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16 papers 0 to 25 followers
Joseph R Pare, Rachel Liu, Christopher L Moore, Tyler Sherban, Michael S Kelleher, Sheeja Thomas, R Andrew Taylor
STUDY OBJECTIVE: Ascending aortic dissection (AAD) is an uncommon, time-sensitive, and deadly diagnosis with a nonspecific presentation. Ascending aortic dissection is associated with aortic dilation, which can be determined by emergency physician focused cardiac ultrasound (EP FOCUS). We seek to determine if patients who receive EP FOCUS have reduced time to diagnosis for AAD. METHODS: We performed a retrospective review of patients treated at 1 of 3 affiliated emergency departments, March 1, 2013, to May 1, 2015, diagnosed as having AAD...
March 2016: American Journal of Emergency Medicine
Simon Li, Cicero T Silva, Adele R Brudnicki, Kenneth E Baker, Joana A Tala, Matthew G Pinto, Lee A Polikoff, Li Qin, E Vincent S Faustino
BACKGROUND: Compared with consultative US performed by the radiology department, point-of-care US performed by non-radiology physicians can accurately diagnose deep venous thrombosis in adults. OBJECTIVE: In preparation for a multicenter randomized controlled trial, we determined the accuracy of point-of-care US in diagnosing central venous catheter-related thrombosis in critically ill children. MATERIALS AND METHODS: Children <18 years old with a central venous catheter who were admitted to the intensive care unit were enrolled...
February 2016: Pediatric Radiology
Jonathan Ken, Darshan Khangura, Sean P Stickles
Hypothenar hammer syndrome (HHS) is a rare condition of distal ulnar artery injury and thrombosis secondary to repetitive blunt trauma to the hypothenar area. We present a case of HHS for which point-of-care ultrasound (POCUS) was used as the initial means of imaging, prompting management and disposition without further imaging studies ordered in the emergency department (ED). This case demonstrates the utility of POCUS to aid the Emergency Physician in the diagnosis and management of patients with extremity vascular issues in the ED, and details a rarely seen clinical entity in the ED...
July 2015: Western Journal of Emergency Medicine
Thilo Witsch, Anna Stephan, Petra Hederer, Hans-Joerg Busch, Jens Witsch
BACKGROUND: Patients with medical conditions may present with psychiatric symptoms, which may lead to worse physical health care. Here we present the case of a patient with acute aortic dissection masked by psychiatric symptoms after a stressful event. CASE REPORT: A 29-year-old female medical student presented to the Emergency Department (ED) complaining about the feeling of "hysteria" after an argument with her boyfriend earlier the same day. She did not report other symptoms or pain...
November 2015: Journal of Emergency Medicine
Adeyinka A Adedipe, Deborah L Fly, Scott D Schwitz, Dawn B Jorgenson, Haris Duric, Michael R Sayre, Graham Nichol
OBJECTIVE: High quality chest compressions are the cornerstone of effective cardiopulmonary resuscitation (CPR). There is no available method of real time noninvasive hemodynamic measurement and feedback to inform rescuers of the efficacy of compressions. Ultrasound-based measures of blood flow may provide immediate, noninvasive hemodynamic information. Our objective was to determine the feasibility and safety of using ultrasound to measure blood flow on patients with cardiac arrest. METHODS: Study design This was a prospective cohort study in an emergency department setting...
November 2015: Resuscitation
Shaun C Ramsey, Patrick M Flaherty
BACKGROUND: Deep vein thrombosis (DVT) is commonly encountered in the emergency department. Clinical models, such as the Wells criteria, allow physicians to estimate the probability of DVT in a patient. Current literature suggests a low pretest probability combined with a negative D-dimer laboratory study rules out DVT approximately 99% of the time. CASE REPORT: This case discusses a 37-year-old male patient who had a low pretest probability and a negative D-dimer, but was found to have a DVT on Doppler ultrasound...
June 2015: Journal of Emergency Medicine
Peter J Carr, James C R Rippey
We report a case of peripherally inserted central venous catheter (PICC)-associated deep vein thrombosis (DVT). Ultrasound images and video of subclavian thrombus are presented. PICC line-associated DVT, particularly in cancer patients is not uncommon. Point-of-care Emergency Department ultrasound can readily diagnose this complication and device removal is not always necessary.
March 2015: Clinical Case Reports
Scott Edward Sparks, Michael Kurz, Doug Franzen
Thoracic aortic dissection is a lethal disease, and emergency department diagnosis is limited by imperfect diagnostic testing and limited resources;however, this case report illustrates the nonspecific presentation of thoracic aortic dissection and the use of emergency physician use of transthoracic echocardiography with the addition of suprasternal notch views to help differentiate all-cause chest pain and aid in accurate diagnosis,as well as earlier surgical correction for best patient outcomes in cases of thoracic aortic dissection...
