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Ultrasound in ED

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https://www.readbyqxmd.com/read/28435488/clinician-performed-bedside-ultrasound-in-improving-diagnostic-accuracy-in-patients-presenting-to-the-ed-with-acute-dyspnea
#1
Dimitrios Papanagnou, Michael Secko, John Gullett, Michael Stone, Shahriar Zehtabchi
INTRODUCTION: Diagnosing acute dyspnea is a critical action performed by emergency physicians (EP). It has been shown that ultrasound (US) can be incorporated into the work-up of the dyspneic patient; but there is little data demonstrating its effect on decision-making. We sought to examine the impact of a bedside, clinician-performed cardiopulmonary US protocol on the clinical impression of EPs evaluating dyspneic patients, and to measure the change in physician confidence with the leading diagnosis before and after US...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28424505/usefulness-of-serum-fetuin-a-level-as-a-marker-of-erectile-dysfunction
#2
W Kandeel, W El-Shaer, A Sebaey, A A Abou-Taleb, A Fathy, B Elmohamady, A I Mansour
This study aimed to evaluate the correlation between serum levels of fetuin-A and the presence and severity of erectile dysfunction (ED) in Egyptian population. The study was performed on 60 ED patients and 20 age-matched healthy controls. A comprehensive medical history and complete physical examination were obtained and performed in all participants. ED and its severity were assessed via International Index of Erectile Function (IIEF-5). Doppler ultrasound, fasting blood glucose level, complete lipid profile, serum total testosterone (TT) and serum fetuin-A were performed...
April 20, 2017: International Journal of Impotence Research
https://www.readbyqxmd.com/read/28414680/a-rare-cause-of-abdominal-pain
#3
E M Dauchy, M Modica, N Masri
CASE: A 54 year old woman with hypothyroidism presented with right flank pain that began acutely one week prior to presentation. She was told initially she had a urinary tract infection and treatment resulted in mild symptomatic improvement. The pain returned and she presented to another Emergency Department (ED); and was told the pain was due to constipation. She returned to the ED the next day when her pain worsened and her labs were notable for WBC of 19,000/uL, BUN/Cr of 28/0.75 mg/dL, AST of 31 U/L, ALT of 92 U/L and total bilirubin of 0...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28410544/does-respiratory-variation-in-inferior-vena-cava-diameter-predict-fluid-responsiveness-a-systematic-review-and-meta-analysis
#4
Elliot Long, Ed Oakley, Trevor Duke, Franz E Babl
BACKGROUND: The aim of fluid resuscitation is to increase stroke volume, yet this effect is observed in only 50% of patients. Prediction of fluid responsiveness may allow fluid resuscitation to be administered to those most likely to benefit. The aim of this study was to systematically review the test characteristics of respiratory variation in inferior vena cava (IVC) diameter as a predictor of fluid responsiveness in patients with acute circulatory failure. METHODS: Electronic searches combined with reference review of identified studies...
May 2017: Shock
https://www.readbyqxmd.com/read/28392182/differences-in-cavernosal-artery-parameters-according-to-different-anatomic-sampling-locations-during-the-diagnosis-of-vascular-erectile-dysfunction-using-duplex-ultrasound
#5
Fabio Pezzoni, Fabrizio Ildefonso Scroppo, Giorgio Cavallini
OBJECTIVE: To establish a standard location for examining penile cavernosal arteries (CAs) using dynamic duplex Doppler ultrasound (PDDU) examination in the diagnosis of non-arterial erectile dysfunction (ED) or arterial insufficiency. PATIENTS AND METHODS: Two groups of 105 patients each were enrolled. The first group (age 56.3 ± 6.0 years) displayed clinical patterns of arterial insufficiency; the second group (age 35.2 ± 4.7 years) displayed clinical patterns of non-arterial ED...
April 6, 2017: Urology
https://www.readbyqxmd.com/read/28376563/the-effect-of-access-to-electronic-health-records-on-throughput-efficiency-and-imaging-utilization-in-the-emergency-department
#6
Matthew M Knepper, Edward M Castillo, Theodore C Chan, David A Guss
STUDY OBJECTIVE: To evaluate whether the availability of Electronic Health Records (EHRs) reduces throughput time and utilization of advanced imaging for patients in an academic ED. DATA SOURCES: All patients arriving at an academic Emergency Department (ED) via ambulance between June 1, 2011, and June 4, 2012, were included in the study. This accounted for 9,970 unique ambulance patient visits. STUDY DESIGN: Retrospective noninterventional analysis of patients in an academic ED...
April 4, 2017: Health Services Research
https://www.readbyqxmd.com/read/28366287/whole-body-computed-tomography-versus-selective-radiological-imaging-strategy-in-trauma-an-evidence-based-clinical-review
#7
Brit Long, Michael D April, Shane Summers, Alex Koyfman
BACKGROUND: Trauma patients often present with injuries requiring resuscitation and further evaluation. Many providers advocate for whole body computed tomography (WBCT) for rapid and comprehensive diagnosis of life-threatening injuries. OBJECTIVE: Evaluate the literature concerning mortality effect, emergency department (ED) length of stay, radiation, and incidental findings associated with WBCT. DISCUSSION: Physicians have historically relied upon history and physical examination to diagnose life-threatening injuries in trauma...
