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surgeon, ultrasound, point of care

F M Ryba, K George
Point-of-care ultrasound is an ultrasound examination that is made at the bedside by the examining clinician in the Accident and Emergency department, clinic, ward, or operating theatre, and it has been growing in popularity since it was first introduced in the 1990s. It is used as an adjunct to clinical examination to aid diagnosis or treatment. We have carried out a pilot survey to assess whether oral and maxillofacial surgeons in the United Kingdom either need or desire to make such an examination. We present the results of our survey and discuss the uses and benefits of point-of-care ultrasound in oral and maxillofacial surgery...
April 22, 2017: British Journal of Oral & Maxillofacial Surgery
Justin D Manley, Benjamin J Mitchell, Joseph J DuBose, Todd E Rasmussen
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to mitigate bleeding and sustain central aortic pressure in the setting of shock. The ER-REBOA™ catheter is a new REBOA technology, previously reported only in the setting of civilian trauma and injury care. The use of REBOA in an out-of-hospital setting has not been reported, to our knowledge. METHODS: We present a case series of wartime injured patients cared for by a US Air Force Special Operations Surgical Team at an austere location fewer than 3km (5-10 minutes' transport) from point of injury and 2 hours from the next highest environment of care-a Role 2 equivalent...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
David Kessler, Lorraine Ng, Mark Tessaro, Jason Fischer
The Precision Medicine Initiative spearheaded by the National Institute of Health has pioneered a new model of health care focused on health care delivery that is tailored to an individual. Medical advances have already provided clinicians with the tools to better predict treatment outcomes based on the individual needs of each patient's disease process. Three-dimensional printing allows medical devices and implants to be custom made-to-order. Technological advances in preoperative imaging have augmented the ability for surgeons to plan a specific surgical approach for each patient...
March 2017: Pediatric Emergency Care
Fikri M Abu-Zidan, Korana Balac, Chetana Anand Bhatia
The indications of point-of-care ultrasound (POCUS) in the management of multiple trauma patients have been expanding. Although computed tomography (CT) scan of the orbit remains the gold standard for imaging orbital trauma, ultrasound is a quick, safe, and portable tool that can be performed bedside. Here we report two patients who had severe eye injuries with major visual impairment where surgeon-performed POCUS was very useful. One had a foreign body injury while the other had blunt trauma. POCUS was done using a linear probe under sterile conditions with minimum pressure on the eyes...
October 16, 2016: World Journal of Clinical Cases
Mustafa Avcı, Nalan Kozacı, İnan Beydilli, Fevzi Yılmaz, Arif Onur Eden, Sadullah Turhan
OBJECTIVE: The objective of the study was to compare the efficacy of point-of-care ultrasound (POCUS) and computed tomography (CT) in the diagnosis of the fracture of the bones that form the elbow joint and the determination of treatment method in elbow injuries. METHODS: Forty-nine patients aged 5 to 65 years, who were admitted with low-energy elbow injuries, had at least 1 fracture of the elbow joint bones, and underwent CT scanning, were included in this study...
November 2016: American Journal of Emergency Medicine
Kelms Amoo-Achampong, Benedict U Nwachukwu, Frank McCormick
BACKGROUND: The utilization of musculoskeletal ultrasound has expanded within the setting of the orthopedic clinic as a cost-effective, point-of-care diagnostic tool for shoulder pathology. In experienced hands, ultrasound exhibits capabilities equivalent to that of magnetic resonance imaging in the diagnosis of many shoulder diseases including full-thickness and partial-thickness rotator cuff tears. Although similarly effective in identifying additional shoulder disease processes, major obstacles to its widespread use include user dependence and intrinsic limitation to extra-articular diagnosis...
November 2016: Physician and Sportsmedicine
Fikri M Abu-Zidan
BACKGROUND: Some surgeons may lack proper experience in abdominal packing. Overpacking may directly compress the inferior vena cava (IVC). This reduces the venous return and possibly causes hypotension. Here, a new on table Point-of-Care Ultrasound application that has been recently used to assess the effect of abdominal packing on the IVC diameter is described. Following abdominal packing, a small print convex array probe with low frequency (2-5 MHz) is used to visualize the IVC. Using the B mode, the IVC can be directly evaluated through a hepatic window between the ribs...
