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Ultrasound in ED

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https://www.readbyqxmd.com/read/29328792/identification-and-management-of-nontraumatic-splenic-rupture
#1
Samanthi De Silva
A 43-year old previously fit and well gentleman presented to the emergency department (ED) with a two day history of worsening epigastric pain. He had had coryzal symptoms the preceding week but had no other past medical history. He was haemodynamically stable at presentation and an ultrasound scan (US) performed in the ED could not definitively rule out intra-abdominal fluid. In view of his tender abdomen on examination and a haemoglobin level of 9.2g/dL, a computerised tomography (CT) scan was performed and revealed extensive high-density fluid within the peritoneal cavity, raising the possibility of a concealed bleed but no obvious source was identified by the scan...
December 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29321112/the-evaluation-and-management-of-urolithiasis-in-the-emergency-department-a-review-of-the-literature
#2
REVIEW
Michael Gottlieb, Brit Long, Alex Koyfman
BACKGROUND: Urolithiasis is a common condition in the U.S. Patients frequently present to the emergency department (ED) for care, including analgesia and treatments to facilitate stone passage. OBJECTIVE: With the new evidence concerning the evaluation and treatment of urolithiasis, this review summarizes current literature regarding the ED management of urolithiasis. DISCUSSION: Urolithiasis occurs primarily through supersaturation of urine and commonly presents with flank pain, hematuria, and nausea/vomiting...
January 5, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29307034/emergency-department-imaging-of-pediatric-trauma-patients-during-combat-operations-in-iraq-and-afghanistan
#3
Jason F Naylor, Michael D April, Jamie L Roper, Guyon J Hill, Paul Clark, Steven G Schauer
BACKGROUND: Military hospitals in Iraq and Afghanistan treated children with traumatic injuries during the recent conflicts. Diagnostic imaging is an integral component of trauma management; however, few published data exist on its use in the wartime pediatric population. OBJECTIVE: The authors describe the emergency department (ED) utilization of radiology resources for pediatric trauma patients in Iraq and Afghanistan. MATERIALS AND METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric patients admitted to military fixed-facility hospitals in Iraq and Afghanistan from January 2007 to January 2016...
January 6, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29306644/increasing-utilization-of-emergency-department-neuroimaging-in-medicare-beneficiaries-from-1994-to-2015
#4
Anand M Prabhakar, Ravi V Gottumukkala, Jennifer Hemingway, Danny R Hughes, Sumir S Patel, Richard Duszak
OBJECTIVE: To assess for changes in emergency department (ED) utilization of neuroimaging in Medicare fee-for-service beneficiaries from 1994 to 2015. METHODS: Using Medicare Physician Supplier Procedure Summary Master Files, annual ED volumes of head computed tomography (CT), magnetic resonance (MR), and carotid duplex ultrasound (CDUS) were assessed from 1994 through 2015. Annual volumes of head CT angiography (CTA), neck CTA, head MR angiography (MRA), and neck MRA studies were assessed from 2001 (first year of unique reporting codes) through 2015...
December 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29306580/comparison-of-the-accuracy-of-emergency-department-performed-point-of-care-ultrasound-pocus-in-the-diagnosis-of-lower-extremity-deep-vein-thrombosis
#5
Jorge Pedraza García, Joaquín Valle Alonso, Pedro Ceballos García, Francisca Rico Rodríguez, Miguel Ángel Aguayo López, María Del Carmen Muñoz-Villanueva
BACKGROUND: Compression ultrasonography is the most effective diagnostic tool in the emergency department (ED) for the diagnosis of deep vein thrombosis (DVT). It has been demonstrated to be highly accurate and cost-effective. OBJECTIVE: The objective of this study was to determine the accuracy of emergency physicians who performed three-point compression ultrasound (US) for suspected above-knee DVT within the context of using Wells score and D-dimer. METHOD: This was a prospective diagnostic test assessment of three-point ultrasound conducted in a district general hospital of patients who presented to the ED with suspected DVT of the lower limb...