March 21, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28341982/pocket-sized-point-of-care-cardiac-ultrasound-devices-role-in-the-emergency-department
#8
A Colclough, P Nihoyannopoulos
BACKGROUND: Acute breathlessness accounts for 8% of accident and emergency attendances. Point-of-care cardiac ultrasound (US) effectively reduces time to diagnosis. Fast and practical information via pocket-sized cardiac US devices may better the diagnosis in this complex patient group. METHODS: We prospectively enrolled 40 consecutive patients presenting with shortness of breath at the emergency department (ED). Divided into two groups were all adult patients over 18 with acute breathing difficulties (triage category 1-3): 21 patients received a short focused cardiac US scan using a pocket-sized Vscan and 19 patients received no scan...
March 24, 2017: Herz
https://www.readbyqxmd.com/read/28336237/point-of-care-ultrasound-sonographic-posterior-fat-pad-sign-a%C3%A2-case-report-and-brief-literature-review
#9
Yoshito Okumura, Nestor Maldonado, Kyle Lennon, Bryan McCarty, Philipp Underwood, Mathew Nelson
BACKGROUND: Diagnosis of elbow fracture can sometimes be difficult with plain radiography due to overlapping bones, growth plates, and maturing bones in the pediatric population. The radiographic posterior fat pad (PFP) sign is one of the frequently referenced indirect signs of an occult elbow fracture. This sign can be falsely negative if the sign is subtle, and can be falsely positive when the position of the elbow is not flexed at 90 degrees. CASE REPORT: We discuss a case in which sonographic PFP sign helped to diagnose an elbow fracture...
March 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28298566/ultrasound-evaluation-of-the-entheses-in-daily-clinical-practice-during-tumor-necrosis-factor-%C3%AE-blocking-therapy-in-patients-with-ankylosing-spondylitis
#10
Fréke Wink, George A Bruyn, Fiona Maas, Ed N Griep, Eveline van der Veer, Hendrika Bootsma, Elisabeth Brouwer, Suzanne Arends, Anneke Spoorenberg
OBJECTIVE: To assess structural and inflammatory ultrasound (US) lesions of entheses in ankylosing spondylitis (AS) patients with active disease and to evaluate inflammatory lesions after 6 months of tumor necrosis factor (TNF-α) blocking therapy, in daily clinical practice. METHODS: Consecutive patients with AS were clinically evaluated and underwent US examination of 9 bilateral entheses before and after 6 months of TNF-α blocking therapy. US examination included the following as inflammatory lesions: bone erosions/cortical irregularities, enthesophytes, calcifications as structural lesions; adjacent bursitis, effusion, increased tendon hypoechogenicity or thickness; and positive power Doppler (PD) signal...
March 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28291706/medical-expulsive-therapy-use-in-emergency-department-patients-diagnosed-with-ureteral-stones
#11
Ralph C Wang, Newton Addo, Thomas Chi, Christopher Moore, Michael Mallin, Stephen Shiboski, Marshall Stoller, Rebecca Smith-Bindman
OBJECTIVE: Recent studies have clarified the role of alpha-blockers, such as tamsulosin, for patients diagnosed with ureteral stones <10mm not requiring an urgent intervention. Prior studies have reported low rates of use of MET by emergency physicians. We sought to describe patterns of alpha-blocker use and to determine factors associated with utilization in patients diagnosed with ureterolithiasis in the ED. METHODS: We used data from a randomized trial of CT scan vs...
February 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28286819/pain-management-via-ultrasound-guided-nerve-block-in-emergency-department-a-case-series-study
#12
Amir Nejati, Houman Teymourian, Leili Behrooz, Gholamreza Mohseni
INTRODUCTION: Pain is the most common complaint of patients referring to emergency department (ED). Considering the importance of pain management in ED, this study aimed to investigate the efficacy and feasibility of ultrasound-guided nerve blocks in this setting. METHODS: 46 patients who came to the ED with injured extremities were enrolled in the study and received either femoral, axillary or sciatic nerve block depending on their site of injury (1.5 mg Bupivacaine per kg of patient's weight)...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28279544/inferior-vena-cava-filter-limb-fracture-with-embolization-to-the-right-ventricle
#13
Bradley S Jackson, Mykel Sepula, Jared T Marx, Chad M Cannon
BACKGROUND: Inferior vena cava (IVC) filter and filter limb embolization is a known phenomenon, with a prevalence of up to 25% for certain filter types. Most commonly, the site of embolization is to the heart. Point-of-care ultrasound is an easily accessible imaging modality that should be utilized when considering IVC filter complications. CASE REPORT: A 28-year-old woman with a history of metastatic sarcoma and IVC filter placement for deep venous thrombosis presented to the Emergency Department (ED) for chest pain...