2016: World Journal of Emergency Surgery: WJES
Pasha Normahani, Mohammed Aslam, Nigel J Standfield, Usman Jaffer
OBJECTIVE: To establish the diagnostic accuracy of a 'focused vascular lower limb arterial duplex scan (F-VLAD)' developed to facilitate rapid decision-making for acute limb ischaemia (ALI). METHODS: Ten cases of ALI were identified from our patient database; clinical details, history and examination findings were extracted from the clinical notes. Original 'full' duplex ultrasound (DUS) pictorial reports were 're-formatted' to include only anatomical segments included in the 'F-VLAD' scan...
January 2017: Perfusion
Rahul Bhatnagar, John P Corcoran, Fabien Maldonado, David Feller-Kopman, Julius Janssen, Philippe Astoul, Najib M Rahman
The burden of a number of pleural diseases continues to increase internationally. Although many pleural procedures have historically been the domain of interventional radiologists or thoracic surgeons, in recent years, there has been a marked expansion in the techniques available to the pulmonologist. This has been due in part to both technological advancements and a greater recognition that pleural disease is an important subspecialty of respiratory medicine. This article summarises the important literature relating to a number of advanced pleural interventions, including medical thoracoscopy, the insertion and use of indwelling pleural catheters, pleural manometry, point-of-care thoracic ultrasound, and image-guided closed pleural biopsy...
June 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
Todd R Fredricks, Jeffrey S Benseler
BACKGROUND: Bicuspid aortic valve disease (BAV) is the most common cardiac valve pathology. BAV is associated with aortic root disorders. The literature has few case reports identifying this condition during routine physical exam. CASE REPORT: A 42-yr-old military reservist flight medic presented for his annual military flight physical. He was found to have a faint cardiac murmur. His past family and medical history were remarkable for familial essential hypertension and being told at age 9 that he had a "murmur...
May 2016: Aerospace Medicine and Human Performance
M Zago, I Martinez Casas, J Pereira, D Mariani, A R Silva, A Casamassima, E Barbosa, F Ferreira, M Ruesseler, G A Bass, L Ponchietti, F Butti, M Marconi, L F Pinheiro
PURPOSE: The European Society for Trauma and Emergency Surgery (ESTES) identified the need for general and trauma surgeons involved in the management of critically ill surgical patients to embrace and learn both basic and advanced US skills. A steering group was created to address this deficit. METHODS: Modular UltraSound ESTES Course (MUSEC) is a modular blended-learning course. It incorporates pre-test/post-test examinations, pre-course online materials, didactic and interactive lectures, interactive case scenarios discussion with pathological US clips, hands-on practice on healthy volunteer models, and on original phantoms for simulating both pathological US findings and practicing US-guided interventional maneuvers...
April 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Fikri M Abu-Zidan, Kamal Idris, Mohammed Khalifa
INTRODUCTION: The physiological reserve of extreme elderly patients is very limited and has major impact on clinical decisions on their management. Hereby we report a 90-year-old man who presented with a strangulated epigastric hernia and who developed postoperative intra-abdominal bleeding, and highlight the value of Point-of-Care Ultrasound (POCUS) in critical decisions made during the management of this patient. PRESENTATION OF CASE: A 90-year-old man presented with a tender irreducible epigastric mass...
2016: International Journal of Surgery Case Reports
Vladimir K Neychev, Maher Ghanem, Stuart L Blackwood, Patricia Aragon Han, Roghayeh Fazeli, Eric Schneider, Alireza Najafian, Dov C Bloch, Michael C Bard, Jay H Klarsfeld, Martha A Zeiger, Richard J Lipton
BACKGROUND: There is ongoing debate about the effectiveness and safety of performing parathyroid surgery in low-volume community hospitals. STUDY DESIGN/METHODS: Cases performed at community hospital by a group of 4 parathyroid surgeons (group 1) were reviewed. Cure and complication rates were analyzed in light of outcomes of an expert endocrine surgeon from high-volume academic center (group 2) as point of reference. RESULTS: During the respective time periods, 204 patients met inclusion criteria in group1 and 218 patients in group 2...
March 2016: International Journal of Surgery
Melissa Hayward, Teresa Chan, Andrew Healey
Point-of-care ultrasound (PoCUS) has become an essential skill in the practice of emergency medicine (EM). Various EM residency programs now require competency in basic PoCUS applications. The education literature suggests that deliberate practice is necessary for skill acquisition and mastery. We used an educational theory, Ericsson's model of deliberate practice, to create a PoCUS curriculum for our Royal College of Physicians and Surgeons of Canada EM residency. Although international recommendations around curriculum requirements exist, this will be one of the first papers to describe the implementation of a specific PoCUS training program...