January 3, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29301653/successful-emergency-pain-control-for-posterior-rib-fractures-with-ultrasound-guided-erector-spinae-plane-block
#6
Josh Luftig, Daniel Mantuani, Andrew A Herring, Brittany Dixon, Eben Clattenburg, Arun Nagdev
The Eastern Association for the Surgery of Trauma and Trauma Anesthesiology Society Guidelines recommend prompt and effective multimodal analgesia for rib fractures that combines regional anesthesia (RA) techniques with pharmacotherapy to treat pain, optimize pulmonary function, and reduce opioid related complications. However, RA techniques such as epidurals and paravertebral blocks, are generally underutilized or unavailable for emergency department (ED) patients. The recently described serratus anterior plane block (SAPB) is a promising technique, but failures with posterior rib fractures have been observed...
December 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29298244/national-imaging-trends-of-recurrent-pediatric-urolithiasis
#7
Lindsey Barrick, Daniel M Cohen, Megan S Schober, Andrew Schwaderer
OBJECTIVES: The aim of this study was to examine computed tomography (CT) and ultrasound (US) utilization trends in incident and prevalent pediatric emergency department (ED) urolithiasis patients before and after imaging guideline release. METHODS: We reviewed imaging modalities for children with 2 or more ED encounters between January 1, 2006, and September 1, 2013, for urolithiasis using the Pediatric Health Information System database. Z scores compared the proportion of patient encounters receiving CT and US before (January 1, 2006, to December 31, 2010) and after (January 1, 2011, to September 1, 2013) the release of imaging guidelines...
January 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29291179/accuracy-of-emergency-transfusion-score-in-prediction-need-for-blood-transfusion-among-multiple-trauma-patients-a-cross-sectional-study-from-iran
#8
Hossein Alimohammadi, Yalda Kianian, Farahnaz Bidari Zerepoosh, Hojjat Derakhshanfar, Mostafa Alavi-Moghadam, Hamid Reza Hatamabadi, Seyed-Mostafa Hosseini-Zijoud
Objective: Prediction of blood transfusion requirement in trauma patients is a dilemma in most trauma centers. The aim of the current study was assessing the accuracy of emergency transfusion score (ETS) in detecting patients' need for blood transfusion in ED. Methods: In this cross-sectional study, all multiple trauma patients referred to the emergency department (ED) of Imam Hossein Hospital, Tehran, Iran, from March to August 2014, were enrolled. ETS parameters including low blood pressure, free fluid on ultrasound, clinical instability of the pelvic ring, age, admission from the scene, and trauma mechanism were recorded for all patients...
October 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29274507/mediterranean-diet-improves-endothelial-function-in-patients-with-diabetes-and-prediabetes-a-report-from-the-cordioprev-study
#9
Jose D Torres-Peña, Antonio Garcia-Rios, Nieves Delgado-Casado, Purificacion Gomez-Luna, Juan F Alcala-Diaz, Elena M Yubero-Serrano, Francisco Gomez-Delgado, Ana Leon-Acuña, Javier Lopez-Moreno, Antonio Camargo, Francisco J Tinahones, Javier Delgado-Lista, Jose M Ordovas, Pablo Perez-Martinez, Jose Lopez-Miranda
BACKGROUND AND AIMS: Endothelial dysfunction (ED) plays a key role in the development of atherosclerotic cardiovascular disease (ASCVD). Likewise, type 2 diabetes (T2D) is a major CVD risk factor. Therefore, our objective was to explore whether long-term consumption of a Mediterranean diet (MedDiet) rich in olive oil or a low-fat diet (LF diet) was associated with an improvement in ED and whether the potential benefits were similar in patients with or without T2D in the CORDIOPREV clinical trial (NCT00924937)...
December 8, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29249008/secondary-imaging-for-suspected-appendicitis-after-equivocal-ultrasound-time-to-disposition-of-mri-compared-to-ct
#10
James F Martin, David J Mathison, Paul C Mullan, Hansel J Otero
PURPOSE: The purpose of this study was to compare MRI to CT as a secondary imaging modality for children age 5 years and older with suspected appendicitis after an equivocal abdominal ultrasound in terms of (1) the time to ED disposition decision, (2) surgery consultation rate, and (3) imaging test accuracy. METHODS: We retrospectively studied children with suspected appendicitis and equivocal ultrasound results who underwent MR or CT as secondary imaging in a pediatric emergency department over two-consecutive 9-month periods...
