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Point of care ultrasound and emergency

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https://www.readbyqxmd.com/read/27916021/use-of-point-of-care-ultrasound-in-long-bone-fractures-a-systematic-review-and-meta-analysis
#1
Lucas B Chartier, Laura Bosco, Lauren Lapointe-Shaw, Jordan Chenkin
OBJECTIVES: Long bone fractures (LBFs) are among the most frequent traumatic injuries seen in emergency departments. Reduction and immobilization is the most common form of treatment for displaced fractures. Point-of-care ultrasound (PoCUS) is a promising technique for diagnosing LBFs and assessing the success of reduction attempts. This article offers a comprehensive review of the use of PoCUS for the diagnosis and reduction of LBFs. Data source MEDLINE and EMBASE databases were searched through July 19, 2015...
December 5, 2016: CJEM
https://www.readbyqxmd.com/read/27859891/diagnostic-performance-of-wells-score-combined-with-point-of-care-lung-and-venous-ultrasound-in-suspected-pulmonary-embolism
#2
Peiman Nazerian, Giovanni Volpicelli, Chiara Gigli, Cecilia Becattini, Giuseppe Francesco Sferrazza Papa, Stefano Grifoni, Simone Vanni
OBJECTIVE: Lung and venous ultrasound are bedside diagnostic tools increasingly used in the early diagnostic approach of suspected pulmonary embolism (PE). However, the possibility of improving the conventional prediction rule for PE by integrating ultrasound has never been investigated. METHODS: We performed lung and venous ultrasound in consecutive patients suspected of PE in four emergency departments. Conventional Wells score (Ws) was adjudicated by the attending physician, and ultrasound was performed by one of 20 investigators...
November 12, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27833699/point-of-care-sonographic-findings-in-acute-upper-airway-edema
#3
Michael Schick, Kendra Grether-Jones
We describe a case where a patient presented with acute angiotensin-converting enzyme inhibitor (ACE-I) induced angioedema without signs or symptoms of upper airway edema beyond lip swelling. Point-of-care ultrasound (POCUS) was used as an initial diagnostic test and identified left-sided subglottic upper airway edema that was immediately confirmed with indirect fiberoptic laryngoscopy. ACE-I induced angioedema and the historical use of ultrasound in evaluation of the upper airway is briefly discussed. To our knowledge, POCUS has not been used to identify acute upper airway edema in the emergency setting...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27833692/rapid-diagnosis-of-rhabdomyolysis-with-point-of-care-ultrasound
#4
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/27830585/correction-fetal-outcomes-following-emergency-department-point-of-care-ultrasound-for-vaginal-bleeding-in-early-pregnancy
#5
(no author information available yet)
This corrects the article "Fetal outcomes following emergency department point-of-care ultrasound for vaginal bleeding in early pregnancy" in Can Fam Physician 62(7) pg 572-578
August 2016: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/27829827/the-prognostic-value-of-using-ultrasonography-in-cardiac-resuscitation-of-patients-with-cardiac-arrest
#6
Ehsan Bolvardi, Seyyed Mohsen Pouryaghobi, Roohye Farzane, Niaz Mohamad Jafari Chokan, Koorosh Ahmadi, Hamidreza Reihani
Cardiopulmonary arrest is the final result of many diseases and therefore, need for a careful implementation of cardiopulmonary resuscitation (CPR) protocols in these cases is undeniably important. The introduction of ultrasound into the emergency department has potentially allowed the addition of an extra data point in the decision about when to cease cardiopulmonary resuscitation (CPR). The aim of this study is to evaluate the ability of cardiac ultrasonography performed by emergency physicians to predict resuscitation outcome in adult cardiac arrest patients...
September 2016: International Journal of Biomedical Science: IJBS
https://www.readbyqxmd.com/read/27829074/fetal-outcomes-following-emergency-department-point-of-care-ultrasound-for-vaginal-bleeding-in-early-pregnancy
#7
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/27828799/a-pilot-assessment-of-3-point-of-care-strategies-for-diagnosis-of-perioperative-lung-pathology
#8
John W Ford, Johan Heiberg, Anthony P Brennan, Colin F Royse, David J Canty, Doa El-Ansary, Alistair G Royse
BACKGROUND: Lung ultrasonography is superior to clinical examination and chest X-ray (CXR) in diagnosis of acute respiratory pathology in the emergency and critical care setting and after cardiothoracic surgery in intensive care. Lung ultrasound may be useful before cardiothoracic surgery and after discharge from intensive care, but the proportion of significant respiratory pathology in this setting is unknown and may be too low to justify its routine use. The aim of this study was to determine the proportion of clinically significant respiratory pathology detectable with CXR, clinical examination, and lung ultrasound in patients on the ward before and after cardiothoracic surgery...
November 8, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27827289/-a-man-with-dyspnoea-after-falling-from-a-roof
#9
J G Veldhuis, L J Geut
We describe a 63-year-old male presented to the emergency room after a blunt thoracic injury. His breathing was painful. The supine X-ray of the thorax did not show signs of a pneumothorax. However, using point-of-care ultrasound we were able to confirm this diagnosis.
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27823894/color-flow-doppler-point-of-care-ultrasound-to-evaluate-vessels-before-infant-lumbar-puncture
#10
Brunhild M Halm, David O Kessler
BACKGROUND: Infant lumbar punctures (LPs) are common procedures performed in the emergency department. However, 10% to 35% of these LPs are unsuccessful or grossly bloody, which can lead to increased hospitalization, increased costs, and prolonged exposure to antibiotics or antivirals. Point of care ultrasound (POCUS) may help to surmount the intrinsic causes of LP failure by providing a visual guide of the vascular structures in the needle path before a LP is performed. CASE REPORT: We report two cases where color flow Doppler POCUS was used to identify vascular structures around the spinal canal in infants before attempting a LP...
