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Point if care ultrasound

Madan Mohan Maddali, Venkitaramanan Arun, Al-Ajmi Ahmed Wala, Maher Jaffer Al-Bahrani, Cheskey Manoj Jayatilaka, Arora Ram Nishant
BACKGROUND: The primary aim of this study was to compare the incidence of accidental arterial puncture during right internal jugular vein (RIJV) cannulation with and without ultrasound guidance (USG). The secondary end points were to assess if USG improves the chances of successful first pass cannulation and if BMI has an impact on incidence of arterial puncture and the number of attempts that are to be made for successful cannulation. SETTINGS AND DESIGN: Prospective observational study performed at a single tertiary cardiac care center...
October 2016: Annals of Cardiac Anaesthesia
Omar Rodriguez-Acevedo, Kristen E Elstner, Kui Martinic, Aaron Zea, Jenny Diaz, Rodrigo T Martins, Fernando Arduini, Alexandra Hodgkinson, Nabeel Ibrahim
BACKGROUND: Endovenous radio frequency ablation for small saphenous vein incompetence by and large appears to be superior and safer than conventional open surgery. Small saphenous vein ablation from approximately mid-calf to the point proximally where the small saphenous vein dives into the popliteal fossa is considered to be safe, as the sural nerve is in most cases separated from this segment of the small saphenous vein by the deep fascia. The outcome of the distal incompetent small saphenous vein remains unclear...
September 29, 2016: Phlebology
Steve Socransky, Andrew Skinner, Mark Bromley, Andrew Smith, Alexandre Anawati, Jeff Middaugh, Peter Ross, Paul Atkinson
Introduction Closed reduction of distal radius fractures (CRDRF) is a commonly performed emergency department (ED) procedure. The use of point-of-care ultrasound (PoCUS) to diagnose fractures and guide reduction has previously been described. The primary objective of this study was to determine if the addition of PoCUS to CRDRF changed the perception of successful initial reduction. This was measured by the rate of further reduction attempts based on PoCUS following the initial clinical determination of achievement of best possible reduction...
2016: Curēus
Shadi Lahham, Priel Schmalbach, Sean P Wilson, Lori Ludeman, Mohammad Subeh, Jocelyn Chao, Nadeem Albadawi, Niki Mohammadi, John C Fox
BACKGROUND: The objective of this study is to determine if point-of-care ultrasound (POCUS) pre-procedure identification of landmarks can decrease failure rate, reduce procedural time, and decrease the number of needle redirections and reinsertions when performing a lumbar puncture (LP). METHODS: This was a prospective, randomized controlled trial comparing POCUS pre-procedure identification of landmarks versus traditional palpation for LP in a cohort of patients in the emergency department and intensive care unit...
2016: World Journal of Emergency Medicine
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
E Segaran, L Wandrag, M Stotz, M Terblanche, M Hickson
BACKGROUND: Critical illness is associated with muscle loss, weakness and poor recovery. The impact that illness and the ensuing metabolic response has on obese patients is not known. Objectives were to test if obese patients lose less muscle depth compared to non-obese patients; if a reduction in muscle depth was associated with reduced strength and recovery; and to assess the feasibility of these methods with a range of body mass index's (BMI). METHODS: A prospective observational pilot study of muscle depth in critically ill patients categorised by BMI was performed...
August 1, 2016: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
Holly Black, Gillian Sheppard, Brian Metcalfe, Jordan Stone-McLean, Heather McCarthy, Adam Dubrowski
BACKGROUND: With the various applications of point-of-care ultrasound (PoCUS) steadily increasing, many medical schools across North America are incorporating PoCUS training into their undergraduate curricula. The Faculty of Medicine at Memorial University also intends to introduce PoCUS training into its own undergraduate medical program. The proposed approach is to introduce a PoCUS curriculum focusing on anatomy and physiology while developing cognitive and psychomotor skills that are later transferred into clinical applications...
