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Point of care ultrasound and emergency

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https://www.readbyqxmd.com/read/29656593/review-article-investigations-and-the-pregnant-woman-in-the-emergency-department-part-1-laboratory-investigations
#1
REVIEW
Adam Morton, Stephanie Teasdale
Accurate assessment of the pregnant patient in the ED depends on knowledge of physiological changes in pregnancy, and how these changes may impact on pathology tests, appearance on point-of-care ultrasound and electrocardiography. In addition the emergency physician needs to be cognisant of disorders that are unique to or more common in pregnancy. Part 1 of this review addresses potential deviations in laboratory investigation reference intervals resulting from physiological alterations in pregnancy, and the important causes of abnormal laboratory results in pregnancy...
April 15, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29656390/documenting-the-growth-of-ultrasound-research-in-emergency-medicine-through-a-bibliometric-analysis-of-accepted-academic-conference-abstracts
#2
Michael I Prats, David P Bahner, Ashish R Panchal, Andrew M King, David P Way, Stephen Lin, J Christian Fox, Creagh T Boulger
OBJECTIVES: Ultrasound (US) has become an indispensable skill for emergency physicians. Growth in the use of US in emergency medicine (EM) has been characterized by practice guidelines, education requirements, and the number of EM US practitioners. Our purpose was to further document the growth of EM US by profiling the breadth, depth, and quality of US-related research presented at EM's most prominent annual research conference: the Society for Academic Emergency Medicine Annual Meeting...
April 15, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29619581/approach-to-undifferentiated-dyspnea-in-emergency-department-aids-in-rapid-clinical-decision-making
#3
Siva Nageswara Rao Guttikonda, Kiran Vadapalli
BACKGROUND: Diagnosis and management of patients presenting with acute dyspnea is one of the major challenges for physicians in emergency department (ED). A correct diagnosis is frequently delayed and difficult to ascertain, and clinical uncertainty is common, explaining the need for rapid diagnosis and a management plan. The primary aim of our study is to assess a diagnostic strategy using multiorgan point of care ultrasonography (USG) to differentiate patients presenting with acute dyspnea to ED into different diagnostic categories for timely management in a resource-limited setting...
April 4, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29606152/bilateral-ureterolithiasis-a-true-positive-and-false-negative-pocus-exam-in-a-patient-with-renal-colic
#4
Matthew P Lowe, Christopher Cox
Acute flank pain from suspected urolithiasis is a common presenting complaint in the Emergency Department. Multiple computed tomography (CT) has traditionally been the standard imaging modality used to diagnose obstructive kidney stones, however point of care ultrasound (PoCUS) can play an important role in the diagnostic algorithm and risk stratification of acute flank pain. Here, we present the case of a 29-year-old female with suspected urolithiasis, who underwent PoCUS that revealed right-sided hydronephrosis and normal left kidney, bladder, and aorta...
April 2, 2018: CJEM
https://www.readbyqxmd.com/read/29581925/isolated-renal-laceration-on-point-of-care-ultrasound
#5
Madeline M Grade, Cori Poffenberger, Viveta Lobo
We report a renal laceration identified on a point-of-care ultrasound (POCUS) performed in the emergency department on a 58-year-old female presenting after blunt trauma. Emergency workup demonstrated a right flank abrasion with tenderness to palpation, hematuria, and decreasing hematocrit. A Focused Assessment with Sonography in Trauma (FAST) exam, performed as part of the intake trauma protocol, identified positive intraperitoneal fluid in the right upper quadrant. A computed tomography (CT) scan established a diagnosis of isolated right renal hematoma arising from a Grade IV laceration, with no collecting duct involvement...
