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Ultrasound in ED

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https://www.readbyqxmd.com/read/28807445/the-accuracy-of-emergency-physician-performed-ultrasonography-as-a-diagnostic-tool-for-lateral-malleolar-fracture
#1
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
https://www.readbyqxmd.com/read/28803375/lung-ultrasound-in-internal-medicine-efficiently-drives-the-management-of-patients-with-heart-failure-and-speeds-up-the-discharge-time
#2
Chiara Mozzini, Marco Di Dio Perna, Giancarlo Pesce, Ulisse Garbin, Anna Maria Fratta Pasini, Andrea Ticinesi, Antonio Nouvenne, Tiziana Meschi, Alder Casadei, Maurizio Soresi, Luciano Cominacini
Lung ultrasound (LUS) is a valid tool for the assessment of heart failure (HF) through the quantification of the B-lines. This study in HF patients aims to evaluate if LUS: (1) can accelerate the discharge time; (2) can efficiently drive diuretic therapy dosage; and (3) may have better performance compared to the amino-terminal portion of B type natriuretic peptide (NT-proBNP) levels in monitoring HF recovery. A consecutive sample of 120 HF patients was admitted from the Emergency Department (ED) to the Internal Medicine Department (Verona University Hospital)...
August 12, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28797559/utilization-of-ultrasound-for-the-evaluation-of-small-bowel-obstruction-a-systematic-review-and-meta-analysis
#3
Michael Gottlieb, Gary D Peksa, Ananda Vishnu Pandurangadu, Damali Nakitende, Sukhjit Takhar, Raghu R Seethala
INTRODUCTION: Small bowel obstruction (SBO) is a common presentation to the Emergency Department (ED). While computed tomography (CT) is frequently utilized to confirm the diagnosis, this modality is expensive, exposes patients to radiation, may lead to time delays, and is not universally available. This study aimed to determine the test characteristics of ultrasound for the diagnosis of SBO. METHODS: PubMed, CINAHL, Scopus, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were assessed for prospective trials evaluating the accuracy of ultrasound for the detection of SBO...
July 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28756934/postoperative-anticholinergic-poisoning-concealed-complications-of-a-commonly-used-medication
#4
Xiao Chi Zhang, Natalija Farrell, Thomas Haronian, Jason Hack
BACKGROUND: Scopolamine is a potent anticholinergic compound used commonly for the prevention of postoperative nausea and vomiting. Scopolamine can cause atypical anticholinergic syndromes due to its prominent central antimuscarinic effects. CASE REPORT: A 47-year-old female presented to the emergency department (ED) 20 h after hospital discharge for a right-knee meniscectomy, with altered mental status (AMS) and dystonic extremity movements that began 12 h after her procedure...
July 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28754527/ultrasound-use-during-cardiopulmonary-resuscitation-is-associated-with-delays-in-chest-compressions
#5
Maite A Huis In 't Veld, Michael G Allison, David S Bostick, Kiondra R Fisher, Olga G Goloubeva, Michael D Witting, Michael E Winters
AIM: High-quality chest compressions are a critical component of the resuscitation of patients in cardiopulmonary arrest. Point-of-care ultrasound (POCUS) is used frequently during emergency department (ED) resuscitations, but there has been limited research assessing its benefits and harms during the delivery of cardiopulmonary resuscitation (CPR). We hypothesized that use of POCUS during cardiac arrest resuscitation adversely affects high-quality CPR by lengthening the duration of pulse checks beyond the current cardiopulmonary resuscitation guidelines recommendation of 10s...
July 25, 2017: Resuscitation
https://www.readbyqxmd.com/read/28746385/quantification-of-carotid-plaque-lipid-content-with-magnetic-resonance-t2-mapping-in-patients-undergoing-carotid-endarterectomy
#6
Mohammad Alkhalil, Luca Biasiolli, Joshua T Chai, Francesca Galassi, Linqing Li, Christopher Darby, Alison Halliday, Linda Hands, Timothy Magee, Jeremy Perkins, Ed Sideso, Peter Jezzard, Matthew D Robson, Ashok Handa, Robin P Choudhury
BACKGROUND AND PURPOSE: Techniques to stratify subgroups of patients with asymptomatic carotid artery disease are urgently needed to guide decisions on optimal treatment. Reliance on estimates of % luminal stenosis has not been effective, perhaps because that approach entirely disregards potentially important information on the pathological process in the wall of the artery. METHODS: Since plaque lipid is a key determinant of plaque behaviour we used a newly validated, high-sensitivity T2-mapping MR technique for a systematic survey of the quantity and distribution of plaque lipid in patients undergoing endarterectomy...
2017: PloS One
https://www.readbyqxmd.com/read/28731535/ultrasound-guided-drainage-for-pediatric-soft-tissue-abscesses-decreases-clinical-failure-rates-compared-to-drainage-without-ultrasound-a-retrospective-study
#7
Romolo Joseph Gaspari, Alexandra Sanseverino
OBJECTIVES: Soft tissue abscesses are common in the pediatric emergency department (ED). Ultrasound (US) can be used to both diagnose soft tissue abscesses as well as guide drainage. We hypothesized that clinical failure rates would be less in pediatric patients with suspected skin abscesses when evaluated with US. METHODS: We performed a retrospective review of suspected pediatric skin abscesses at 4 EDs over a 22-month period. Cases were identified through electronic medical record descriptions, discharge diagnoses, and US database records...
