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Point of care ultrasound and emergency

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https://www.readbyqxmd.com/read/28214369/diagnostic-accuracy-of-history-physical-exam-laboratory-tests-and-point-of-care-ultrasound-for-pediatric-acute-appendicitis-in-the-emergency-department-a-systematic-review-and-meta-analysis
#1
Roshanak Benabbas, Mark Hanna, Jay Shah, Richard Sinert
BACKGROUND: Acute appendicitis (AA) is the most common surgical emergency in children. Accurate and timely diagnosis is crucial but challenging due to atypical presentations and the inherent difficulty of obtaining a reliable history and physical examination in younger children. OBJECTIVES: To determine the utility of history, physical exam, laboratory tests, Pediatric Appendicitis Score (PAS) and Emergency Department-Point-of-Care Ultrasound (ED-POCUS) in the diagnosis of AA in ED pediatric patients...
February 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28211003/an-easy-to-build-low-budget-point-of-care-ultrasound-simulator-from-linux-to-a-web-based-solution
#2
Domagoj Damjanovic, Ulrich Goebel, Benedikt Fischer, Martin Huth, Hartmut Breger, Hartmut Buerkle, Axel Schmutz
BACKGROUND: Hands-on training in point-of-care ultrasound (POC-US) should ideally comprise bedside teaching, as well as simulated clinical scenarios. High-fidelity phantoms and portable ultrasound simulation systems are commercially available, however, at considerable costs. This limits their suitability for medical schools. A Linux-based software for Emergency Department Ultrasound Simulation (edus2TM) was developed by Kulyk and Olszynski in 2011. Its feasibility for POC-US education has been well-documented, and shows good acceptance...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28202294/point-of-care-lung-ultrasound-in-children-with-community-acquired-pneumonia
#3
Hayri Levent Yilmaz, Ahmet Kağan Özkaya, Sinem Sarı Gökay, Özlem Tolu Kendir, Hande Şenol
OBJECTIVES: To present lung ultrasound findings in children assessed with suspected pneumonia in the emergency department and to show the benefit of lung ultrasound in diagnosing pneumonia in comparison with chest X-rays. METHODS: This observational prospective study was performed in the pediatric emergency department of a single center. Point of care lung ultrasound was performed on each child by an independent sonographer blinded to the patient's clinical and chest X-ray findings...
February 1, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28178729/re-examining-physical-findings-with-point-of-care-ultrasound-a-narrative-review
#4
William Diprose, Francois Verster, Cameron Schauer
The art of physical examination has continued to be practised by physicians largely unchanged for over 200 years. Ultrasound, once the domain of the radiologist, is now being increasingly used by emergency physicians and intensivists to make rapid, accurate diagnoses at the point-of-care. We review the growing body of evidence supporting point-of-care ultrasound (PoCUS) as the preferred alternative to many aspects of the cardiovascular, respiratory, abdominal and neurological examinations in internal medicine...
January 27, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28171688/diagnostic-value-and-effect-of-bedside-ultrasound-in-acute-appendicitis-in-the-emergency-department
#5
Faruk Gungor, Taylan Kilic, Kamil Can Akyol, Gizem Ayaz, Umut Cengiz Cakir, Mehmet Akcimen, Cenker Eken
OBJECTIVE: Early and accurate diagnosis of acute appendicitis (AA) with ultrasound can minimize the morbidity and mortality of the patients. In this regard, ultrasound can help to the emergency physicians (EPs) in the diagnosing process and clinical decision making for AA. Therefore, we primarily aimed to evaluate the effectiveness of point of care ultrasound (POCUS) in clinical decision making of EPs for the diagnostic evaluation for AA in the emergency department (ED). METHODS: The study sample consisted of patients aged >18 years that presented to the ED with an abdominal pain and underwent diagnostic evaluation for AA...
February 7, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28164320/perception-of-point-of-care-ultrasound-performed-by-emergency-medicine-physicians
#6
Whitney Hansen, Carl E Mitchell, Bikash Bhattarai, Napatkamon Ayutyanont, Jeffrey R Stowell
PURPOSE: Point-of-care ultrasound (POCUS) is integral to the practice of emergency medicine (EM). Furthermore, EM-performed POCUS (EM-POCUS) offers consultants the opportunity to avoid delays in care due to wait times for confirmatory imaging studies. This study is the first to describe the perception of POCUS to consulting services at a single institution where EM-POCUS is routinely performed. METHODS: This study was conducted as a survey distributed to residents from consultant specialties (internal medicine [IM], general surgery [GS], and obstetrics and gynecology [OB-GYN])...