March 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28277414/implementation-of-an-electronic-clinical-decision-support-tool-for-pediatric-appendicitis-within-a-hospital-network
#14
Marissa A Hendrickson, Andrew R Wey, Philippe R Gaillard, Anupam B Kharbanda
OBJECTIVES: Computed tomography (CT) has been widely used in the evaluation of children with suspected appendicitis, but concerns about ionizing radiation have increased interest in ultrasound for these patients. We sought to assess the effectiveness of an appendicitis electronic clinical decision support (E-CDS) system in increasing ultrasound and decreasing CT use in children evaluated in emergency departments (EDs) for suspected appendicitis. METHODS: This was a preintervention and postintervention analysis of an E-CDS implemented into an electronic health record system shared by an academic, tertiary-care children's hospital and a community hospital...
March 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28274021/pharmaco-penile-duplex-ultrasonography-in-the-evaluation-of-erectile-dysfunction
#15
Phani Chakravarty Mutnuru, Harshavardhana Kuruba Ramanjaneyulu, Rammurti Susarla, Jyotsna Yarlagadda, Rahul Devraj, Prabakaran Palanisamy
INTRODUCTION: The National Institute of Health defined 'erectile dysfunction' as the persistent inability to achieve and/or to maintain an erection for a satisfactory sexual performance. In last few years, the concept of erectile dysfunction has evolved from that of a disorder referred to as 'impotence' which used to be considered predominantly psychogenic to that of 'Erectile Dysfunction' (ED), a well understood physiologic result of multiple risk factors, both psychological and organic...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28268118/the-role-of-early-focused-cardiac-ultrasound-in-a-not-so-typical-presentation-of-takotsubo-cardiomyopathy-a-case-report
#16
Jithin G Varghese, Qurat-Ul-Ain Jelani, Stuart Zarich, Brooks Walsh
BACKGROUND: Focused cardiac ultrasound (FoCUS) can be extremely helpful in identifying unexpected diagnoses that can significantly alter treatment options. The diagnosis of Takotsubo cardiomyopathy (TCM) may be difficult to identify. CASE REPORT: We describe a 47-year-old woman who presented to the emergency department (ED) with atypical features of TCM. Her clinical features included being a premenopausal woman with mild chest pain with a lack of identifiable emotional or physical stressors or significant electrocardiographic changes...
March 3, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28258838/ultrasound-guided-axillary-nerve-block-for-emergency-department-incision-and-drainage-of-deltoid-abscess
#17
Claire Lyons, Andrew A Herring
Deltoid abscesses are common and painful, often a consequence of injection drug use and seen frequently in emergency departments (EDs). The required incision and drainage can be completed successfully with effective pain relief using a peripheral nerve block. The brachial plexus nerve block works well, however it is technically complex with a low, but potentially serious, risk of complications such as phrenic nerve paralysis. Selective blockade of the axillary nerve eliminates the risks associated with a brachial plexus block, while providing more specific anesthesia for the deltoid region...
February 1, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28258097/lung-ultrasound-a-useful-tool-in-the-assessment-of-the-dyspnoeic-patient-in-the-emergency-department-fact-or-fiction
#18
REVIEW
Yashvi Wimalasena, Laura Kocierz, Dan Strong, Joanna Watterson, Brian Burns
Patients with respiratory distress present a frequent and challenging dilemma for emergency physicians (EPs). The accurate diagnosis and treatment of the underlying pathology is vitally important in these sick patients to ensure the best outcome and minimise harm from unnecessary treatments. Within the last decade, studies have shown lung ultrasonography (LU) to be valuable in the accurate diagnosis of a variety of lung pathologies, including cardiogenic pulmonary oedema, pleural effusion, pneumothorax, haemothorax and pneumonia...
March 3, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28246137/heart-failure-in-patients-presenting-with-dyspnoea-to-the-emergency-department-in-the-asia-pacific-region-an-observational-study
#19
Gerben Keijzers, Anne-Maree Kelly, Louise Cullen, Sharon Klim, Colin A Graham, Simon Craig, Win Sen Kuan, Peter Jones, Anna Holdgate, Charles Lawoko, Said Laribi
OBJECTIVES: To describe demographic features, assessment, management and outcomes of patients who were diagnosed with heart failure after presenting to an emergency department (ED) with a principal symptom of dyspnoea. DESIGN: Planned substudy of the prospective, descriptive cohort study: Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM). SETTING: 46 EDs in Australia, New Zealand, Singapore, Hong Kong and Malaysia collected data over 3 72-hour periods in May, August and October 2014...
February 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28238394/the-authors-respond-top-cited-articles-on-ultrasound-in-the-ed
#20
Başak Bayram, Önder Limon, Gülsüm Limon, Volkan Hancı
No abstract text is available yet for this article.
February 11, 2017: American Journal of Emergency Medicine
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