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Procedural Guidance

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15 papers 0 to 25 followers
Phillip D Levin, Olga Sheinin, Yaacov Gozal
OBJECTIVE: To assess the role of a portable ultrasound device in the insertion of radial artery catheters. DESIGN: Prospective, randomized, comparative study. SETTING: Tertiary university hospital. PATIENTS: Elective surgery patients requiring arterial catheter insertion for intraoperative monitoring. INTERVENTIONS: A portable ultrasound device was used to visualize the radial artery at the wrist and to direct arterial catheter insertion...
February 2003: Critical Care Medicine
Stephen Shiver, Michael Blaivas, Matthew Lyon
BACKGROUND: Arterial cannulation for continuous blood-pressure measurement and frequent arterial-blood sampling commonly are required in critically ill patients. OBJECTIVES: To compare ultrasound (US)-guided versus traditional palpation placement of arterial lines for time to placement, number of attempts, sites used, and complications. METHODS: This was a prospective, randomized interventional study at a Level 1 academic urban emergency department with an annual census of 78,000 patients...
December 2006: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Ariel L Shiloh, Richard H Savel, Laura M Paulin, Lewis A Eisen
BACKGROUND: Ultrasound guidance commonly is used for the placement of central venous catheters (CVCs). The Agency for Healthcare Research and Quality recommends the use of ultrasound for CVC placement as one of its 11 practices to improve patient care. Despite increased access to portable ultrasound machines and comfort with ultrasound-guided CVC access, fewer clinicians are familiar with ultrasound-guided techniques of arterial catheterization. The goal of this systematic review and meta-analysis was to determine the utility of real-time two-dimensional ultrasound guidance for radial artery catheterization...
March 2011: Chest
Pankaj A Patel, Frank R Ernst, Candace L Gunnarsson
PURPOSE.: We performed an analysis of hospitalizations involving thoracentesis procedures to determine whether the use of ultrasonographic (US) guidance is associated with differences in complications or hospital costs as compared with not using US guidance. METHODS.: We used the Premier hospital database to identify patients with ICD-9 coded thoracentesis in 2008. Use of US guidance was identified using CPT-4 codes. We performed univariate and multivariable analyses of cost data and adjusted for patient demographics, hospital characteristics, patient morbidity severity, and mortality...
March 2012: Journal of Clinical Ultrasound: JCU
Phillip W Jones, J Phillip Moyers, Jeffrey T Rogers, R Michael Rodriguez, Y C Gary Lee, Richard W Light
STUDY OBJECTIVES: The objectives of this study are as follows: (1) to determine the incidence of complications from thoracentesis performed under ultrasound guidance by interventional radiologists in a tertiary referral teaching hospital; (2) to evaluate the incidence of vasovagal events without the use of atropine prior to thoracentesis; and (3) to evaluate patient or radiographic factors that may contribute to, or be predictive of, the development of re-expansion pulmonary edema after ultrasound-guided thoracentesis...
February 2003: Chest
Alfredo Tirado, Teresa Wu, Vicki E Noble, Calvin Huang, Resa E Lewiss, Jennifer A Martin, Michael C Murphy, Adam Sivitz, Stephanie G Cohen
Bedside ultrasound is an extremely valuable and rapidly accessible diagnostic and therapeutic modality in potentially life- and limb-threatening situations in the emergency department. In this report, the authors discuss the role of ultrasound in quick assessment of pathologic conditions and its use to aid in diagnostic and therapeutic interventions.
February 2013: Emergency Medicine Clinics of North America
Michael B Stone, Darrell Sutijono
No abstract text is available yet for this article.
December 2009: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Alfredo Tirado, Arun Nagdev, Charlotte Henningsen, Pav Breckon, Kris Chiles
Ultrasound has rapidly become an essential tool in the emergency department, specifically in procedural guidance. Its use has been demonstrated to improve the success rate of procedures, while decreasing complications. In this article, we explore some of these specific procedures involving needle guidance and structure localization with ultrasound.
