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critical care sonography

James Spain, Matthew Rheinboldt
Representing an ascending, sexually spread pyogenic infection of the female genital tract, pelvic inflammatory disease (PID) is a commonly encountered cause for emergency visits and hospitalizations among young and adult female patients. Though gynecologic evaluation and sonography constitute the mainstay of diagnosis, multidetector CT imaging of the abdomen and pelvis is not uncommonly performed, often as the initial imaging modality, due to the frequently vague and indeterminate clinical presentation. As such, knowledge and attenuation to the often subtle early imaging features of PID afford the radiologist a critical chance to direct and expedite appropriate pathways of patient care, minimizing the risk for secondary complications, including infertility, ectopic pregnancy, and enteric adhesions...
September 19, 2016: Emergency Radiology
Toru Kameda, Nobuyuki Taniguchi
Point-of-care abdominal ultrasound (US), which is performed by clinicians at bedside, is increasingly being used to evaluate clinical manifestations, to facilitate accurate diagnoses, and to assist procedures in emergency and critical care. Methods for the assessment of acute abdominal pain with point-of-care US must be developed according to accumulated evidence in each abdominal region. To detect hemoperitoneum, the methodology of a focused assessment with sonography for a trauma examination may also be an option in non-trauma patients...
2016: Journal of Intensive Care
Yunus Oktay Atalay, Ramazan Aydin, Omer Ertugrul, Selim Baris Gul, Ahmet Veysel Polat, Muhammet Sukru Paksu
BACKGROUND: A nasogastric tube (NGT) insertion is a common procedure in intensive care units, with some serious complications that result from the malposition of the NGT tip. This pilot study was designed to investigate the efficiency of ultrasound in verifying correct NGT placement and to compare these results with radiographic findings. MATERIALS AND METHODS: This was a single-center, double-blind prospective study of patients who had received an NGT in the pediatric critical care unit...
March 30, 2016: Nutrition in Clinical Practice
Siew-Na Lim, Yeu-Jhy Chang, Shinn-Kuang Lin
OBJECTIVES: The prevalence of carotid disease in stroke patients has been underestimated because most stroke patients who receive carotid sonography have already survived the acute event. Little is known about the extracranial carotid arteries of patients with acute stroke who need intensive care. This study reviewed color-coded carotid duplex sonographic examinations of the extracranial carotid arteries of patients with acute critical hemispheric ischemic stroke. METHODS: We retrospectively reviewed 30 consecutive patients who had acute critical hemispheric ischemic stroke and received color-coded carotid duplex sonography in the intensive care unit...
February 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
E Guerado, A Medina, M I Mata, J M Galvan, M L Bertrand
PURPOSE: An update paper on massive bleeding after major trauma. A review of protocols to address massive bleeding, and its possible complications, including coagulation abnormalities, complications related to blood storage, immunosuppression and infection, lung injury associated with transfusion, and hypothermia is carried out. METHODS: Literature review and discussion with authors' experience. RESULTS: Massive bleeding is an acute life-threatening complication of major trauma, and consequently its prompt diagnosis and treatment is of overwhelming importance...
June 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
A Seibel, C-A Greim
Since the introduction of portable ultrasound systems, sonography has become well established as an integral part of the anesthesiological and critical care equipment and of monitoring. The selection of various ultrasound transducers, sonographic techniques and imaging modes enables a broad variety of clinical applications. In depth background knowledge of the technical aspects is crucial for obtaining what a highly sophisticated ultrasound system has to offer, i.e., sonographic transparency of the complete body and valid information on the structure and dynamics of organs and the circulation...
November 2015: Der Anaesthesist
Jantina McMurray, Søren Boysen, Serge Chalhoub
OBJECTIVE: To evaluate the use of abdominal- and thoracic-focused assessment with sonography for trauma (AFAST and TFAST) in nontraumatized dogs and cats in the emergency and critical care setting and to compare prevalence of free fluid identified via these techniques between stable and unstable patients. DESIGN: Prospective observational study. SETTING: University Distributed Veterinary Learning Community. ANIMALS: One hundred client-owned dogs and cats presenting to an emergency service with no evidence of trauma...
January 2016: Journal of Veterinary Emergency and Critical Care
Shawn C Roll, Christina Asai, Julieann Tsai
BACKGROUND: Musculoskeletal sonography use in point-of-care physical medicine and rehabilitation is rapidly expanding, not only by physiatrists, but also by non-physician rehabilitation providers. AIM: The aim of the present review was to evaluate the current range, extent and nature of the related literature and to identify emerging areas of evidence for the use of musculoskeletal sonography involving non-physician rehabilitation providers to guide research and clinical practice...
April 2016: European Journal of Physical and Rehabilitation Medicine
Robert Ohle, Sarah M McIsaac, Michael Y Woo, Jeffrey J Perry
OBJECTIVES: The diagnosis of raised intracranial pressure (ICP) is important in many critically ill patients. The optic nerve sheath is contiguous with the subarachnoid space; thus, an increase in ICP results in a corresponding increase in the optic nerve sheath diameter. The objective of this study was to assess the diagnostic accuracy of sonography of the optic nerve sheath diameter compared to computed tomography (CT) for predicting raised ICP. METHODS: We searched PubMed, EMBASE, and the Cochrane database from 1986 to August 2013 and performed hand searches...
July 2015: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Aarti Sarwal, Selina M Parry, Michael J Berry, Fang-Chi Hsu, Marc T Lewis, Nicholas W Justus, Peter E Morris, Linda Denehy, Sue Berney, Sanjay Dhar, Michael S Cartwright
OBJECTIVES: There is growing interest in the use of quantitative high-resolution neuromuscular sonography to evaluate skeletal muscles in patients with critical illness. There is currently considerable methodological variability in the measurement technique of quantitative muscle analysis. The reliability of muscle parameters using different measurement techniques and assessor expertise levels has not been examined in patients with critical illness. The primary objective of this study was to determine the interobserver reliability of quantitative sonographic measurement analyses (thickness and echogenicity) between assessors of different expertise levels and using different techniques for selecting the region of interest...