2016: Curēus
John W Hall, Nicolas Denne, Joseph J Minardi, Debra Williams, B J Balcik
BACKGROUND: Early pregnancy complaints in emergency medicine are common. Emergency physicians (EP) increasingly employ ultrasound (US) in the evaluation of these complaints. As a result, it is likely that rare and important diagnoses will be encountered. We report a case of fetal anencephaly diagnosed by bedside emergency US in a patient presenting with first-trimester vaginal bleeding. CASE REPORT: A 33-year-old patient at 10 weeks gestation presented with vaginal bleeding...
July 2016: Western Journal of Emergency Medicine
Ross Kessler, Jeffrey R Stowell, Jody A Vogel, Michael M Liao, John L Kendall
While the implementation of Picture Archiving and Communication Systems (PACS) has revolutionized the field of radiology, there has been considerably less utilization of PACS by emergency physicians with point-of-care ultrasound. Benefits of PACS archival of images include improved quality assurance, preservation of image quality, and accessibility of images. Our objective was to determine if a simple interventional program would influence the utilization of PACS in point-of-care ultrasound. A before-after study was conducted in an urban, academic emergency department...
July 13, 2016: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
P R de Reuver, A H van Dijk, S Z Wennmacker, M P Lamberts, D Boerma, B L den Oudsten, M G W Dijkgraaf, S C Donkervoort, J A Roukema, G P Westert, J P H Drenth, C J H van Laarhoven, M A Boermeester
BACKGROUND: Five to 22 % of the adult Western population has gallstones. Among them, 13 to 22 % become symptomatic during their lifetime. Cholecystectomy is the preferred treatment for symptomatic cholecystolithiasis. Remarkably, cholecystectomy provides symptom relief in only 60-70 % of patients. The objective of this trial is to compare the effectiveness of usual (operative) care with a restrictive strategy using a standardized work-up with stepwise selection for cholecystectomy in patients with gallstones and abdominal complaints...
2016: BMC Surgery
Turandot Saul, Sebastian D Siadecki, Gabriel Rose, Rachel Berkowitz, Aaran B Drake, Noah Delone, Nicholas Avitabile
BACKGROUND: Point-of-care ultrasound may be used to facilitate foreign body (FB) localization and removal. We hypothesized that injection of normal saline adjacent to an FB may make it easier to detect. METHODS: The study was performed on one embalmed human cadaver. Potential FB sites were created of wood (24), metal (24), and null (24). Two sonographers evaluated each of the 72 sites both before and after a 25-gauge needle was inserted into each incision and 3 cc of normal saline was injected...
September 2016: American Journal of Emergency Medicine
Erden Erol Ünlüer, Rıfat Urnal, Utku Eser, Serkan Bilgin, Mehmet Hacıyanlı, Orhan Oyar, Haldun Akoğlu, Arif Karagöz
BACKGROUND: Appendicitis is a common disease requiring surgery. Bedside ultrasound (BUS) is a core technique for emergency medicine (EM). The Alvarado score is a well-studied diagnostic tool for appendicitis. This study aimed to investigate the relationship between patients' symptoms, Alvarado score and ultrasound (US) findings, as performed by emergency physicians (EPs) and radiologists, of patients with suspected appendicitis. METHODS: Three EM specialists underwent the BUS course and core course for appendicitis assessment...
2016: World Journal of Emergency Medicine
Kevin P Rooney, Sari Lahham, Shadi Lahham, Craig L Anderson, Bryan Bledsoe, Bryan Sloane, Linda Joseph, Megan B Osborn, John C Fox
BACKGROUND: Point-of-care ultrasound (US) is a proven diagnostic imaging tool in the emergency department (ED). Modern US devices are now more compact, affordable and portable, which has led to increased usage in austere environments. However, studies supporting the use of US in the prehospital setting are limited. The primary outcome of this pilot study was to determine if paramedics could perform cardiac ultrasound in the field and obtain images that were adequate for interpretation...
2016: World Journal of Emergency Medicine
Terry Varshney, Elise Mok, Adam J Shapiro, Patricia Li, Alexander S Dubrovsky
OBJECTIVE: Characterise lung ultrasound (LUS) findings, diagnostic accuracy and agreement between novice and expert interpretations in young children with respiratory tract infections and wheeze. METHODS: Prospective cross-sectional study in a paediatric ED. Patients ≤2 years with a respiratory tract infection and wheeze at triage were recruited unless in severe respiratory distress. Prior to clinical management, a novice sonologist performed the LUS using a six-zone scanning protocol...
