Articles

Interscalene brachial plexus nerve block in the emergency department: an effective and practice-changing workshop

The interscalene brachial plexus nerve block (ISNB) is a potentially useful method of regional analgesia for humerus fracture and shoulder dislocation reduction in the Emergency Department (ED). We examined th...

Authors: Tyler Beals, Kay Odashima, Lawrence E. Haines, Antonios Likourezos, Jefferson Drapkin and Eitan Dickman

Giant rectus sheath hematoma

Rectus sheath hematoma (RSH) is an uncommon entity associated with predisposing factors such as anticoagulation. It may mimic more frequent abdominal conditions and its accurate diagnosis is important to focus...

Authors: Gabriela Bello and Pablo Blanco

“Sigmoid diverticulitis mimicking cholecystitis” a clinical challenge

Diverticular disease is a common disorder and its incidence increases with ageing. Pathophysiology is multifactorial. Lifestyle, including smoking, alcohol intake, decreased dietary fibres and lack of physical...

Authors: Ilaria Pulzato, Enrico Boero, Elona Shaipi and Luciano Cardinale

Point-of-care ultrasound diagnosis of stump appendicitis in the emergency department

Stump appendicitis (SA) is a rare entity in patients with a history of appendectomy and may result in missed or delayed diagnosis. We report a case of SA diagnosed by emergency department (ED) point-of-care ul...

Authors: Apichaya Monsomboon, Bret P. Nelson, Phillip Andrus and James W. Tsung

Diagnostic value of whole-body-focused ultrasonography in high-acuity patients in the emergency department: a prospective single-center cross-sectional study

A fast and diagnostic accurate tool to assess the unselected category of high-acuity patients, in whom the underlying pathology is not always obvious, is needed in the emergency departments (ED). We aim to des...

Authors: M. Riishede, C. B. