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https://www.readbyqxmd.com/read/29740831/do-emergency-physicians-rely-on-point-of-care-ultrasound-for-clinical-decision-making-without-additional-confirmatory-testing
#1
Mohamad Moussa, Julie M Stausmire
PURPOSE: It is unknown if Emergency Physicians (EPs) rely solely on Emergency Medicine performed Point-Of-Care Ultrasound (EM-POCUS) for clinical decision making or if they proceed to subsequent "gold standard" studies for confirmatory diagnosis. METHODS: After Institutional Review Board approval, an online survey was distributed by the Ohio Chapter of the American College of Emergency Physicians to its members. RESULTS: The most common EM-POCUS procedures used without confirmatory testing were: determination of cardiac activity during cardiac arrest (81...
May 8, 2018: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29708590/standardised-assessment-of-competence-in-focused-assessment-with-sonography-for-trauma
#2
L Russell, M L Østergaard, M B Nielsen, L Konge, K R Nielsen
PURPOSE: The aim of this study was to develop and gather validity evidence for a standardised test of competence in Focused Assessment with Sonography for Trauma (FAST) and to define the appropriate cut-off point in simulation-based learning of the FAST protocol. METHODS: A 20-item simulation-based test for assessing competence in FAST was created. The test was administered to thirteen novices and twelve radiologists experienced in abdominal ultrasound diagnostics...
April 30, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29688110/a-mixed-methods-evaluation-of-a-multidisciplinary-point-of-care-ultrasound-program
#3
Andrew Smith, Michael Parsons, Tia Renouf, Sarah Boyd, Peter Rogers
BACKGROUND: Point of Care Ultrasound (PoCUS) is well established within emergency medicine, however, the availability of formal training for other clinical disciplines is limited. Memorial University has established a cost-efficient, multidisciplinary PoCUS training program focusing on training residents' discipline-specific ultrasound skills. This study evaluates the skills, knowledge, and attitudes of residents who participated in the program. METHODS: Analysis was conducted using a mixed-methods, sequential exploratory approach...
April 24, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29666715/identification-of-hollow-viscus-injury-with-fast-examination-in-kurdistan-iraq
#4
Ruj Al-Sindy, Heleen Alaqrawy, Mahmood Sh Hafdullah, Christine Butts
Point-of-care ultrasound has become indispensable in the evaluation of trauma, particularly in low resource areas, where it may be the only rapidly available imaging modality. The FAST (Focused Assessment with Sonography in Trauma) in particular can be lifesaving, by rapidly detecting signs of intra-abdominal hemorrhage. However, the FAST is primarily designed to identify free fluid associated with solid organ injury and is thought to have less sensitivity and power in identifying evidence of hollow viscus injury...
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29662732/institutional-review-of-hemorrhagic-pelvic-emergencies-effectively-managed-with-percutaneous-arterial-embolization
#5
Muhammad Azeemuddin, Raza Sayani, Nauman Turab, Syed M Mustahsan, Mohammad Hasan, Dawar B Khan, Fatima Mubarak
OBJECTIVE: Our aim was to review the results of pelvic arterial embolization (PAE) performed in the interventional radiology suite. METHOD: The data of all patients in whom pelvic angioembolization was performed was collected from July 2011 to June 2017. Procedures were performed by an experienced interventional radiologist. The clinical and laboratory data, as well as the outcome data, were obtained from the medical records of our hospital. The following parameters were collected for each patient, including the age, gender, presenting symptoms, site of bleeding, catheters used for embolization, material used for embolization, previous computed tomography (CT) scan and/or focused assessment with sonography for trauma (FAST) ultrasound, average hemoglobin before the procedure, and patient clinical status on discharge...
February 15, 2018: Curēus
https://www.readbyqxmd.com/read/29655645/proton-beam-irradiation-a-safe-procedure-in-post-equatorial-extraocular-extension-from-uveal-melanoma
#6
Ira Seibel, Aline I Riechardt, Katharina Erb-Eigner, Alexander Böker, Dino Cordini, Jens Heufelder, Antonia M Joussen
PURPOSE: This study was performed to show long-term outcomes concerning metastasis rates and local recurrence rates after primary proton beam therapy in uveal melanoma with posterior extraocular extension (EOE) with the main focus on optic nerve invasion. DESIGN: Retrospective case series METHODS: All patients treated with primary proton beam therapy for choroidal or ciliary body melanoma with posterior EOE between July 1998 and August 2010 were included. EOE was either detected upon sonography at primary examination or during the surgical application of tantalum clips onto the sclera...