September 2016: Emergency Medicine Journal: EMJ
Tatnai L Burnett, Arturo Garza-Cavazos, Kathleen Groesch, Randall Robbs, Paula Diaz-Sylvester, Sohail A Siddique
STUDY OBJECTIVE: To determine whether the location of the superior and inferior epigastric vessels (deep epigastric vessels) change with abdominal insufflation. DESIGN: Descriptive study (Canadian Task Force classification III). SETTING: Tertiary care academic institution. PATIENTS: Patients undergoing gynecologic laparoscopic surgery were recruited. A total of 35 subjects were enrolled. INTERVENTIONS: Subjects underwent color Doppler ultrasound assessment of deep epigastric vessel location preoperatively and intraoperatively following abdominal insufflation...
July 2016: Journal of Minimally Invasive Gynecology
J Nguyen, M Cascione, S Noori
OBJECTIVE: Point-of-care ultrasonography (POCUS) is becoming increasingly available for neonatologists and pediatric subspecialists (PSS); however, concerns over potential litigation from possible missed diagnoses or incorrect management have been documented. This study aims to define the extent and quality of lawsuits filed against neonatologists and PSS related to POCUS. STUDY DESIGN: We conducted a retrospective study of all United States reported state and federal cases in the Westlaw database from January 1990 through October 2015...
September 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Mercy Nkuba Nassali, Tadele Melese Benti, Moreri Bandani-Ntsabele, Elly Musinguzi
BACKGROUND: Despite advances in diagnostic imaging and focused antenatal care, cases of undiagnosed abdominal pregnancies at term are still reported in obstetric practice. It is atypical and very rare for a patient to be asymptomatic late in pregnancy and for the pregnancy to result in a live birth with no evidence of intrauterine growth restriction despite the unfavourable implantation site. This late term asymptomatic presentation despite routine antenatal care demonstrates a diagnostic challenge...
2016: BMC Research Notes
Kate A Walsh, Rosalie M Grivell
BACKGROUND: During childbirth, many women sustain trauma to the perineum, which is the area between the vaginal opening and the anus. These tears can involve the perineal skin, the pelvic floor muscles, the external and internal anal sphincter muscles as well as the rectal mucosa (lining of the bowel). When these tears extend beyond the external anal sphincter they are called 'obstetric anal sphincter injuries' (OASIS). When women sustain an OASIS, they are at increased risk of developing anal incontinence either immediately following birth or later in life...
2015: Cochrane Database of Systematic Reviews
Shane Arishenkoff, Christopher Eddy, J Mark Roberts, Luke Chen, Silvia Chang, Parvathy Nair, Rose Hatala, Kevin W Eva, Graydon S Meneilly
OBJECTIVES: Easily palpable splenomegaly can be identified on physical examination, but it is difficult to detect lesser degrees of splenomegaly. Rapid bedside assessment can be conducted with hand-carried ultrasound. We performed this study to determine whether medical residents could reliably assess spleen size using hand-carried ultrasound after a brief educational intervention. METHODS: Postgraduate year 1 internal medicine residents were shown a brief (45-minute) presentation on ultrasound basics, the use of hand-carried ultrasound, and principles of splenic ultrasound imaging...
December 2015: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Jordan Chenkin, Colin J L McCartney, Tomislav Jelic, Michael Romano, Claire Heslop, Glen Bandiera
BACKGROUND: Unrecognized esophageal intubations are associated with significant patient morbidity and mortality. No single confirmatory device has been shown to be 100 % accurate at ruling out esophageal intubations in the emergency department. Recent studies have demonstrated that point-of-care ultrasound (POCUS) may be a useful adjunct for confirming endotracheal tube placement; however, the amount of practice required to become proficient at this technique is unclear. The purpose of this study is to determine the amount of practice required by emergency physicians to become proficient at interpreting ultrasound video clips of esophageal and endotracheal intubations...
December 2015: Critical Ultrasound Journal
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