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Ultrasound in ED

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https://www.readbyqxmd.com/read/28336237/point-of-care-ultrasound-sonographic-posterior-fat-pad-sign-a%C3%A2-case-report-and-brief-literature-review
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28237601/short-communication-optimization-of-a-timed-artificial-insemination-program-for-reproductive-management-of-heifers-in-canadian-dairy-herds
#13
K Macmillan, K Loree, R J Mapletoft, M G Colazo
Pregnancy per AI (P/AI) following the use of 1 of 2 timed AI (TAI) protocols and 2 different intervals between TAI and resynchronization were compared in heifers that were inseminated with either conventional or sex-sorted semen. Holstein heifers (n = 317; 527 inseminations) were submitted to a 5-d Cosynch protocol with (+) or without (-) GnRH at the time of controlled internal drug release (CIDR) insertion on d 0, CIDR removal and a single PGF2α treatment on d 5, and TAI plus GnRH on d 8 (72 h later). Visual estrus detection (ED) was conducted on d 6 in the afternoon and d 7 in the morning and heifers observed in estrus were artificially inseminated on d 7 in the afternoon...
February 22, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28237424/downstream-imaging-utilization-after-emergency%C3%A2-department-ultrasound-interpreted-by%C3%A2-radiologists%C3%A2-versus-nonradiologists-a-medicare-claims-based-study
#14
Bibb Allen, L Van Carrol, Danny R Hughes, Jennifer Hemingway, Richard Duszak, Andrew B Rosenkrantz
OBJECTIVE: To study differences in imaging utilization downstream to initial emergency department (ED) ultrasound examinations interpreted by radiologists versus nonradiologists. METHODS: Using 5% Medicare Research Identifiable Files from 2009 to 2014, we identified episodes where the place of service was "emergency room hospital" and the patient also underwent an ultrasound examination. We determined whether the initial ultrasound was interpreted by a radiologist or nonradiologist and then summed all additional imaging events occurring within 7, 14, and 30 days of each initial ED ultrasound...
February 17, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28228343/ultrasound-guided-femoral-nerve-blockage-in-a-patellar-dislocation-an-effective-technique-for-emergency-physicians
#15
Sami Eksert, Sinan Akay, Murtaza Kaya, Ali Kantemir, Kenan Keklikci
BACKGROUND: Patellar dislocation is an orthopedic emergency and its reduction can be painful. The aim of this case is to show that the ultrasound-guided femoral nerve blockage can be effectively used in the pain management of patellar reduction in the emergency department (ED). CASE REPORT: A 21-year-old man was admitted to our ED after suffering a fall down a flight of stairs. The initial physical examination and plain radiography showed a patellar dislocation in the right knee...
February 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28214369/diagnostic-accuracy-of-history-physical-exam-laboratory-tests-and-point-of-care-ultrasound-for-pediatric-acute-appendicitis-in-the-emergency-department-a-systematic-review-and-meta-analysis
#16
Roshanak Benabbas, Mark Hanna, Jay Shah, Richard Sinert
BACKGROUND: Acute appendicitis (AA) is the most common surgical emergency in children. Accurate and timely diagnosis is crucial but challenging due to atypical presentations and the inherent difficulty of obtaining a reliable history and physical examination in younger children. OBJECTIVES: To determine the utility of history, physical exam, laboratory tests, Pediatric Appendicitis Score (PAS) and Emergency Department-Point-of-Care Ultrasound (ED-POCUS) in the diagnosis of AA in ED pediatric patients...
February 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28207968/mri-vs-ultrasound-as-the-initial-imaging-modality-for-pediatric-and-young-adult-patients-with-suspected-appendicitis
#17
Daniel Imler, Christine Keller, Shyam Sivasankar, Nancy Ewen Wang, Shreyas Vasanawala, Matias Bruzoni, James Quinn
BACKGROUND: While ultrasound (US), given its lack of ionizing radiation is currently the recommended initial imaging study of choice for the diagnosis of appendicitis in pediatric and young adult patients, it does have significant shortcomings. US is time intensive, operator dependent, and results in frequent inconclusive studies, thus necessitating further imaging, and admission for observation or repeat clinical visits. A rapid focused Magnetic Resonance Imaging (MRI) for appendicitis has been shown to have definitive sensitivity and specificity, similar to Computed tomography (CT) but without radiation and offers a potential alternative to US...
February 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28171688/diagnostic-value-and-effect-of-bedside-ultrasound-in-acute-appendicitis-in-the-emergency-department
#18
Faruk Gungor, Taylan Kilic, Kamil Can Akyol, Gizem Ayaz, Umut Cengiz Cakir, Mehmet Akcimen, Cenker Eken
OBJECTIVE: Early and accurate diagnosis of acute appendicitis (AA) with ultrasound can minimize the morbidity and mortality of the patients. In this regard, ultrasound can help to the emergency physicians (EPs) in the diagnosing process and clinical decision making for AA. Therefore, we primarily aimed to evaluate the effectiveness of point of care ultrasound (POCUS) in clinical decision making of EPs for the diagnostic evaluation for AA in the emergency department (ED). METHODS: The study sample consisted of patients aged >18 years that presented to the ED with an abdominal pain and underwent diagnostic evaluation for AA...
February 7, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28150328/use-of-emergency-ultrasound-in-arizona-community-emergency-departments
#19
Richard Amini, Michael T Wyman, Nicholas C Hernandez, John A Guisto, Srikar Adhikari
OBJECTIVES: Despite the increased educational exposure to point-of-care ultrasound (US) at all levels of medical training, there are utilization gaps between academic and nonacademic emergency department (ED) settings. The purpose of this study was to assess the current practices and potential barriers to the use of point-of-care US in nonacademic EDs throughout the state of Arizona. METHODS: We conducted a cross-sectional study. An online questionnaire was electronically sent to all nonacademic EDs in Arizona...
February 2, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28132006/ultrasound-and-nicom-in-the-assessment-of-fluid-responsiveness-in-patients-with-mild-sepsis-in-the-emergency-department-a-pilot-study
#20
Martha Oord, Tycho J Olgers, Mirjam Doff-Holman, Mark P M Harms, Jack J M Ligtenberg, Jan C Ter Maaten
OBJECTIVE: We investigated whether combining the caval index, assessment of the global contractility of the heart and measurement of stroke volume with Noninvasive Cardiac Output Monitoring (NICOM) can aid in fluid management in the emergency department (ED) in patients with sepsis. SETTING: A prospective observational single-centre pilot study in a tertiary care centre. PRIMARY AND SECONDARY OUTCOMES: Ultrasound was used to assess the caval index, heart contractility and presence of B-lines in the lungs...
January 27, 2017: BMJ Open
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