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paramedic ultrasound

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https://www.readbyqxmd.com/read/27754802/diagnosis-of-abcc8-congenital-hyperinsulinism-of-infancy-in-a-20-year-old-man-evaluated-for-factitious-hypoglycemia
#1
Amichai Gutgold, David J Gross, Benjamin Glaser, Auryan Szalat
CONTEXT: Hypoglycemia is a rare event in healthy adults, and the differential diagnosis includes many diseases some of which are rare and easily missed. Description of the case: A 20 year-old male military paramedic was referred to our Emergency Department for the investigation of recurrent hypoglycemia episodes during the last months. Factitious hypoglycemia was excluded and organic hyperinsulinemic hypoglycemia was diagnosed by prolonged fast. Imaging studies (endoscopic ultrasound and triple-phase computed tomography) were normal...
October 18, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27638418/introduction-of-paramedic-led-echo-in-life-support-into-the-pre-hospital-environment-the-puca-study
#2
Matthew J Reed, Louise Gibson, Alistair Dewar, Steven Short, Polly Black, Gareth R Clegg
OBJECTIVES: Can pre-hospital paramedic responders perform satisfactory pre-hospital Echo in Life Support (ELS) during the 10-second pulse check window, and does pre-hospital ELS adversely affect the delivery of cardiac arrest care. METHODS: Prospective observational study of a cohort of ELS trained paramedics using saved ultrasound clips and wearable camera videos. RESULTS: Between 23rd June 2014 and 31st January 2016, seven Resuscitation Rapid Response Unit (3RU) paramedics attended 45 patients in Lothian suffering out-of-hospital CA where resuscitation was attempted and ELS was available and performed...
September 13, 2016: Resuscitation
https://www.readbyqxmd.com/read/27313806/pre-hospital-assessment-with-ultrasound-in-emergencies-implementation-in-the-field
#3
Kevin P Rooney, Sari Lahham, Shadi Lahham, Craig L Anderson, Bryan Bledsoe, Bryan Sloane, Linda Joseph, Megan B Osborn, John C Fox
BACKGROUND: Point-of-care ultrasound (US) is a proven diagnostic imaging tool in the emergency department (ED). Modern US devices are now more compact, affordable and portable, which has led to increased usage in austere environments. However, studies supporting the use of US in the prehospital setting are limited. The primary outcome of this pilot study was to determine if paramedics could perform cardiac ultrasound in the field and obtain images that were adequate for interpretation...
2016: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27312767/prospective-evaluation-of-the-learning-curve-for-ultrasound-guided-peripheral-intravenous-catheter-placement
#4
Lori A Stolz, Anthony R Cappa, Michael R Minckler, Uwe Stolz, Ryan G Wyatt, Carl W Binger, Richard Amini, Srikar Adhikari
INTRODUCTION: It is unclear how many ultrasound-guided peripheral intravenous catheters (USG PIVC) one must place to become proficient at the procedure. The objective of this study was to determine the learning curve associated with PIVC placement and determine how many attempts are required for non-physician learners to reach proficiency. METHODS: This is a prospective observational study. Emergency department (ED) nurses and paramedics with competence in traditional PIVC placement underwent a USG PIVC placement training program...
July 12, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/26611224/assessment-of-paramedic-ultrasound-curricula-a-systematic-review
#5
REVIEW
Jessica McCallum, Erik Vu, David Sweet, Hussein D Kanji
OBJECTIVE: Prehospital ultrasound is being applied in the field. The purpose of this systematic review is to describe evidence pertaining to ultrasound curricula for paramedics specifically, including content, duration, setting, design, evaluation, and application. METHODS: Electronic searches of MEDLINE, Embase, CINAHL, and the Cochrane Center Register of Controlled Trials were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
November 2015: Air Medical Journal
https://www.readbyqxmd.com/read/26376030/remote-sonography-in-routine-clinical-practice-between-two-isolated-medical-centers-and-the-university-hospital-using-a-robotic-arm-a-1-year-study
#6
Monica Georgescu, Arnaud Sacccomandi, Bernard Baudron, Philippe L Arbeille
BACKGROUND: A robotic arm was developed by our laboratory for tele-operated echography on patients in locations isolated from a trained sonographer. The objective of the study was to evaluate, over a 1-year period, the use of the robotic arm for telesonography performed by a sonographer located at the University Hospital (Tours, France) on patients in two isolated medical centers 50 km away linked via the Internet. MATERIALS AND METHODS: A nonsonographer operator (physician or paramedic) located the ultrasound probe attached to the robotic arm over the appropriate acoustic window for the organ of interest by rolling the whole robotic arm and mechanical support across the floor...