April 12, 2018: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29644294/isolated-right-atrial-appendage-rupture-following-blunt-chest-trauma
#7
Rakesh Hegde, Nathan Lafayette, Michael Sywak, Gregory Ricketts, Jorge Otero, Scott Kurtzman, Zhongqiu Zhang
Background: Right sided tears or rupture are the most common injury to the heart after blunt chest trauma. The majority of these injuries are to the thin walled atrium. Reports of localized right atrial appendage rupture are rare. The classical features of Beck's triad are unreliable in the trauma bay. With the advent of EFAST (Focused assessment with sonography for trauma extended to thorax), Beck's triad should be considered but not used as the primary clinical tool for diagnosis of cardiac tamponade [1]...
February 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29644270/importance-of-the-capability-for-complete-resuscitative-treatment-combining-surgery-and-interventional-radiology-for-potentially-lethal-multiple-injuries-a-case-report
#8
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
Background: Recently, trauma management has been complicated owing to the introduction of damage-control strategies and interventional radiology. Here, we discuss important aspects regarding survival of patients with severe trauma. Case presentation: A 74-year-old Japanese woman experienced a traffic accident on a highway. On arrival, paramedics were unable to measure her blood pressure, and her condition deteriorated. The patient was immediately transferred to our hospital in a physician-staffed emergency helicopter, during which she was administered emergency blood transfusions...
October 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29643121/fast-in-the-deployed-military-setting
#9
Nicholas James Carter, D Gay
INTRODUCTION: Focused assessment with sonography in trauma (FAST) is historically an effective method of assessing the patient in the trauma bay in order to aid decision-making and optimise patient outcomes. However, in the UK civilian practice, the use of FAST may decline given a recent change in National Institute for Health and Care Excellence guidance as a result of improvement in CT availability and resuscitation techniques. METHOD: In the Role 3 Medical Treatment Facility, Camp Bastion, 187 patients with trauma who received FAST in the trauma bay in 2014 were reviewed to determine the accuracy of FAST in the deployed environment...
April 10, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29616352/efast-for-the-diagnosis-of-a-perioperative-complication-during-percutaneous-nephrolithotomy
#10
Achyut Sharma, Prajjwal Bhattarai, Apurb Sharma
A 29-year-old patient with normal preanesthetic evaluation was planned for percutaneous nephrolithotomy (PCNL) for right nephrolithiasis with right pyelolithiasis. Surgery was performed under general anesthesia with endotracheal intubation with muscle relaxation. At the conclusion of surgery, when the patient was turned over to supine position, tense abdomen was noted. Immediately extended focused assessment with sonography in trauma (eFAST) was done in which both right and left quadrants of abdomen including pericardial and suprapubic region, right and left thoracic, and both lung basis were examined...
April 3, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29600007/not-so-fast-let-s-not-abandon-the-pediatric-focused-assessment-with-sonography-in-trauma-yet
#11
EDITORIAL
Chris Moore, Rachel Liu
No abstract text is available yet for this article.
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29581925/isolated-renal-laceration-on-point-of-care-ultrasound
#12
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/29580349/efast-for-pneumothorax-real-life-application-in-an-urban-level-1-center-by-trauma-team-members
#13
Steven Maximus, Cesar Figueroa, Matthew Whealon, Jacqueline Pham, Eric Kuncir, Cristobal Barrios
The focused assessment with sonography for trauma (FAST) examination has become the standard of care for rapid evaluation of trauma patients. Extended FAST (eFAST) is the use of ultrasonography for the detection of pneumothorax (PTX). The exact sensitivity and specificity of eFAST detecting traumatic PTX during practical "real-life" application is yet to be investigated. This is a retrospective review of all trauma patients with a diagnosis of PTX, who were treated at a large level 1 urban trauma center from March 2013 through July 2014...
February 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29560289/use-of-focused-assessment-with-sonography-in-trauma-examination-skills-in-the-evaluation-of-non-trauma-patients
#14
Parisa P Javedani, Gregory S Metzger, Jeremy R Oulton, Srikar Adhikari
Study objectives Although the focused assessment with sonography in trauma (FAST) examination was initially developed for rapid evaluation of trauma patients, the basic skillset required to perform a FAST examination provides valuable information that may alter a non-trauma patient's clinical course. The objective of this study was to determine the utility of the FAST examination in the emergency department management of non-trauma patients. Methods Cases in which the FAST examination was used to direct care in non-trauma patients were retrospectively reviewed...