July 21, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28720719/introduction-of-a-new-imaging-guideline-for-suspected-renal-colic-in-the-ed-reduces-ct-urography-utilisation
#8
Gabriel Blecher, Rob Meek, Diana Egerton-Warburton, Philip McCahy
BACKGROUND: Patients presenting to the ED with suspected renal colic are frequently imaged with CT urography (CTU), which rarely alters diagnosis or management. To reduce use of CTU in this population, we instigated a new imaging and management guideline in our ED. METHODS: This was a quasi-experimental prospective study, whereby a new guideline was commenced at the intervention site (Monash Medical Centre) and the existing guideline continued at the control site (Dandenong Hospital)...
July 18, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28710184/diagnostic-value-of-four-dimensional-ct-angiography-in-arterial-erectile-dysfunction-using-320-detector-row-dynamic-volume-ct
#9
Cheng-Cheng Xu, Xin-Zhong Ruan, Yi-Fan Tang, Jiao-Hai Pan, Guo-Yao Wang, Qiu-Li Huang
The study aims to evaluate the diagnostic value of four-dimensional CT angiography (4D-CTA) in the diagnosis of arterial erectile dysfunction (ED) using 320-detector row dynamic volume CT. Arterial ED patients attributed to arterial insufficiency were enrolled. To induce penile erection, an intracavernous injection of corpus cavernosum with a vasoactive drug was administered. Patients were assigned into the erection hardness score (EHS) 1/2 group or EHS 3/4 group. Color duplex Doppler ultrasound (CDDU) was used to analyze blood flow spectrum...
July 14, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/28688887/predicting-need-for-additional-ct-scan-in-children-with-a-non-diagnostic-ultrasound-for-appendicitis-in-the-emergency-department
#10
Takuya Nishizawa, Shigenobu Maeda, Ran D Goldman, Hiroyuki Hayashi
OBJECTIVE: This study aimed to determine which children with suspected appendicitis should be considered for a computerized tomography (CT) scan after a non-diagnostic ultrasound (US) in the Emergency Department (ED). METHODS: We retrospectively reviewed patients 0-18year old, who presented to the ED with complaints of abdominal pain, during 2011-2015 and while in the hospital had both US and CT. We recorded demographic and clinical data and outcomes, and used univariate and multivariate methods for comparing patients who did and didn't have appendicitis on CT after non-diagnostic US...
July 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28676304/imaging-trends-in-acute-venous-thromboembolic-disease-2000-to-2015
#11
Isaac Wang, Matthew S Davenport, Ella A Kazerooni
PURPOSE: To measure diffusion of new knowledge and correlate imaging utilization for suspected acute venous thromboembolism (VTE) with d-dimer utilization, landmark publications, and institutional guidelines. MATERIALS: Between 2000 and 2015, the number of CT pulmonary angiograms (CTPAs), CTPA combined with indirect CT venography (CTV), ventilation-perfusion (VQ) scans, and lower extremity venous Doppler ultrasound (US) examinations were obtained for inpatients and emergency department (ED) patients and correlated with d-dimer utilization, landmark publications regarding radiation and VTE imaging, and an institutional inpatient best-practice alert requiring VTE prophylaxis assessment (2008)...
July 1, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28673696/appendicitis-following-blunt-abdominal-trauma
#12
Travis Cobb
Appendicitis is a frequently encountered surgical problem in the Emergency Department (ED). Appendicitis typically results from obstruction of the appendiceal lumen, although trauma has been reported as an infrequent cause of acute appendicitis. Intestinal injury and hollow viscus injury following blunt abdominal trauma are well reported in the literature but traumatic appendicitis is much less common. The pathophysiology is uncertain but likely results from several mechanisms, either in isolation or combination...
June 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28672064/response-to-letter-diagnostic-value-of-bedside-ultrasound-in-acute-appendicitis-in-ed-methodological-and-statistical-issues-on-diagnostic-value
#13
Faruk Gungor, Erkan Goksu, Taylan Kilic
The validity of a diagnostic test can be demonstrated by comparing it to a gold standard test. Sensitivity, specificity, positive and negative predictive values (PPV, NPV), positive and negative likelihood ratios, diagnostic odds ratio, and the area under the ROC curve are the parameters that reflect the discriminative ability of a diagnostic study. Diagnostic accuracy is very sensitive to the characteristics of the study population and it is affected by the prevalence or the spectrum of the disease studied...