January 25, 2018: Curēus
https://www.readbyqxmd.com/read/29578644/point-of-care-diaphragm-ultrasound-in-infants-with-bronchiolitis-a-prospective-study
#6
Danilo Buonsenso, Maria C Supino, Emanuele Giglioni, Massimo Battaglia, Alessia Mesturino, Simona Scateni, Barbara Scialanga, Antonino Reale, Anna M C Musolino
BACKGROUND: Bronchiolitis is the most common reason for hospitalization of children worldwide. Many scoring systems have been developed to quantify respiratory distress and predict outcome, but none of them have been validated. We hypothesized that the ultrasound evaluation of the diaphragm could quantify respiratory distress and therefore we correlated the ultrasound diaphragm parameters with outcome. METHODS: Prospective study of infants with bronchiolitis (1-12 months) evaluated in a pediatric emergency department...
March 26, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29577627/review-article-investigations-and-the-pregnant-woman-in-the-emergency-department-part-2-point-of-care-ultrasound-electrocardiography-respiratory-function-tests-and-radiology
#7
REVIEW
Adam Morton, Stephanie Teasdale
Accurate assessment of the pregnant patient in the ED depends on knowledge of physiological changes in pregnancy, and how these changes may impact on pathology tests, appearance on point-of-care ultrasound, electrocardiography and respiratory function tests. In addition, the emergency physician needs to be cognisant of disorders that are unique to or more common during pregnancy. Part 2 of this review addresses the role of point-of-care ultrasound in pregnancy, physiological changes that may affect interpretation of point-of-care ultrasound, changes in electrocardiography and respiratory function tests, and the safety of radiological procedures in the pregnant patient...
March 25, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29574878/effect-of-emergency-physician-performed-point-of-care-ultrasound-and-radiology-department-performed-ultrasound-examinations-on-the-emergency-department-length-of-stay-among-pregnant-women-at-less-than-20-weeks-gestation
#8
Brian B Morgan, Amanda Kao, Stacy A Trent, Nicole Hurst, Lauren Oliveira, Andrea L Austin, John L Kendall
OBJECTIVES: We sought to confirm retrospective studies that measured an approximately 20% reduction in emergency department (ED) length of stay (LOS) in early-gestation pregnant women who receive emergency physician-performed point-of-care ultrasound (US) examinations rather than radiology department-performed US examinations for evaluation of intrauterine pregnancy (IUP). METHODS: A randomized controlled clinical trial was performed at an urban academic safety net hospital and 2 Naval medical centers in the United States...
March 25, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29564661/the-learning-curve-of-sonographic-inferior-vena-cava-evaluation-by-novice-medical-students-the-pavia-experience
#9
Santi Di Pietro, Francesco Falaschi, Alice Bruno, Tiziano Perrone, Valeria Musella, Stefano Perlini
PURPOSE: The sonographic evaluation of inferior vena cava diameters and its collapsibility-that is also defined as the caval index-has become a popular way to easily obtain a noninvasive estimate of central venous pressure. This is generally considered an easy sonographic task to perform, and according to the American College of Emergency Physicians (ACEP) Guidelines 25 repetitions of this procedure should be sufficient to reach proficiency. However, little is known about the learning process for this sonographic technique...
March 21, 2018: Journal of Ultrasound
https://www.readbyqxmd.com/read/29547367/left-ventricular-outflow-tract-pseudoaneurysm-diagnosed-with-point-of-care-ultrasound-in-the-emergency-department
#10
Puneet Kapur, Melanie Baimel, Jordan Chenkin
Left ventricular outflow tract pseudoaneurysms are a rare but life-threatening disorder, often caused by complications of cardiac surgery or myocardial infarction. We present a case report of a patient with no prior risk factors who presented with a six-month history of progressive exertional dyspnea, bilateral leg swelling and cough. Point-of-care ultrasound revealed an unexpected outpouching of the left ventricle. He was diagnosed with a left ventricular outflow tract pseudoaneurysm and subsequently went into cardiogenic shock secondary to extension of pseudoaneurysm causing extrinsic compression of the coronary arteries...