July 2015: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
David Schnell, Michael Darmon
Three Doppler-derived techniques have been proposed to assess renal perfusion at bedside: Doppler-based renal resistive index (RI) which has been extensively but imperfectly studied in assessing renal allograft status and changes in renal perfusion in critically ill patients and for predicting the reversibility of an acute kidney injury (AKI), semi-quantitative evaluation of renal perfusion using colour-Doppler which may be easier to perform and may give similar information than RI and contrast-enhanced sonography that may allow more precise renal and cortical perfusion assessment...
December 2015: Critical Ultrasound Journal
Adam R Parks, Glenn Verheul, Denise LeBlanc-Duchin, Paul Atkinson
BACKGROUND: Goal-directed point-of-care ultrasound (PoCUS) protocols have been shown to improve the diagnostic accuracy of the initial clinical assessment of the critically ill patient. The diagnostic impact of the Abdominal and Cardiac Evaluation with Sonography in Shock (ACES) protocol was assessed in simulated emergency medical scenarios. METHODS: Following a focused PoCUS training program, the diagnostic accuracy, confidence, and precision of 12 medical learners participating in standardized scenarios were tested using high-fidelity clinical and ultrasound simulators...
May 2015: CJEM
Daniel A Lichtenstein
This review article describes two protocols adapted from lung ultrasound: the bedside lung ultrasound in emergency (BLUE)-protocol for the immediate diagnosis of acute respiratory failure and the fluid administration limited by lung sonography (FALLS)-protocol for the management of acute circulatory failure. These applications require the mastery of 10 signs indicating normal lung surface (bat sign, lung sliding, A-lines), pleural effusions (quad and sinusoid sign), lung consolidations (fractal and tissue-like sign), interstitial syndrome (lung rockets), and pneumothorax (stratosphere sign and the lung point)...
June 2015: Chest
M Cody O'Dell, Christopher Cassady, Gregory Logsdon, Laura Varich
BACKGROUND: Cranial ultrasound is an essential screening and diagnostic tool in the care of neonates and is especially useful in the premature population for evaluation of potential germinal matrix/intraventricular hemorrhage (GM/IVH). There are typically two screening examinations, with the initial cranial sonography performed between 3 days and 14 days after birth, usually consisting of a series of static images plus several cinegraphic sweeps. OBJECTIVE: Our primary goal was to assess whether cinegraphic sweeps alone are as accurate for diagnosing neurological abnormalities as combined static and cinegraphic imaging in the initial cranial US evaluation of premature infants...
October 2015: Pediatric Radiology
Muzzafer Chaudery, James Clark, Derf Ap Dafydd, Joel Dunn, Duncan Bew, Mark H Wilson, Ara Darzi
OBJECTIVE: Hemorrhage identification in trauma care is a major priority. Focused assessment in sonography for trauma (FAST) offers a rapid, reliable means of detecting torso bleeding. The aims of this study were to conduct a face, content, and construct validity assessment of a FAST simulator and establish a rigorous assessment tool. DESIGN: Participants were requested to perform a FAST scan and state if any abnormality was found in each region. Metrics evaluated included time, errors, and missed targets...
September 2015: Journal of Surgical Education
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
D Wastl, K Helwig, C F Dietrich
As a point-of-care tool, emergency sonography has the potential to rule out or to confirm a diagnosis in the context to the leading symptom of critically ill persons. Extended focused assessment with sonography for trauma (E-FAST) and focused echo entry level (FEEL) are examples of algorithms that have been developed for this purpose. Echoscopy is another form of point-of-care sonography that is used at the bedside. It helps to answer simple questions (yes/no) and allows follow-up examinations to be made with little effort...
April 2015: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Stephan Lang, Benjamin Kansy
The lymph nodes are an essential part of the body's immune system and as such are affected in many infectious, autoimmune, metabolic and malignant diseases. The cervical lymph nodes are particularly important because they are the first drainage stations for key points of contact with the outside world (mouth/throat/nose/eyes/ears/respiratory system) - a critical aspect especially among children - and can represent an early clinical sign in their exposed position on a child's slim neck. Involvement of the lymph nodes in multiple conditions is accompanied by a correspondingly large number of available diagnostic procedures...
2014: GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery
Elizabeth Ashby, Andreas Roposch
OBJECTIVE: The purpose of this study is to determine the impact of sonographic information on surgeons' diagnostic thinking and decision making in the management of infants with a possible diagnosis of developmental dysplasia of the hip (DDH). SUBJECTS AND METHODS: Five experienced orthopedic surgeons examined 66 hips of infants who were referred for a possible diagnosis of DDH and reported for each hip a confidence level about the diagnosis of DDH using a visual analog scale (VAS) before and after hip sonography was obtained...
January 2015: AJR. American Journal of Roentgenology
Daniel Lichtenstein, Simon van Hooland, Paul Elbers, Manu L N G Malbrain
Over the past decade, critical care ultrasound has gained its place in the armamentarium of monitoring tools. A greater understanding of lung, abdominal, and vascular ultrasound plus easier access to portable machines have revolutionised the bedside assessment of our ICU patients. Because ultrasound is not only a diagnostic test, but can also be seen as a component of the physical exam, it has the potential to become the stethoscope of the 21st century. Critical care ultrasound is a combination of simple protocols, with lung ultrasound being a basic application, allowing assessment of urgent diagnoses in combination with therapeutic decisions...
November 2014: Anaesthesiology Intensive Therapy
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