December 16, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/29243193/comparison-between-two-point-and-three-point-compression-ultrasound-for-the-diagnosis-of-deep-vein-thrombosis
#11
Rona Zuker-Herman, Irit Ayalon Dangur, Ron Berant, Elinor Cohen Sitt, Libbi Baskin, Yossi Shaya, Shachaf Shiber
Lower extremity deep vein thrombosis (DVT) is a frequent cause of admission to the emergency departments (ED). Although the gold standard for diagnosis is the Duplex ultrasound examination, the current study used for diagnosis of DVT in the ED by emergency physicians is the point-of-care compression ultrasound (POCUS). To compare the sensitivity and specificity of the two-point and three-point compression ultrasound (2PCUS and 3PCUS respectively) for diagnosis of lower extremity DVT in an ED management. We prospectively recruited outpatients who were admitted to the ED with suspected lower extremity DVT...
December 14, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29230555/non-visualization-of-the-ovary-on-ct-or-ultrasound-in-the-ed-setting-utility-of-immediate-follow-up-imaging
#12
Elena Motuzko, Maria Solis, Moazzem Kazi, Ron Gefen
PURPOSE: In the setting of female patients in the ED receiving both a CT scan and ultrasound of the pelvis, we compared the studies to assess the diagnostic value of non-visualization of the ovary in predicting the absence of ovarian disease. METHODS: A retrospective review of the electronic medical record identified adult female non-pregnant patients who received both a CT abdomen and pelvis and a transabdominal and transvaginal pelvic ultrasound within a 48-h period through the emergency department...
December 11, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29223612/predictive-value-of-focused-assessment-with-sonography-for-trauma-fast-for-laparotomy-in-unstable-polytrauma-egyptians-patients
#13
Adel Hamed Elbaih, Sameh T Abu-Elela
PURPOSE: The emergency physicians face significant clinical uncertainty when multiple trauma patients arrive in the emergency department (ED). The priorities for assessment and treatment of polytrauma patients are established in the primary survey. Focused assessment with sonography for trauma (FAST) is very essential clinical skill during trauma resuscitation. Use of point of care ultrasound among the trauma team working in the primary survey in emergency care settings is lacking in Suez Canal University Hospitals even ultrasound machine not available in ED...
November 23, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29211402/sonographic-patterns-of-peyronie-s-disease-in-patients-with-absence-of-palpable-plaques
#14
Lucio Dell'Atti, Andrea Benedetto Galosi
PURPOSE: Non-palpable isolated septal plaques of the penis are likely present in a significant number of patients affected by erectile dysfunction (ED) and penile pain without deformity or curvature. The aim of this study was to evaluate the ultrasound (US) patterns observed in patients investigated for ED or penile pain without curvature. MATERIALS AND METHODS: We reviewed the medical records of 386 patients who underwent an initial colour-Doppler ultrasonography (CDU) of the penis for DE and/or penile pain without curvature...
December 7, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29203048/a-review-of-the-management-of-loss-of-pregnancy-in-the-emergency-department
#15
Brittany E Punches, Kimberly D Johnson, Gordon L Gillespie, Shauna A Acquavita, Dianne M Felblinger
INTRODUCTION: Women frequently seek ED care for complications in early pregnancy, including loss of pregnancy. This review evaluates the current literature and discusses the care of patients experiencing loss of pregnancy in the emergency department. METHODS: A review of pertinent studies identified through multiple database searches was conducted to determine the existing body of knowledge for the care of ED patients diagnosed with loss of pregnancy. Each of the studies was examined for inclusion criteria and a subsequent analysis of the included studies identified themes related to the care of the women...