April 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/26265961/prehospital-evaluation-of-effusion-pneumothorax-and-standstill-peeps-point-of-care-ultrasound-in-emergency-medical-services
#7
Sundeep R Bhat, David A Johnson, Jessica E Pierog, Brita E Zaia, Sarah R Williams, Laleh Gharahbaghian
INTRODUCTION: In the United States, there are limited studies regarding use of prehospital ultrasound (US) by emergency medical service (EMS) providers. Field diagnosis of life-threatening conditions using US could be of great utility. This study assesses the ability of EMS providers and students to accurately interpret heart and lung US images. METHODS: We tested certified emergency medical technicians (EMT-B) and paramedics (EMT-P) as well as EMT-B and EMT-P students enrolled in prehospital training programs within two California counties...
July 2015: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/25647037/training-paramedics-in-focussed-echo-in-life-support
#8
Katherine L Booth, Matthew J Reed, Shirin Brady, Kristina R Cranfield, Ravin Kishen, Katy Letham, Graeme McAlpine, Douglas B Murray, Emma-Beth Wilson, Mike Wilson, Steven Short, Gareth R Clegg
OBJECTIVES: The aim of this study was to determine whether paramedics can be trained to perform and interpret focussed Echo in Life Support (ELS) for the assessment of cardiac movement and the recognition of reversible causes of cardiac arrest. METHODS: This study is a prospective observational pilot study. Data were collected during a 1-day course training 11 paramedics to perform ELS scans on healthy volunteers. The students were assessed on image acquisition skills and theoretical knowledge (including interpretation)...
December 2015: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/25391692/the-use-of-fast-scan-by-paramedics-in-mass-casualty-incidents-a-simulation-study
#9
RANDOMIZED CONTROLLED TRIAL
Brian West, Andrew Cusser, Stuart Etengoff, Hank Landsgaard, Virginia LaBond
INTRODUCTION: The Focused Abdominal Sonography in Trauma (FAST) scan is used to detect free fluid in the peritoneal cavity, or pericardium, to quickly assess for injuries needing immediate surgical intervention. Mass-casualty incidents (MCIs) are settings where paramedics must make triage decisions in minutes. The Simple Triage and Rapid Transport (START) system is used to prioritize transport. The FAST scan can be added to the triage of critical patients, and may aid in triage. METHODS: This was a single-blinded, randomized control trial...
December 2014: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/25295481/-management-of-surgical-abdominal-emergencies-in-kara-teaching-hospital-togo-10-year-retrospective-study-of-594-cases
#10
I Kassegne, K Kanassoua, E V Sewa, B Tchangaï, J Sambiani, A E Ayité, E D Dosseh
PURPOSE: The aim of this study was to describe the epidemiologic, diagnostic, and therapeutic aspects of surgical abdominal emergencies in a teaching hospital in a developing country (Togo). MATERIAL AND METHOD: This retrospective study included the medical files of all patients managed for surgical abdominal emergencies from March 1, 2002, to March 1, 2012. RESULTS: The study included 594 patients, with a mean age of 30.3 years (range: 1 month to 80 years) and a 2...
