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ultrasound, point of care

H R Touw, K L Parlevliet, M Beerepoot, P Schober, A Vonk, J W Twisk, P W Elbers, C Boer, P R Tuinman
Postoperative pulmonary complications are common after cardiothoracic surgery and are associated with adverse outcomes. The ability to detect postoperative pulmonary complications using chest X-rays is limited, and this technique requires radiation exposure. Little is known about the diagnostic accuracy of lung ultrasound for the detection of postoperative pulmonary complications after cardiothoracic surgery, and we therefore aimed to compare lung ultrasound with chest X-ray to detect postoperative pulmonary complications in this group of patients...
March 12, 2018: Anaesthesia
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
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
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
Jennifer E Melvin, Michael C Ost, Jennifer R Marin
We present 2 cases of patients with abdominal trauma who were found to have hydronephrosis on point-of-care ultrasound secondary to previously undiagnosed ureteropelvic junction obstructions. We review the ultrasound findings, technique, and relevant literature regarding renal point-of-care ultrasound and ureteropelvic junction obstruction.
March 5, 2018: Pediatric Emergency Care
Benjamin Marchandot, François Levy, Nicola Santelmo, Paul-Michel Mertes, Olivier Morel
BACKGROUND: Adequate strategies using either transthoracic (TTE) or transesophageal (TEE) echocardiography in patients receiving cardiopulmonary resuscitation (CPR) is an ongoing area of research. OBJECTIVES: As transthoracic point-of-care ultrasound (POCUS) during cardiac arrest resuscitation might result in an increased duration of interruptions in the delivery of chest compressions; the use of TEE has been proposed as an alternative. METHODS: No technical complications of either TTE nor TEE are so far being reported in the literature...
March 2, 2018: Heart & Lung: the Journal of Critical Care
Albeir Y Mousa, Mike Broce, David De Wit, Mina Baskarioun, Shadi AbuHalema, Michael Yacoub, Mark C Bates
BACKGROUND: The D-Dimer (DD) level combined with the pretest Wells criteria probability (WCP) score can safely exclude Deep Venous Thrombosis (DVT). The objective for this study was to examine the correlation between DD results alongside WCP score with findings on venous duplex ultrasound (VDU). The hypothesis is that VDU remains over utilized in low-risk patients with negative DD and that higher DD levels may correlate with thrombus burden and location. METHODS: Patients who presented to a high volume tertiary care center with lower limb swelling with or without associated pain were retrospectively examined through June and July for four consecutive years (2012 to 2015)...
March 1, 2018: Annals of Vascular Surgery
Brent Burbridge, Chris Plewes, Grant Stoneham, Peter Szkup, Rob Otani, Paul Babyn, Rhonda Bryce
PURPOSE: To evaluate the hypothesis that power-injectable totally implanted venous access devices (TIVADs) situated in the arm are associated with more frequent complications and complication-related removal than non-power-injectable arm TIVADs among adult cancer patients. MATERIALS AND METHODS: In this single-center trial, 211 adult chemotherapy patients were randomized to receive either a power-injectable or a non-power-injectable arm TIVAD. Follow-up involved a standardized telephone interview 1 week after insertion, followed by a chest X-ray, arm X-ray, and Doppler ultrasound at 3 months and 12 months...
February 27, 2018: Journal of Vascular and Interventional Radiology: JVIR
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
Doaa El Amrousy, Mohamed Elkashlan, Nagat Elshmaa, Ahmed Ragab
OBJECTIVES: To assess the efficacy of ultrasound-guided laryngeal air column width difference in predicting postextubation stridor in children. DESIGN: Prospective observational study. SETTING: Single, tertiary care pediatric hospital. PATIENTS: This study was carried out at PICU and surgical ICU, Tanta University Hospital on 400 ventilated children between January 2015 and May 2017. Patients who received mechanical ventilation and met criteria for a weaning trial were included...
March 1, 2018: Critical Care Medicine
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
Karen R Boretsky
No abstract text is available yet for this article.
March 1, 2018: Anesthesiology
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
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
Benji K Mathews, Kreegan Reierson, Khuong Vuong, Ankit Mehta, Paula Miller, Seth Koenig, Mangala Narasimhan
BACKGROUND: Literature supports the use of point-ofcare ultrasound performed by the treating hospitalist in the diagnosis of common diseases. There is no consensus on the training paradigm or the evaluation of skill retention for hospitalists. OBJECTIVE: To evaluate the effectiveness of a comprehensive bedside ultrasound training program with postcourse competency assessments for hospitalists. DESIGN: A retrospective report of a training program with 53 hospitalists...
February 28, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Giulia I Lane, Ronak A Gor, Jenna Katorski, Sean P Elliott
AIMS: Neurogenic bladders (NGB) with detrusor leak point pressures >40 cm H2 O (dLPP > 40) have been associated with deterioration of renal function in children with myelomeningocele. For these children, careful pressure management preserves renal function. However, similar evidence is lacking in adult congenital urology (ACU) patients with NGB. We describe renal functional outcomes of non-surgical management of adults with dLPP > 40 or premicturition detrusor pressure (PMDP) >40 cm H2 O, consisting of close follow-up with urodynamic studies (UDS) and renal ultrasound (RUS), paired with adjustments to clean intermittent catheterization (CIC) frequency, anticholinergics, and addition of onabotulinumtoxinA toxin (BTX) injection...
February 28, 2018: Neurourology and Urodynamics
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
Michael Narvey, Kenny K Wong, Anne Fournier
Pulse oximetry screening is safe, noninvasive, easy to perform and proven to enhance detection of critical congenital heart disease in newborns. However, this test has yet to be adopted as routine practice in Canada. The present practice point highlights essential details and recommendations for screening, which research has shown to be highly specific, with low false-positive rates. Optimal screening for critical congenital heart disease should include prenatal ultrasound, physical examination and pulse oximetry screening...
November 2017: Paediatrics & Child Health
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
Vandana Dua Niyyar, W Charles O'Neill
Sonography is increasingly being performed by clinicians and has applications throughout the spectrum of nephrology, including acute and chronic renal failure, urinary obstruction, cystic disease, pain, hematuria, transplantation, kidney biopsy, temporary and permanent vascular access, and assessment of fluid status. The skill is relatively easily acquired, expedites patient care, and enhances the practice of nephrology. However, the lack of exposure in most training programs remains a major obstacle.
February 22, 2018: Kidney International
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