February 6, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28160251/erratum-to-pediatric-emergency-medicine-point-of-care-ultrasound-summary-of-the-evidence
#7
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
No abstract text is available yet for this article.
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28150328/use-of-emergency-ultrasound-in-arizona-community-emergency-departments
#8
Richard Amini, Michael T Wyman, Nicholas C Hernandez, John A Guisto, Srikar Adhikari
OBJECTIVES: Despite the increased educational exposure to point-of-care ultrasound (US) at all levels of medical training, there are utilization gaps between academic and nonacademic emergency department (ED) settings. The purpose of this study was to assess the current practices and potential barriers to the use of point-of-care US in nonacademic EDs throughout the state of Arizona. METHODS: We conducted a cross-sectional study. An online questionnaire was electronically sent to all nonacademic EDs in Arizona...
February 2, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28146012/identification-of-optic-nerve-swelling-using-point-of-care-ocular-ultrasound-in-children
#9
Ronald F Marchese, Rakesh D Mistry, Gil Binenbaum, Grant T Liu, Richard J Scarfone, Ashley L Woodford, Aaron E Chen
OBJECTIVE: The aim of this study was to determine the feasibility and accuracy of point-of-care (POC) ocular ultrasound (US) when performed by a pediatric emergency medicine (PEM) physician to detect optic nerve abnormalities concerning for swelling, as compared with the fundus examination performed by an ophthalmologist. METHODS: This was a single-center, prospective cohort pilot study of children aged 12 months to 18 years who required optic disc evaluation by an ophthalmologist...
January 31, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28145770/objective-and-structured-assessment-of-lung-ultrasound-competence-a-multispecialty-delphi-consensus-and-construct-validity-study
#10
Søren Helbo Skaarup, Christian B Laursen, Anne Sofie Bjerrum, Ole Hilberg
RATIONALE: Point-of-care lung ultrasound imaging has substantial diagnostic value and is widely used in respiratory, emergency and critical care medicine. Like other ultrasound examinations, lung ultrasound is operator-dependent. The current recommendations for competence in lung ultrasound sets a fixed number of ultrasound procedures to be performed without considering different learning rates. Recommendations do not consider different uses of lung ultrasound across specialties. OBJECTIVE: To create a reliable, valid and feasible instrument to assess lung ultrasound competence that includes the diverse use of lung ultrasound among medical specialties...
February 1, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28141773/point-of-care-ultrasound-use-to-differentiate-hematoma-and-sarcoma-of-the-thigh-in-the-pediatric-emergency-department
#11
Cathie-Kim Le, Gregory Harvey, Lianne McLean, Jason Fischer
Hematomas and soft tissue sarcomas can be difficult to differentiate clinically, even with the addition of traditional imaging modalities. There are several case reports of sarcomas being misdiagnosed as hematomas, most commonly with a history of mild trauma. In this case report, we described a sarcoma initially misinterpreted as a hematoma on ultrasound. Key clinical features and sonographic findings that may assist clinicians using point-of-care ultrasound to correctly differentiate sarcomas from hematomas are reviewed...
February 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28141772/cardiac-tamponade-diagnosed-by-point-of-care-ultrasound
#12
Austin T Smith, Caroline Watnick, Robinson M Ferre
We present a case involving a 12-year-old boy who presented to the emergency department and was diagnosed with a pericardial effusion with tamponade physiology by point-of-care ultrasound. The diagnosis resulted in prompt treatment and definitive therapy.
February 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28123616/simplified-point-of-care-ultrasound-protocol-to-confirm-central-venous-catheter-placement-a-prospective-study
#13
Sean P Wilson, Samer Assaf, Shadi Lahham, Mohammad Subeh, Alan Chiem, Craig Anderson, Samantha Shwe, Ryan Nguyen, John C Fox
BACKGROUND: The current standard for confirmation of correct supra-diaphragmatic central venous catheter (CVC) placement is with plain film chest radiography (CXR). We hypothesized that a simple point-of-care ultrasound (POCUS) protocol could effectively confirm placement and reduce time to confirmation. METHODS: We prospectively enrolled a convenience sample of patients in the emergency department and intensive care unit who required CVC placement. Correct positioning was considered if turbulent flow was visualized in the right atrium on sub-xiphoid, parasternal or apical cardiac ultrasound after injecting 5 cc of sterile, non-agitated, normal saline through the CVC...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28119013/bedside-sonography-for-the-diagnosis-of-esophageal-food-impaction
#14
Jennifer Singleton, Jesse M Schafer, Jeremiah M Hinson, Erin M Kane, Sherieka Wright, Beatrice Hoffmann
BACKGROUND: Esophageal foreign body (EFB) and impaction are common gastrointestinal emergencies. Detection with standard imaging can be challenging. Computed tomography is a commonly used non-invasive imaging modality, but is not 100% sensitive and not always feasible. Sensitivity of plain film x-ray varies widely and the addition of a barium swallow can obscure evaluation by subsequent esophagogastroduodenoscopy (EGD). Use of emergency ultrasound (EUS) for detection of EFB in adults has not been previously studied...