January 2015: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/25116305/prehospital-stroke-care-limitations-of-current-interventions-and-focus-on-new-developments
#11
REVIEW
Laetitia Yperzeele, Robbert-Jan Van Hooff, Ann De Smedt, Alexis Valenzuela Espinoza, Rohny Van de Casseye, Ives Hubloue, Jacques De Keyser, Raf Brouns
BACKGROUND: The global burden of stroke is immense, both in medical and economic terms. With the aging population and the ongoing industrialization of the third world, stroke prevalence is expected to increase and will have a major effect on national health expenditures. Currently, the medical treatment for acute ischemic stroke is limited to intravenous recombinant tissue plasminogen activator (IV r-tPA), but its time dependency leads to low utilization rates in routine clinical practice...
2014: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/25092798/the-necksafe-head-articulation-control-system-a-novel-cervical-immobilisation-device
#12
Alison Sparke, Karina Torlei, Sarah Voss, Mike Page, Jonathan Benger, Ed Matthews, Michael Hillman, Darren Hart, Ella McLaughlin, Jane Carter, Nigel Harris
INTRODUCTION: The early application of a semirigid disposable cervical collar following trauma is considered a routine practice. The aim of these devices is to immobilise the cervical spine and minimise the risk of additional neurological damage. However, these collars provide only partial immobilisation, are uncomfortable and are associated with a number of complications. Our team designed and tested a novel cervical immobilisation device that aims to improve immobilisation with reduced complications: the 'Necksafe'...
July 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/24572006/prehospital-stroke-diagnostics-based-on-neurological-examination-and-transcranial-ultrasound
#13
Moriz Herzberg, Sandra Boy, Thilo Hölscher, Michael Ertl, Markus Zimmermann, Karl-Peter Ittner, Josef Pemmerl, Hendrik Pels, Ulrich Bogdahn, Felix Schlachetzki
BACKGROUND: Transcranial color-coded sonography (TCCS) has proved to be a fast and reliable tool for the detection of middle cerebral artery (MCA) occlusions in a hospital setting. In this feasibility study on prehospital sonography, our aim was to investigate the accuracy of TCCS for neurovascular emergency diagnostics when performed in a prehospital setting using mobile ultrasound equipment as part of a neurological examination. METHODS: Following a '911 stroke code' call, stroke neurologists experienced in TCCS rendezvoused with the paramedic team...
February 27, 2014: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/23101484/just-in-time-cost-effective-off-the-shelf-remote-telementoring-of-paramedical-personnel-in-bedside-lung-sonography-a-technical-case-study
#14
Nancy Biegler, Paul B McBeth, Martha C Tevez-Molina, Janelle McMillan, Innes Crawford, Douglas R Hamilton, Andrew W Kirkpatrick
PURPOSE: Remote telementored ultrasound (RTMUS) is a new discipline that allows a remote expert to guide variably experienced clinical responders through focused ultrasound examinations. We used the examination of the pleural spaces after tube thoracostomy (TT) removal by a nurse with no prior ultrasound experience as an illustrative but highly accurate example of the technique using a simple cost-effective system. MATERIALS AND METHODS: The image outputs of a handheld ultrasound machine and a head-mounted Web camera were input into a customized graphical user interface and streamed over a freely available voice over Internet protocol system that allowed two-way audio and visual communication between the novice examiner and the remote expert...
December 2012: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/22932065/who-s-the-doctor-patients-perceptions-of-the-role-of-the-breast-radiologist-a-lesson-for-all-radiologists
#15
N O'Mahony, E McCarthy, R McDermott, S O'Keeffe
OBJECTIVE: The aim of this study was to explore patients' perceptions of the role of the radiologist in their care. METHODS: The questionnaire used was designed in conjunction with a psychologist who had an interest in oncology, and piloted. The final questionnaires were distributed to patients attending the breast clinic at St James's Hospital, Dublin, Ireland, from 1 March to 1 July 2011. Patients requiring imaging (mammography and/or ultrasound) were asked to complete the same questionnaire again after imaging procedures were performed...
