA is a common condition, with over 200,000 patients affected annually, and is associated with risk of stroke...
November 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27862628/history-physical-exam-laboratory-testing-and-emergency-department-ultrasonography-for-the-diagnosis-of-acute-cholecystitis
#14
Ashika Jain, Ninfa Mehta, Michael Secko, Joshua Schecter, Dimitri Papanagnou, Shreya Pandya, Richard Sinert
BACKGROUND: Acute Cholecystitis (AC) is a common differential for patients presenting to the Emergency Department (ED) with abdominal pain. The diagnostic accuracy of history, physical exam and bedside lab tests for AC have not been quantitatively described. OBJECTIVES: We performed a systematic review to determine the utility of History/Physical exam (H&P), Laboratory studies and Ultrasonography (US) in diagnosing AC in the ED. METHODS: We searched medical literature from January 1965 to March 2016 in PubMed, EMBASE and SCOPUS using a strategy derived from the following formulation of our clinical question: Patients: ED patients suspected of AC...
November 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27857946/can-bedside-ultrasound-inferior-vena-cava-measurements-accurately-diagnose-congestive-heart-failure-in-the-emergency-department-a-clin-iq
#15
Miranda Gaskamp, Mark Blubaugh, Laine H McCarthy, Dewey C Scheid
Congestive heart failure (CHF) is a major cause of morbidity and mortality. Early diagnosis of CHF in patients presenting to the emergency department (ED) with undifferentiated dyspnea would allow clinicians to begin appropriate treatment more promptly. Current guidelines recommend B-type natriuretic peptide (BNP) levels for more accurate diagnosis of CHF in dyspneic patients. Although BNP levels are relatively inexpensive, the test is not usually performed at bedside and results may take up to an hour or more...
October 2016: Journal of Patient-centered Research and Reviews
https://www.readbyqxmd.com/read/27856357/clinical-effectiveness-in-the-diagnosis-and-acute-management-of-pediatric-nephrolithiasis
#16
REVIEW
Jason P Van Batavia, Gregory E Tasian
The incidence of pediatric nephrolithiasis has risen over the past few decades leading to a growing public health burden. Children and adolescents represent a unique patient population secondary to their higher risks from radiation exposure as compared to adults, high risk of recurrence, and longer follow up time given their longer life expectancies. Ultrasound imaging is the first-line modality for diagnosing suspected nephrolithiasis in children. Although data is limited, the best evidence based medicine supports the use of alpha-blockers as first-line MET in children, especially when stones are small and in a more distal ureteral location...
December 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27847919/phosphorus-as-predictive-factor-for-erectile-dysfunction-in-middle-aged-men-a-cross-sectional-study-in-korea
#17
Seung Ki Min, Kwibok Choi, Soon Ki Kim, Gyeong In Lee, In-Chang Cho
PURPOSE: High serum inorganic phosphorus level is related with atherosclerosis and an elevated risk of cardiovascular disease. At the same time, the association of phosphorus with erectile dysfunction (ED) is not well reported. We studied the effect of serum phosphorus on ED and the relationship with other clinical variables. MATERIALS AND METHODS: From March to September 2013, 1,899 police men aged 40 to 59 years who entered in a prostate health screening were targeted...
November 2016: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/27833692/rapid-diagnosis-of-rhabdomyolysis-with-point-of-care-ultrasound
#18
Alicia Nassar, Richard Talbot, Ashley Grant, Charlotte Derr
It is important to rapidly diagnosis and treat rhabdomyolysis in order to decrease morbidity and mortality. To date there are no reports in the emergency medicine literature on the use of point-of-care ultrasound in the diagnosis of rhabdomyolysis. This unique case describes how ultrasound was used in the emergency department (ED) to quickly diagnose and treat rhabdomyolysis prior to confirmation with an elevated serum creatine kinase. When coupled with a high index of suspicion, ultrasound can be one of the most portable, readily available, low cost, and minimally invasive techniques for making a rapid diagnosis of rhabdomyolysis in the ED...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27829074/fetal-outcomes-following-emergency-department-point-of-care-ultrasound-for-vaginal-bleeding-in-early-pregnancy
#19
Catherine Varner, Dahlia Balaban, Shelley McLeod, Sally Carver, Bjug Borgundvaag
OBJECTIVE: To determine 20- and 40-week fetal outcomes following documentation of fetal cardiac activity (FCA) and intrauterine pregnancy (IUP) in women at less than 20 weeks' gestation presenting to the emergency department (ED) with vaginal bleeding. DESIGN: Prospective observational cohort study. SETTING: Single-centre tertiary care ED. PARTICIPANTS: Pregnant women at less than 20 weeks' gestation presenting to the ED with vaginal bleeding...
July 2016: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/27825744/small-intestinal-submucosa-grafting-for-peyronie-disease-outcomes-and-patient-satisfaction
#20
Pedro Valente, Carolina Gomes, Nuno Tomada
OBJECTIVE: To evaluate surgical outcomes and complications and assess overall patient satisfaction after small intestinal submucosa (SIS) grafting for Peyronie disease. METHODS: Twenty-eight patients were treated with tunical incision and grafting with SIS. Mean age of the patients was 58 (range: 43-71) years. A preoperative protocol was applied to all patients. Patients were also evaluated at follow-up clinic visits. The International Index of Erectile Function, a modified Erectile Dysfunction Inventory of Treatment Satisfaction questionnaire, postoperative self-reports, and clinical characteristics were used to measure outcomes...
November 4, 2016: Urology
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