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Ultrasound in ED

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https://www.readbyqxmd.com/read/27904260/sonographic-identification-of-peripheral-nerves-in-the-forearm
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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...
November 14, 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
#10
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
#11
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
#12
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-s-disease-outcomes-and-patient-satisfaction
#13
Pedro Valente, Carolina Gomes, Nuno Tomada
OBJECTIVES: To evaluate surgical outcomes and complications and assess overall patient satisfaction after small intestinal submucosa (SIS) grafting for PD. METHODS: Twenty-eight patients were treated with tunical incision and grafting with SIS. Mean age was 58 years (range:43-71). A preoperative protocol was applied to all patients. Patients were also evaluated at follow-up clinic visits. The International Index of Erectile Function (IIEF-5), a modified Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire, postoperative self-reports and clinical characteristics were used to measure outcomes...
November 4, 2016: Urology
https://www.readbyqxmd.com/read/27803496/left-atrial-to-esophageal-fistula-a-case-report-and-literature-review
#14
Muhammad Yasir Khan, Waqas Javed Siddiqui, Praneet S Iyer, Ahmed Dirweesh, Nigahus Karabulut
BACKGROUND Left atrial to esophageal fistula (LAEF) is a rare fatal complication of radiofrequency ablation (RFA) for atrial fibrillation and is associated with high mortality. Clinical features can be nonspecific and include fever, dysphagia, upper gastrointestinal (GI) bleeding, sepsis, and embolic stroke a after recent history of RFA for atrial fibrillation. CASE REPORT  A 57-year-old Caucasian male was brought to the emergency department (ED) by his family because of an altered mental status. He had undergone a radiofrequency ablation for paroxysmal atrial fibrillation three weeks earlier...
November 2, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27787895/regional-nerve-blocks-improve-pain-and-functional-outcomes-in-hip-fracture-a-randomized-controlled-trial
#15
R Sean Morrison, Eitan Dickman, Ula Hwang, Saadia Akhtar, Taja Ferguson, Jennifer Huang, Christina L Jeng, Bret P Nelson, Meg A Rosenblatt, Jeffrey H Silverstein, Reuben J Strayer, Toni M Torrillo, Knox H Todd
OBJECTIVES: To compared outcomes of regional nerve blocks with those of standard analgesics after hip fracture. DESIGN: Multisite randomized controlled trial from April 2009 to March 2013. SETTING: Three New York hospitals. PARTICIPANTS: Individuals with hip fracture (N = 161). INTERVENTION: Participants were randomized to receive an ultrasound-guided, single-injection, femoral nerve block administered by emergency physicians at emergency department (ED) admission followed by placement of a continuous fascia iliaca block by anesthesiologists within 24 hours (n = 79) or conventional analgesics (n = 82)...
October 27, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27770490/point-of-care-ultrasound-for-diagnosis-of-abscess-in-skin-and-soft-tissue-infections
#16
Sathyaseelan Subramaniam, Jacqueline Bober, Jennifer Chao, Shahriar Zehtabchi
BACKGROUND: Traditionally, emergency department (ED) physicians rely on their clinical examination to differentiate between cellulitis and abscess when evaluating skin and soft tissue infections (SSTI). Management of an abscess requires incision and drainage, whereas cellulitis generally requires a course of antibiotics. Misdiagnosis often results in unnecessary invasive procedures, sedations (for incision and drainage in pediatric patients), or a return ED visit for failed antibiotic therapy...
November 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27765438/power-injection-through-ultrasound-guided-intravenous-lines-safety-and-efficacy-under-an-institutional-protocol
#17
Michael D Witting, Siamak Moayedi, Kathy Dunning, Lisa S Babin, Brad M Cogan
BACKGROUND: After an index case of contrast-associated compartment syndrome, an urban hospital instituted a protocol limiting high-speed injection to intravenous (IV) lines started proximal to the forearm and testing those lines before contrast injection. OBJECTIVE: In this article, we estimate the safety and efficacy of high-speed injection using this protocol in patients with IV lines inserted under ultrasound guidance. METHODS: In an ambispective study, we enrolled prospective cohorts of ED patients requiring high-speed radiographic contrast media injection (≥3...
October 17, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27755330/the-use-of-routine-blood-cultures-in-pediatric-appendicitis
#18
Graham Cameron Thompson, Ellen Morrison, Marshall Ross, Helena Liu, Otto G Vanderkooi, Robin Eccles
OBJECTIVES: To determine the proportion of true-positive blood culture results in children presenting to the ED with suspected appendicitis. To describe the current practice of obtaining blood cultures in children with suspected appendicitis. METHODS: We performed a 2-year retrospective health record review of all children aged 2 through 17 years investigated for suspected appendicitis at a tertiary Pediatric Emergency Department. Subjects were identified by searching (a) institutional records for ICD-10-CA coding, (b) diagnostic imaging records of ultrasounds for appendicitis, and (c) surgical database records for nonincidental appendectomies...
October 17, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27753717/pediatric-referrals-to-an-emergency-department-from-urgent-care-centers
#19
Robert P Olympia, Robert Wilkinson, Jennifer Dunnick, Brendan J Dougherty, Debra Zauner
OBJECTIVE: The aims of this study were to describe pediatric emergency department (ED) referrals from urgent care centers and to determine the percentage of referrals considered essential and serious. METHODS: A prospective study was conducted between April 2013 and April 2015 on patients younger than 21 years referred directly to an ED in central Pennsylvania from surrounding urgent care centers. Referrals were considered essential or serious based on investigations/procedures performed or medications/consultations received in the ED...
October 8, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27749905/real-time-tele-mentored-low-cost-point-of-care-us-in-the-hands-of-paediatricians-in-the-emergency-department-diagnostic-accuracy-compared-to-expert-radiologists
#20
Floriana Zennaro, Elena Neri, Federico Nappi, Daniele Grosso, Riccardo Triunfo, Francesco Cabras, Francesca Frexia, Stefania Norbedo, Pierpaolo Guastalla, Massino Gregori, Elisabetta Cattaruzzi, Daniela Sanabor, Egidio Barbi, Marzia Lazzerini
BACKGROUND: The use of point-of-care ultrasonography (POC US) in paediatrics is increasing. This study investigated the diagnostic accuracy of POC US in children accessing the emergency department (ED) when performed by paediatricians under the remote guidance of radiologists (TELE POC). METHODS: Children aged 0 to 18 years accessing the ED of a third level research hospital with eight possible clinical scenarios and without emergency/severity signs at the triage underwent three subsequent US tests: by a paediatrician guided remotely by a radiologist (TELE POC); by the same radiologist (UNBLIND RAD); by an independent blinded radiologist (BLIND RAD)...
2016: PloS One
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