September 2015: CJEM
Meera Kotagal, Elina Quiroga, Benjamin J Ruffatto, Adeyinka A Adedipe, Brandon H Backlund, Robert Nathan, Anthony Roche, Dana Sajed, Sachita Shah
OBJECTIVE: Point-of-care ultrasound (POCUS) is a vital tool for diagnosis and management of critically ill patients, particularly in resource-limited settings where access to diagnostic imaging may be constrained. We aimed to develop a novel POCUS training curriculum for surgical practice in the United States and in resource-limited settings in low- and middle-income countries and to determine its effect on surgical resident self-assessments of efficacy and confidence. DESIGN: We conducted an observational cohort study evaluating a POCUS training course that comprised 7 sessions of 2 hours each with didactics and proctored skills stations covering ultrasound applications for trauma (Focused Assessement with Sonography for Trauma (FAST) examination), obstetrics, vascular, soft tissue, regional anesthesia, focused echocardiography, and ultrasound guidance for procedures...
July 2015: Journal of Surgical Education
Stefan Moosmayer, Gerty Lund, Unni S Seljom, Benjamin Haldorsen, Ida C Svege, Toril Hennig, Are H Pripp, Hans-Jørgen Smith
BACKGROUND: There is limited Level-I evidence that compares operative and nonoperative treatment of rotator cuff tears. We compared outcomes of patients treated with primary tendon repair with outcomes of those treated with physiotherapy and optional secondary tendon repair if needed. METHODS: A single-center, pragmatic, randomized controlled study with follow-ups after six months and one, two, and five years was conducted in a secondary-care institution. One hundred and three patients with a rotator cuff tear not exceeding 3 cm were randomized to primary tendon repair (n = 52) or physiotherapy (n = 51)...
September 17, 2014: Journal of Bone and Joint Surgery. American Volume
Maria Studer, Peter Studer
Ultrasound is an easy to learn and highly efficient diagnostic tool to complete the clinical examination and improve bedside decision-making. In the trauma room, surgeons are often required to make a quick decision as to whether or not a patient needs an emergency intervention or whether further diagnostics are required. For this reason, education of surgeons in performing focused emergency ultrasound is pivotal. The goal of ICAN is to improve and expand the education of surgeons in Switzerland. This article provides a short review of the most frequent surgical pathologies encountered in the emergency room...
June 4, 2014: Praxis
Sarah B Murthi, Heidi L Frankel, Mayur Narayan, Matthew Lissauer, Mary Furgusen, Syeda H Fatima, Thomas M Scalea
BACKGROUND: We sought to demonstrate that a well-staffed, surgeon-directed, critical care ultrasound program (CCUP) is financially sustainable and provides administrative and educational support for point-of-care ultrasound. METHODS: The CCUP provides a clinical service and training as well as conducts research. Initial costs, annual costs (C), revenue (R), and savings (S) were prospectively recorded. Using data from the first 3 years, we calculated the projected C, R, and S at 5 years...
February 2014: Journal of Trauma and Acute Care Surgery
Henrik Hedelin, Lars-Åke Goksör, Jon Karlsson, Stina Stjernström
BACKGROUND: An ankle sprain is a common injury, and patients are usually examined with plain radiographs to rule out a fracture despite the fact that only a small minority actually have one. PURPOSE: To investigate if ultrasound (US)-guided triage can decrease the need for radiographic imaging in patients with ankle trauma. HYPOTHESIS: Orthopedic surgeons can use point-of-care US with limited training to triage ankle trauma that requires standard radiographs...
December 2013: American Journal of Emergency Medicine
Denise Carneiro-Pla, Sonesh Amin
BACKGROUND: Cervical ultrasonography (US) is mandatory before surgery for thyroid cancer and recommended for thyroid nodule evaluation. Therefore, most patients undergo thyroid ultrasound before surgical evaluation. Several US findings are critical for adequate surgical planning but they are often not mentioned on preconsultation US. The goal of this study is to compare the preconsultation US findings with surgeon-performed US (SUS) and describe the changes in management as a consequence of SUS findings in patients with thyroid cancer...
March 2014: World Journal of Surgery
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