November 4, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27812885/pediatric-emergency-medicine-point-of-care-ultrasound-summary-of-the-evidence
#11
REVIEW
Jennifer R Marin, Alyssa M Abo, Alexander C Arroyo, Stephanie J Doniger, Jason W Fischer, Rachel Rempell, Brandi Gary, James F Holmes, David O Kessler, Samuel H F Lam, Marla C Levine, Jason A Levy, Alice Murray, Lorraine Ng, Vicki E Noble, Daniela Ramirez-Schrempp, David C Riley, Turandot Saul, Vaishali Shah, Adam B Sivitz, Ee Tein Tay, David Teng, Lindsey Chaudoin, James W Tsung, Rebecca L Vieira, Yaffa M Vitberg, Resa E Lewiss
The utility of point-of-care ultrasound is well supported by the medical literature. Consequently, pediatric emergency medicine providers have embraced this technology in everyday practice. Recently, the American Academy of Pediatrics published a policy statement endorsing the use of point-of-care ultrasound by pediatric emergency medicine providers.  To date, there is no standard guideline for the practice of point-of-care ultrasound for this specialty. This document serves as an initial step in the detailed "how to" and description of individual point-of-care ultrasound examinations...
December 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27803918/surgeon-performed-point-of-care-ultrasound-in-severe-eye-trauma-report-of-two-cases
#12
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
https://www.readbyqxmd.com/read/27802866/point-of-care-ultrasonography-as-a-training-milestone-for-internal-medicine-residents-the-time-is-now
#13
Bruce F Sabath, Gurkeerat Singh
Point-of-care (POC) ultrasonography is considered fundamental in emergency medicine training and recently has become a milestone in critical care fellowship programs as well. Currently, there is no such standard requirement for internal medicine residency programs in the United States. We present a new case and briefly review another case at our institution - a community hospital - in which internal medicine house staff trained in ultrasonography were able to uncover unexpected and critical diagnoses that significantly changed patient care and outcomes...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27798497/recent-advances-in-the-diagnosis-and-management-of-tuberculous-meningitis
#14
Nguyen T H Mai, Guy E Thwaites
PURPOSE OF REVIEW: Tuberculous meningitis is a devastating infection that is hard to diagnose and treat. We have reviewed tuberculous meningitis original research published within the past 18 months, selecting studies which we consider have most advanced knowledge. RECENT FINDINGS: We review advances in diagnostic methods, anti-tuberculosis chemotherapy, and the common complications of tuberculous meningitis. New commercial molecular diagnostic tests, such as GeneXpert MTB/RIF, have an important role in tuberculous meningitis diagnosis, but as with all other available tests, they lack sensitivity and cannot rule out the disease...
October 27, 2016: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/27783380/common-pitfalls-in-point-of-care-ultrasound-a-practical-guide-for-emergency-and-critical-care-physicians
#15
REVIEW
Pablo Blanco, Giovanni Volpicelli
BACKGROUND: Point-of-care ultrasonography (POCUS) is a widely used tool in emergency and critical care settings, useful in the decision-making process as well as in interventional guidance. While having an impressive diagnostic accuracy in the hands of highly skilled operators, inexperienced practitioners must be aware of some common misinterpretations that may lead to wrong decisions at the bedside. OBJECTIVES: This article provides a revision list of common POCUS misdiagnoses usually found in practice and offers useful tips to recognize and avoid them...
December 2016: Critical Ultrasound Journal
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/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
#17
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
https://www.readbyqxmd.com/read/27749674/point-of-care-ultrasound-diagnosis-of-diaphragmatic-hernia-in-an-infant-with-respiratory-distress
#18
Jessica H Rankin, Marsha Elkhunovich, Dina Seif, Mikaela Chilstrom
Neonatal respiratory distress is an emergent condition with a wide differential diagnosis. A 12-day-old newborn presented to the emergency department in respiratory distress. Point-of-care ultrasound allowed clinicians to rapidly exclude cardiac disease and pneumothorax as possible causes of the patient's respiratory distress, and expedited the identification of congenital diaphragmatic hernia. The ultrasound findings and technique, epidemiology, pathophysiology, and radiological diagnosis of congenital diaphragmatic hernia are reviewed...
October 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27749664/emergency-point-of-care-ultrasound-diagnosis-of-diaphragmatic-hernia-in-the-pediatric-emergency-department
#19
Marie Pier Desjardins, Kirstin D Weerdenburg, Jason W Fischer
We present a case series of 2 patients who presented to a pediatric emergency department with history and symptoms suggestive of diaphragmatic hernia. Point-of-care ultrasound was used at the bedside to demonstrate the presence of bowel in the thorax and accurately guided the care of these children.
October 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27748231/feasibility-of-emergency-department-point-of-care-ultrasound-for-rib-fracture-diagnosis-in-minor-thoracic-injury
#20
Élizabeth Lalande, Chantal Guimont, Marcel Émond, Marc Charles Parent, Claude Topping, Brice Lionel Batomen Kuimi, Valérie Boucher, Natalie Le Sage
OBJECTIVES: The main objective of this study was to evaluate the feasibility of emergency department (ED) point-of-care ultrasound (PoCUS) for rib fracture diagnosis in patients with minor thoracic injury (mTI). Secondary objectives were to 1) evaluate patients' pain during the PoCUS procedure, 2) identify the limitations of the use of PoCUS technique, and 3) compare the diagnosis obtained with PoCUS to radiography results. METHODS: Adult patients who presented with clinical suspicion of rib fractures after mTI were included...
October 17, 2016: CJEM
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