July 3, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28652122/predictors-of-hospital-admission-and-urologic-intervention-in-adult-emergency-department-patients-with-ct-confirmed-ureteral-stones
#14
Brock Daniels, Elizabeth Schoenfeld, Andrew Taylor, Karrin Weisenthal, Dinesh Singh, Christopher L Moore
PURPOSE: Over one million patients seek care in an Emergency Department (ED) for kidney stones annually, but a minority require admission or urologic procedure. We aim to describe predictors of hospital admission or urologic intervention. MATERIALS AND METHODS: This secondary analysis of prospective data includes ED patients with CT-confirmed obstructing ureteral stone. All patients also received a point-of-care limited renal ultrasound (PLUS). Need for urologic intervention at 90 days was assessed by follow-up interview...
June 23, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28640133/effectiveness-of-education-in-point-of-care-ultrasound-assisted-physical-examinations-in-an-emergency-department-a-before-and-after-study
#15
Yoo Jin Choi, Jae Yun Jung, Hyuksool Kwon
Implementation of point-of-care ultrasonography (POCUS)-assisted physical examination (PE) in emergency departments (EDs) was conducted in the ED of an urban tertiary teaching hospital. This study examines the effect of POCUS implementation in emergency medicine departments by using a systematic education program on image acquisition to analyze decision making.Educating staff on POCUS involved a technique related to image acquisition and then accurately diagnosing subsequent POCUS results. The quasi-experimental, uncontrolled before-and-after study was performed to evaluate the education effect...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28629375/diagnostic-performance-of-multi-organ-ultrasound-with-pocket-sized-device-in-the-management-of-acute-dyspnea
#16
Alfonso Sforza, Costantino Mancusi, Maria Viviana Carlino, Agostino Buonauro, Marco Barozzi, Giuseppe Romano, Sossio Serra, Giovanni de Simone
BACKGROUND: The availability of ultra-miniaturized pocket ultrasound devices (PUD) adds diagnostic power to the clinical examination. Information on accuracy of ultrasound with handheld units in immediate differential diagnosis in emergency department (ED) is poor. The aim of this study is to test the usefulness and accuracy of lung ultrasound (LUS) alone or combined with ultrasound of the heart and inferior vena cava (IVC) using a PUD for the differential diagnosis of acute dyspnea (AD)...
June 19, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28625217/the-core-emergency-ultrasound-curriculum-project-a-report-from-the-curriculum-working-group-of-the-caep-emergency-ultrasound-committee
#17
Paul Olszynski, Dan Kim, Jordan Chenkin, Louise Rang
Emergency ultrasound (EUS) is now widely considered to be a "skill integral to the practice of emergency medicine." 1 The Canadian Association of Emergency Physicians (CAEP) initially issued a position statement in 1999 supporting the availability of focused ultrasound 24 hours per day in the emergency department (ED). 2.
June 19, 2017: CJEM
https://www.readbyqxmd.com/read/28624064/assessing-written-communication-during-interhospital-transfers-of-emergency-general-surgery-patients
#18
Felicity N R Harl, Megan C Saucke, Caprice C Greenberg, Angela M Ingraham
BACKGROUND: Poor communication causes fragmented care. Studies of transitions of care within a hospital and on discharge suggest significant communication deficits. Communication during transfers between hospitals has not been well studied. We assessed the written communication provided during interhospital transfers of emergency general surgery patients. We hypothesized that patients are transferred with incomplete documentation from referring facilities. METHODS: We performed a retrospective review of written communication provided during interhospital transfers to our emergency department (ED) from referring EDs for emergency general surgical evaluation between January 1, 2014 and January 1, 2016...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28611874/ultrasound-vs-computed-tomography-for-severity-of-hydronephrosis-and-its-importance-in-renal-colic
#19
Megan M Leo, Breanne K Langlois, Joseph R Pare, Patricia Mitchell, Judith Linden, Kerrie P Nelson, Cristopher Amanti, Kristin A Carmody
INTRODUCTION: Supporting an "ultrasound-first" approach to evaluating renal colic in the emergency department (ED) remains important for improving patient care and decreasing healthcare costs. Our primary objective was to compare emergency physician (EP) ultrasound to computed tomography (CT) detection of hydronephrosis severity in patients with suspected renal colic. We calculated test characteristics of hydronephrosis on EP-performed ultrasound for detecting ureteral stones or ureteral stone size >5mm...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28609532/effect-of-abdominal-ultrasound-on-clinical-care-outcomes-and-resource-use-among-children-with-blunt-torso-trauma-a-randomized-clinical-trial
#20
RANDOMIZED CONTROLLED TRIAL
James F Holmes, Kenneth M Kelley, Sandra L Wootton-Gorges, Garth H Utter, Lisa P Abramson, John S Rose, Daniel J Tancredi, Nathan Kuppermann
Importance: The utility of the focused assessment with sonography for trauma (FAST) examination in children is unknown. Objective: To determine if the FAST examination during initial evaluation of injured children improves clinical care. Design, Setting, and Participants: A randomized clinical trial (April 2012-May 2015) that involved 975 hemodynamically stable children and adolescents younger than 18 years treated for blunt torso trauma at the University of California, Davis Medical Center, a level I trauma center...
June 13, 2017: JAMA: the Journal of the American Medical Association
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