January 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28117110/hemorrhagic-pericardial-cyst-diagnosis-accelerated-by-emergency-physician-echocardiography-a-case-report
#15
Michael F Yip, Brooks M Walsh
BACKGROUND: The differential diagnosis for chest pain in the emergency department is broad and includes both benign and life-threatening conditions-with pericardial cyst as a rare example. Emergency physician-performed point-of-care focused cardiac ultrasound (FOCUS) is increasingly recognized as a useful modality in the evaluation of patients with chest pain. CASE REPORT: We report a case of hemorrhagic pericardial cyst in a young woman presenting with chest pain in which findings on FOCUS contradicted findings on chest x-ray study and thus, accelerated diagnosis and definitive treatment...
January 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28114159/revolution-or-evolution-a-proposal-for-the-integration-of-point-of-care-ultrasound-into-physician-assistant-clinical-practice
#16
Jonathan Monti
Advances in technology and increased affordability of machines have allowed ultrasound to become ubiquitous across the spectrum of medical care. Increasing portability has brought ultrasound to the point of care in multiple medical specialties. Formal ultrasound training is rapidly being incorporated into multispecialty residency programs and undergraduate medical education curricula, yet little formal training exists for physician assistants (PAs) on this emerging clinical adjunct. This article outlines recommendations for and barriers to the incorporation of bedside ultrasound into PA clinical practice...
March 2017: Journal of Physician Assistant Education
https://www.readbyqxmd.com/read/28105581/point-of-care-ultrasound-identification-of-pneumatosis-intestinalis-in-pediatric-abdominal-pain-a-case-report
#17
Vigil James, Aswin Warier, Khai Pin Lee, Gene Yong-Kwang Ong
We describe a case report of an infant with intussusception who presented to a pediatric emergency department with diarrhea and increased irritability. Pneumatosis intestinalis (intra-mural air) detected on point-of-care ultrasonography (but not apparent on plain abdominal radiographs) alerted the emergency physicians towards the severity of disease process.
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28095957/point-of-care-ultrasound-utility-and-potential-for-high-altitude-crew-recovery-missions
#18
Laura A Galdamez, Jonathan B Clark, Erik L Antonsen
INTRODUCTION: Flights to high altitude can lead to exposure and unique pathology not seen in normal commercial aviation. METHODS: This paper assesses the potential for point-of-care ultrasound to aid in management and disposition of injured crewmembers from a high altitude incident. This was accomplished through a systematic literature review regarding current diagnostic and therapeutic uses of ultrasound for injuries expected in high altitude free fall and parachuting...
February 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28087089/point-of-care-ultrasound-diagnosis-of-posterior-sternoclavicular-joint-dislocation
#19
Rachel R Bengtzen, Ryan C Petering
BACKGROUND: Posterior sternoclavicular dislocations can be challenging diagnostically, as traumatic force often happens to the lateral shoulder rather than directly to the sternoclavicular joint. Shoulder radiographs do not illustrate the sternoclavicular joint well, and can miss the diagnosis. This injury, however, has the potential for life-threatening complications due to proximity of mediastinal structures that might also be injured. CASE REPORT: The following case illustrates a delayed diagnosis of posterior sternoclavicular dislocation...
January 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28063721/point-of-care-lung-ultrasound-of-children-with-acute-asthma-exacerbations-in-the-pediatric-emergency-department
#20
Samantha Dankoff, Patricia Li, Adam J Shapiro, Terry Varshney, Alexander S Dubrovsky
OBJECTIVES: Primary objective was to characterize lung ultrasound findings in children with asthma presenting with respiratory distress to the emergency department (ED). Secondary objectives included correlating these findings with patients' clinical course in the ED. METHODS: Eligible patients 2-17years of age, underwent a lung ultrasound by the study sonographer between November 2014 to December 2015. Positive lung ultrasound was defined as the presence of ≥1 of the following findings: ≥3 B-lines per intercostal space, consolidation and/or pleural abnormalities...
December 26, 2016: American Journal of Emergency Medicine
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