January 16, 2018: Curēus
https://www.readbyqxmd.com/read/29560099/atypical-appearance-of-hepatic-hemangiomas-with-contrast-enhanced-ultrasound
#15
Min Huang, Qiyu Zhao, Fen Chen, Qihan You, Tian'an Jiang
To describe the atypical enhancement pattern of hepatic hemangiomas on contrast-enhanced sonography. 22 patients with hepatic hemangiomas that were atypical on contrast-enhanced ultrasound were included in the study, all of them were confirmd by biopsy or surgery pathology. Atypical appearance of hepatic hemangiomas on contrast-enhanced ultrasound were divided into seven subtypes: (i) peripheral nodular enhancement in the arterial phase with centripedal filling, hypoechoic change in the delayed phase; (ii) peripheral circular enhancement; (iii) peripheral nodular enhancement; (iv) none enhancement; (v) septal enhancement; (vi) a central enhancing focus in the arterial phase, followed by a centrifugal enhancement in the portal venous phase, hypoechoic change in the delayed phase; (vii) slowly spoke wheel enhancement...
February 27, 2018: Oncotarget
https://www.readbyqxmd.com/read/29487770/point-of-care-ultrasound-diagnosis-of-upper-gastrointestinal-bleeding
#16
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/29466514/basic-ultrasound-training-assessment-in-the-initial-abdominal-trauma-screening
#17
Luan Geraldo Ocaña Oliveira, Debora Tagliari, Mariana Juliato Becker, Thiago Adame, José Cruvinel Neto, Fernando Antônio Campelo Spencer Netto
OBJECTIVE: to verify the efficiency and usefulness of basic ultrasound training in trauma (FAST - Focused Assessment with Sonography in Trauma) for emergency physicians in the primary evaluation of abdominal trauma. METHODS: a longitudinal and observational study was carried out from 2015 to 2017, with 11 emergency physicians from Hospital Universitário do Oeste do Paraná, submitted to ultrasound training in emergency and trauma (USET® - SBAIT). FAST results started to be collected two months after the course...
February 19, 2018: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/29443857/the-fast-exam-can-reliably-identify-patients-with-significant-intraabdominal-hemorrhage-in-life-threatening-pelvic-fractures
#18
Nicole Townsend Christian, Clay Cothren Burlew, Ernest E Moore, Andrea E Geddes, Amy E Wagenaar, Charles J Fox, Fredric M Pieracci
BACKGROUND: The Focused Abdominal Sonography for Trauma (FAST) exam has been reported to be unreliable in pelvic fracture patients. Additionally, given the advent of new therapeutic interventions, such as Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), rapid identification of intraabdominal hemorrhage compared to zone III hemorrhage may guide different therapeutic strategies. We hypothesized that FAST is reliable for detecting clinically significant intraabdominal hemorrhage in the face of complex pelvic fractures...
February 14, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29428103/risk-factors-and-metabolic-abnormality-of-patients-with-non-alcoholic-fatty-liver-disease-either-non-obese-or-obese-chinese-population
#19
Shou-Wu Lee, Teng-Yu Lee, Sheng-Shun Yang, Chun-Fang Tung, Hong-Zen Yeh, Chi-Sen Chang
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) occurs not only in obese individuals but also in non-obese ones. The aim of this study was to focus on the association between NAFLD and metabolic events in a non-obese or obese Chinese population. METHODS: Data collected from subjects registered at Taichung Veterans General Hospital from January to December 2009 were analyzed. The exclusion criteria were alcoholics, chronic hepatitis B or C. Patients included in analyses were assigned to four groups according to sonography of their liver (normal or NAFLD), and body mass index (BMI) levels (non-obese if BMI < 25 kg/m2 or obese if BMI ≥ 25 kg/m2 )...
February 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/29409085/-point-of-care-sonography-in-emergency-and-intensive-care-medicine
#20
Caroline Busche, Hans-Jörg Busch, Guido Michels
The use of Point-of-care ultrasonography (POC Ultrasonography) is getting more and more important in the bedside care of patients, especially in emergency- and intensive care units. In addition to the focused sonography of the heart, lungs and abdomen, the POC Ultrasonography recently includes also cases in prehospital care. Increasingly special applications in intensive care, e.g. the assessment of weaning from mechanical ventilation or evaluation of the hemodynamics of a patient by means of sonographic control, gain meaning...
February 2018: Deutsche Medizinische Wochenschrift
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