December 1, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29198510/does-calculated-free-testosterone-overcome-total-testosterone-in-protecting-from-sexual-symptom-impairment-findings-of-a-cross-sectional-study
#16
Luca Boeri, Paolo Capogrosso, Eugenio Ventimiglia, Walter Cazzaniga, Filippo Pederzoli, Donatella Moretti, Federico Dehò, Emanuele Montanari, Francesco Montorsi, Andrea Salonia
BACKGROUND: Although erectile dysfunction (ED) has been associated with low circulating total testosterone (TT) levels, the utility of free testosterone (FT) over TT is debatable. AIM: To assess the relative impact of low TT and low calculated FT (cFT) on androgen-related sexual symptoms in men with ED. METHODS: Data from 485 men were analyzed. Comorbidities were scored with the Charlson Comorbidity Index (CCI). Patients completed the International Index of Erectile Function (IIEF) and the Beck Inventory for Depression (BDI)...
December 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/29189351/lung-ultrasound-in-diagnosing-pneumonia-in-the-emergency-department-a-systematic-review-and-meta-analysis
#17
Daniele Orso, Nicola Guglielmo, Roberto Copetti
Community-acquired pneumonia (CAP) is one of the most widespread and severe infectious diseases worldwide. In the emergency department (ED), there is still a need for a rapid and accurate tool that can diagnose CAP. Lung ultrasound (LUS) is a recent tool that is increasingly being for this purpose. So far, the LUS has been evaluated on a wide range of patients, but not yet on the specific population in the ED through a meta-analysis. Our aim was to assess the accuracy of the LUS in diagnosing CAP in this setting through a systematic review and a meta-analysis...
November 20, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29174452/diagnosing-centrally-located-pulmonary-embolisms-in-the-emergency-department-using-point-of-care-ultrasound
#18
Kristin H Dwyer, Joshua S Rempell, Michael B Stone
OBJECTIVE: The study objective was to investigate the combined accuracy of right heart strain on focused cardiac ultrasound (FOCUS) and deep vein thrombosis (DVT) on compression ultrasound (CUS) for identification of centrally located pulmonary embolism (PE) diagnosed on computed tomography pulmonary angiography (CTPA). METHODS: This was a prospective observational study using a convenience sample of patients undergoing CTPA in the emergency department (ED) for evaluation of PE...
November 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29162442/utility-of-common-bile-duct-measurement-in-emergency-department-point-of-care-ultrasound-a-prospective-study
#19
Shadi Lahham, Brent A Becker, Abdulatif Gari, Steven Bunch, Maili Alvarado, Craig L Anderson, Eric Viquez, Sophia C Spann, John C Fox
BACKGROUND: Measurement of the common bile duct (CBD) is considered a fundamental component of biliary point-of-care ultrasound (POCUS), but can be technically challenging. OBJECTIVE: The primary objective of this study was to determine whether CBD diameter contributes to the diagnosis of complicated biliary pathology in emergency department (ED) patients with normal laboratory values and no abnormal biliary POCUS findings aside from cholelithiasis. METHODS: We performed a prospective, observational study of adult ED patients undergoing POCUS of the right upper quadrant (RUQ) and serum laboratory studies for suspected biliary pathology...
November 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29162403/cope-s-sign-and-complete-heart-block-in-a-78-year-old-patient-with-biliary-colic
#20
Panteleimon E Papakonstantinou, Natalia I Asimakopoulou, Emmanuel Kanoupakis, Spyridon Maragkoudakis, Simeon Panagiotakis, Achilleas Gikas
INTRODUCTION: Acute cholecystitis and biliary colic may have signs and symptoms similar to those of Acute Coronary Syndrome(ACS) along with ischemic ECG changes. Cholecystitis and/or biliary colic have been both reported as trigger factors for bradyarrhythmia in the literature. CASE REPORT: A 78-year-old male patient was admitted to our Emergency Department (ED) due to acute abdominal pain. The ECG on admission showed sinus bradycardia with a rate of 40 beats per minute (bpm) without signs of acute ischemia and a brief period (7 s) of complete atrioventricular (AV) block...
November 18, 2017: International Emergency Nursing
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