July 2015: American Journal of Emergency Medicine
Srikar Adhikari, Wes Zeger, Christopher Thom, J Matthew Fields
STUDY OBJECTIVE: Two-point compression ultrasonography focuses on the evaluation of common femoral and popliteal veins for complete compressibility. The presence of isolated thrombi in proximal veins other than the common femoral and popliteal veins should prompt modification of 2-point compression technique. The objective of this study is to determine the prevalence and distribution of deep venous thrombi isolated to lower-extremity veins other than the common femoral and popliteal veins in emergency department (ED) patients with clinically suspected deep venous thrombosis...
September 2015: Annals of Emergency Medicine
Christopher R Tainter, Alan W Huang, Reuben J Strayer
BACKGROUND: Isolated distal deep vein thrombosis (DVT) is not traditionally viewed as a potentially life-threatening condition. There are conflicting recommendations regarding its evaluation and treatment, and wide variability in clinical practice. The presentation of this case highlights the fatal potential of this condition. CASE REPORT: This is the report of a previously healthy young woman who presented to the emergency department with calf pain concerning for a DVT...
February 2015: Journal of Emergency Medicine
Rajeev S Wadia, Jamie M Schwartz, Sapna R Kudchadkar
Aortic dissection secondary to thoracoabdominal aortic aneurysms is very uncommon in children, and this life-threatening diagnosis requires a high clinical index of suspicion. Unlike adults, in whom atherosclerosis, inflammation, and advanced age are typically contributing factors, aortic dissection in children is usually due to nonatherosclerotic causes.Aortic aneurysms can be asymptomatic when small but, when significantly enlarged, can compromise organ function and dissect, resulting in high mortality rates...
September 2015: Pediatric Emergency Care
Edward Vincent S Faustino, Philip C Spinella, Simon Li, Matthew G Pinto, Petronella Stoltz, Joana Tala, Mary Elizabeth Card, Veronika Northrup, Kenneth E Baker, T Rob Goodman, Lei Chen, Cicero T Silva
OBJECTIVE: To determined the current incidence and acute complications of asymptomatic central venous catheter (CVC)-related deep venous thrombosis (DVT) in critically ill children. STUDY DESIGN: We performed a prospective cohort study in 3 pediatric intensive care units. A total of 101 children with newly inserted untunneled CVC were included. CVC-related DVT was diagnosed using compression ultrasonography with color Doppler. RESULTS: Asymptomatic CVC-related DVT was diagnosed in 16 (15...
February 2013: Journal of Pediatrics
Carlo Lomonte, Mario Meola, Ilaria Petrucci, Francesco Casucci, Carlo Basile
Vascular access (VA) is the lifeline for the hemodialysis patient and the native arterio-venous fistula (AVF) is the first-choice access. Among the different tests used in the VA domain, color Doppler ultrasound (CD-US) plays a key role in the clinical work-up. At the present time, three are the main fields of CD-US application: (i) evaluation of forearm arteries and veins in surgical planning; (ii) testing of AVF maturation; (iii) VA complications. Specifically, during the AVF maturation, CD-US allows to measure the diameter and flow volume in the brachial artery and calculate the peak systolic velocity (PSV) of the arterial axis, anastomosis and efferent vein, to detect critical stenosis...
March 2015: Seminars in Dialysis
Amin Abdi, Erick Armijo, Dina Seif, Tarina Kang
A vascular pseudoaneurysm can present similarly to an abscess; yet incision and drainage of a pseudoaneurysm can lead to uncontrolled bleeding and expose the patient to further morbidity. This is a case of a patient with a forehead pseudoaneurysm who presented to our emergency room after blunt head trauma. Here we review different diagnostic modalities as well as some of the treatment options that are described in the literature.
2014: Case Reports in Emergency Medicine
David J Blehar, Scott Glazier, Romolo J Gaspari
PURPOSE: Assessment of volume status remains a challenge in critical care. Our purpose was to determine if Doppler waveform analysis of carotid artery blood flow correlates with changes in volume status. MATERIALS AND METHODS: Dehydrated patients receiving an intravenous fluid bolus were enrolled with exclusions including age less than 18 years, pregnancy, vasopressor administration, or atrial fibrillation. Ultrasound examination with Doppler analysis of the carotid artery was performed with measurements taken to calculate corrected flow time (FTc)...
August 2014: Journal of Critical Care
R Wunsch, L von Rohden, R Cleaveland, V Aumann
Small-part sonography refers to the display of small, near-surface structures using high-frequency linear array transducers. Traditional applications for small part ultrasound imaging include visualization and differential diagnostic evaluation in unclear superficial bodily structures with solid, liquid and mixed texture, as well as similar structures in nearly superficial organs such as the thyroid glands and the testes. Furthermore indications in the head and neck regions are the assessment of the outer CSF spaces in infants, the sonography of the orbit, the sonography of the walls of the large neck vessels, the visualization of superficially situated lymph nodes and neoplasms...
September 2014: European Journal of Radiology
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