March 16, 2018: CJEM
https://www.readbyqxmd.com/read/29528889/new-directions-in-point-of-care-ultrasound-at-the-crossroads-of-paediatric-emergency-and-critical-care
#11
William Bortcosh, Ashkon Shaahinfar, Sakina Sojar, Jean E Klig
PURPOSE OF REVIEW: The diagnostic capability, efficiency and versatility of point-of-care ultrasound (POCUS) have enabled its use in paediatric emergency medicine (PEM) and paediatric critical care (PICU). This review highlights the current applications of POCUS for the critically ill child across PEM and PICU to identify areas of progress and standardized practice and to elucidate areas for future research. RECENT FINDINGS: POCUS technology continues to evolve and advance bedside clinical care for critically ill children, with ongoing research extending its use for an array of clinical scenarios, including respiratory distress, trauma and dehydration...
March 9, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29525246/evaluation-and-management-of-aortic-stenosis-for-the-emergency-clinician-an-evidence-based-review-of-the-literature
#12
Michael Gottlieb, Brit Long, Alex Koyfman
INTRODUCTION: Aortic stenosis is a common condition among older adults that can be associated with dangerous outcomes, due to both the disease itself and its influence on other conditions. OBJECTIVE: This review provides an evidence-based summary of the current emergency department (ED) evaluation and management of aortic stenosis. DISCUSSION: Aortic stenosis refers to significant narrowing of the aortic valve and can be caused by calcific disease, congenital causes, or rheumatic valvular disease...
March 7, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29519537/positioning-document-on-incorporating-point-of-care-ultrasound-in-internal-medicine-departments
#13
J Torres Macho, F J García Sánchez, P Garmilla Ezquerra, L Beltrán Romero, J Canora Lebrato, J M Casas Rojo, P Arribas Arribas, S López Palmero, S Pintos Martínez, J M Cepeda Rodrigo, D Luordo, M Beltrán López, M Méndez Bailón, E Rodilla Sala, L Manzano Espinosa, A Zapatero Gaviria, G García de Casasola
This positioning document describes the most important aspects of clinical ultrasonography in the internal medicine setting, from its fundamental indications to the recommended training period. There is no question as to the considerable usefulness of this tool in the standard clinical practice of internists in numerous clinical scenarios and settings (emergencies, hospital ward, general and specific consultations and home care). Ultrasonography has a relevant impact on the practitioner's ability to resolve issues, increasing diagnostic reliability and safety and providing important information on the prognosis and progression...
March 5, 2018: Revista Clínica Española
https://www.readbyqxmd.com/read/29499992/point-of-care-ultrasound-for-the-diagnosis-of-skull-fractures-in-children-younger-than-two-years-of-age
#14
Niccolò Parri, Bradley J Crosby, Lisa Mills, Zachary Soucy, Anna Maria Musolino, Liviana Da Dalt, Angela Cirilli, Laura Grisotto, Nathan Kuppermann
OBJECTIVES: To determine the accuracy of skull point-of-care ultrasound (POCUS) for identifying fractures in children younger than 2 years of age with signs of head trauma, and the ability of POCUS to identify the type and depth of fracture depression. STUDY DESIGN: This was a multicenter, prospective, observational study of children younger than 2 years of age with nontrivial mechanisms of injury and signs of scalp/skull trauma. Patients were enrolled if they underwent computed tomography (CT)...
February 28, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29494462/point-of-care-ultrasound-to-identify-congenital-heart-disease-in-the-pediatric-emergency-department
#15
Daniel Rosenfield, Jason W Fischer, Charisse W Kwan
The first presentation of congenital heart disease can be a diagnostic challenge in the emergency department. We report on 2 cases where point-of-care ultrasound identified gross cardiac abnormalities in 2 children and expedited disposition and downstream care.