December 2012: British Journal of Radiology
https://www.readbyqxmd.com/read/22823884/burning-man-2011-mass-gathering-medical-care-in-an-austere-environment
#16
Bryan Bledsoe, Pat Songer, Kelly Buchanan, Jeff Westin, Ryan Hodnick, Loren Gorosh
INTRODUCTION: Burning Man is a large weeklong outdoor arts festival held annually in the rugged and austere Black Rock Desert in northern Nevada. The 2011 event presented several unusual challenges in terms of emergency medical services (EMS) and medical care provision. OBJECTIVE: This paper details the planning and subsequent emergency medical care for Burning Man 2011. METHODS: This was a retrospective, observational review of the preparation, management, and medical care at Burning Man 2011...
October 2012: Prehospital Emergency Care
https://www.readbyqxmd.com/read/22595631/a-pilot-study-examining-the-viability-of-a-prehospital-assessment-with-ultrasound-for-emergencies-pause-protocol
#17
Eric J Chin, Connie H Chan, Rod Mortazavi, Craig L Anderson, Christopher A Kahn, Shane Summers, J Christian Fox
BACKGROUND: Prehospital ultrasound has been shown to aid in the diagnosis of multiple conditions that do not generally change prehospital management. On the other hand, the diagnoses of cardiac tamponade, tension pneumothorax, or cardiac standstill may directly impact patient resuscitation in the field. STUDY OBJECTIVE: To determine if prehospital care providers can learn to acquire and recognize ultrasound images for several life-threatening conditions using the Prehospital Assessment with UltraSound for Emergencies (PAUSE) protocol...
January 2013: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/22261817/transcranial-ultrasound-from-diagnosis-to-early-stroke-treatment-part-2-prehospital-neurosonography-in-patients-with-acute-stroke-the-regensburg-stroke-mobile-project
#18
Felix Schlachetzki, Moriz Herzberg, Thilo Hölscher, Michael Ertl, Markus Zimmermann, Karl Peter Ittner, Hendrik Pels, Ulrich Bogdahn, Sandra Boy
BACKGROUND AND PURPOSE: The primary aim of this study was to investigate the diagnostic accuracy and time frames for neurological and transcranial color-coded sonography (TCCS) assessments in a prehospital '911' emergency stroke situation by using portable duplex ultrasound devices to visualize the bilateral middle cerebral arteries (MCAs). METHODS: This study was conducted between May 2010 and January 2011. Patients who had sustained strokes in the city of Regensburg and the surrounding area in Bavaria, Germany, were enrolled in the study...
2012: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/22164403/an-evidence-based-approach-to-emergency-ultrasound
#19
James Q Hwang, Heidi Harbison Kimberly, Andrew S Liteplo, Dana Sajed
Paramedics bring into the ED an elderly man who is complaining of right-sided chest and abdominal pain. Earlier this morning, a friend had arrived at the patient's home and found him on the floor at the bottom of the stairs. The patient is in pain, somewhat altered, and unable to provide further details about what happened. After numerous attempts, the paramedics were only able to place a 22-gauge peripheral line. On examination, his blood pressure is 98/55 mm Hg, heart rate is 118 beats per minute, respiratory rate is 32 breaths per minute, oxygen saturation is 94% on a nonrebreather, and temperature is 36...
March 2011: Emergency Medicine Practice
https://www.readbyqxmd.com/read/21817908/prehospital-chest-emergency-sonography-trial-in-germany-a-prospective-study
#20
Albrecht Neesse, Andreas Jerrentrup, Saskia Hoffmann, Alexander Sattler, Christian Görg, Clemens Kill, Thomas Mathias Gress, Steffen Kunsch
OBJECTIVES: To examine the feasibility and diagnostic value of a novel prehospital chest ultrasound algorithm in patients with dyspnea. METHODS: Sixty-two patients (32 men, 30 women, mean 67.1 years, range 20-90 years) with acute dyspnea prospectively underwent chest sonography with a portable ultrasound device. The algorithm included five sectional views (four-chamber subxyphoidal view, left and right laterodorsal view, left and right anterior intercostal space two to four view) screening for pleural and pericardial effusion, right heart distension, and pneumothorax...
June 2012: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
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