February 2013: Emergency Medicine Clinics of North America
Thomas G Costantino, Wayne A Satz, Wade Dehnkamp, Harry Goett
OBJECTIVES: Traditionally, emergency physicians (EPs) have used anatomic landmark-based needle aspiration to drain peritonsillar abscesses (PTAs). If this failed, an imaging study and/or consultation with another service to perform the drainage is obtained. Recently, some EPs have used ultrasound (US) to guide PTA drainage. This study seeks to determine which initial approach leads to greater successful drainage. The primary objective of this study was to compare the diagnostic accuracy of EPs for detecting PTA or peritonsillar cellulitis (PTC) using either intraoral US or initial needle aspiration after visual inspection (the landmark technique [LM])...
June 2012: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Darlene R Duncan, Timothy I Morgenthaler, Jay H Ryu, Craig E Daniels
BACKGROUND: We studied the reasons why patients undergoing thoracenteses performed in our outpatient pulmonary clinic had a higher frequency of iatrogenic pneumothorax compared to that in the concurrent radiology practice in our institution, which utilizes ultrasound guidance. We reviewed our practice model and implemented a unique experiential training paradigm in a zero-risk simulation environment to improve efficacy, timeliness, service orientation, and safety. METHODS: We retrospectively determined the rate of clinically significant pneumothoraces in our practice (phase I, July 1, 2001, to June 30, 2002)...
May 2009: Chest
Jason T Nomura, Stephen J Leech, Srikala Shenbagamurthi, Paul R Sierzenski, Robert E O'Connor, Melissa Bollinger, Margaret Humphrey, Jason A Gukhool
OBJECTIVE: Evidence showing the systematic utility of ultrasound imaging during lumbar puncture (LP) in the emergency department is lacking. Our hypothesis was that ultrasound-assisted LP would increase the success rate and ease of performing LP with a greater benefit in obese patients. METHODS: This was an Institutional Review Board-approved, randomized, prospective, double-blind study conducted at the emergency department of a teaching institution. Patients undergoing LP from January to December 2004 were eligible for enrollment...
October 2007: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Kirk A Stiffler, Sharhabeel Jwayyed, Scott T Wilber, Angela Robinson
OBJECTIVE: This study was conducted to assess the ultrasound's (US's) ability to identify pertinent landmarks for lumbar puncture (LP) in patients of various body mass indices (BMIs) and establish spatial relationships of pertinent LP landmarks across BMIs. METHODS: In this institutional review board-approved cross-sectional study, we calculated the BMIs of eligible patients and then categorized them as normal (BMI < or =24.9), overweight (BMI 24.9-30), or obese (BMI > or =30)...
March 2007: American Journal of Emergency Medicine
Shameem R Nazeer, Hillary Dewbre, Adam H Miller
STUDY OBJECTIVE: To determine if emergency center ultrasound (ECUS) can be of value to emergency physicians in the evaluation of possible ascites and accompanying decisions to perform emergent paracentesis. METHODS: During a 7-month period, patients suspected of having ascites and potentially requiring paracentesis were prospectively entered into a randomized study in an urban public hospital emergency center (>140 000 annual visits). Patients were randomized to receive paracentesis using the traditional or the bedside ECUS-assisted technique...
May 2005: American Journal of Emergency Medicine
Michael A Peterson, Jennifer Abele
Lumbar puncture is a common procedure performed in the emergency department for evaluation of several life-threatening conditions, including meningitis and subarachnoid hemorrhage. We describe the use of bedside ultrasound to assist in performance of the lumbar puncture in situations where the standard "blind" technique of needle insertion using palpable spinal landmarks is likely to be difficult or to fail. Use of ultrasound to guide lumbar puncture needle placement was originally reported 30 years ago in the Russian literature...
February 2005: Journal of Emergency Medicine
Teresa S M Tsang, Maurice Enriquez-Sarano, William K Freeman, Marion E Barnes, Lawrence J Sinak, Bernard J Gersh, Kent R Bailey, James B Seward
OBJECTIVES: To evaluate consecutive therapeutic echocardiographically (echo)-guided pericardiocenteses performed at Mayo Clinic, Rochester, Minn, from 1979 to 2000 and to determine whether patient profiles, practice patterns, and outcomes have changed over time. PATIENTS AND METHODS: Consecutive echo-guided pericardiocenteses performed between February 1, 1979, and January 31, 2000, for treatment of clinically significant pericardial effusions were identified in the Mayo Clinic Echocardiographic-guided Pericardiocentesis Registry...
May 2002: Mayo Clinic Proceedings
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