March 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29493853/physiotherapist-inter-rater-reliability-of-the-haemophilia-early-arthropathy-detection-with-ultrasound-protocol
#16
D Stephensen, S Classey, H Harbidge, V Patel, S Taylor, A Wells
INTRODUCTION: Prevention of arthropathy is the major goal of haemophilia treatment, and early detection of the first signs of joint damage is important so that prevention strategies can be initiated to limit physical disability and improve quality of life. AIM: The aim of this study was to determine the inter-rater repeatability of the HEAD-US protocol when performed by haemophilia physiotherapists. METHODS: Sixty-three joints (21 elbows, 21 knees and 21 ankles) were examined in 21 patients (mean age; 29...
March 1, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29492363/the-case-of-an-obstructed-stone-at-the-distal-urethra
#17
Kelcy Higa, Stephen Irving, Richard J Cervantes, Jayce Pangilinan, Laura R Slykhouse, Dale P Woolridge, Richard Amini
This report highlights a presentation of urinary calculus impacted at the urethral meatus and bedside extraction after evaluation with point-of-care ultrasound (POCUS). Visualization of a stone at the urethral meatus prompted a point-of-care ultrasound of the penile shaft and glans. The ultrasound ruled out anatomic variations such as urethral diverticula and as a result bedside removal was expedited. The stone was successfully removed with traction and intraurethral lidocaine gel without urethral lesions or injury to the meatus...
December 20, 2017: Curēus
https://www.readbyqxmd.com/read/29487770/point-of-care-ultrasound-diagnosis-of-upper-gastrointestinal-bleeding
#18
Robert P Jamplis, Lucas Friedman, Srikar Adhikari
A 28-year-old male was brought to the emergency department by the Emergency medical services (EMS) after being found unconscious and unresponsive. Upon arrival, he was hypotensive, intubated with a Glasgow Coma Scale (GCS) 3T, without the signs of trauma or the evidence of bleeding. A focused assessment with sonography in trauma (FAST), point-of-care ultrasound (POCUS) was performed, obscuring part of the spleen from the distended stomach, which was filled with the heterogeneous contents, with the internal movement being identified...
December 17, 2017: Curēus
https://www.readbyqxmd.com/read/29478017/what-resources-are-used-in-emergency-departments-in-rural-sub-saharan-africa-a-retrospective-analysis-of-patient-care-in-a-district-level-hospital-in-uganda
#19
Cindy Carol Bitter, Brian Rice, Usha Periyanayagam, Bradley Dreifuss, Heather Hammerstedt, Sara W Nelson, Mark Bisanzo, Samuel Maling, Stacey Chamberlain
OBJECTIVES: To determine the most commonly used resources (provider procedural skills, medications, laboratory studies and imaging) needed to care for patients. SETTING: A single emergency department (ED) of a district-level hospital in rural Uganda. PARTICIPANTS: 26 710 patient visits. RESULTS: Procedures were performed for 65.6% of patients, predominantly intravenous cannulation, wound care, bladder catheterisation and orthopaedic procedures...
February 24, 2018: BMJ Open
https://www.readbyqxmd.com/read/29464491/do-i-need-to-operate-on-that-in-the-middle-of-the-night-development-of-a-nomogram-for-the-diagnosis-of-severe-acute-cholecystitis
#20
Mattia Portinari, Michele Scagliarini, Giorgia Valpiani, Simona Bianconcini, Dario Andreotti, Rocco Stano, Paolo Carcoforo, Savino Occhionorelli
BACKGROUND: Some authors have proposed different predictive factors of severe acute cholecystitis, but generally, the results of risk analyses are expressed as odds ratios, which makes it difficult to apply in the clinical practice of the acute care surgeon. The severe form of acute cholecystitis should include both gangrenous and phlegmonous cholecystitis, due to their severe clinical course, and cholecystectomy should not be delayed. The aim of this study was to create a nomogram to obtain a graphical tool to compute the probability of having a severe acute cholecystitis...
February 20, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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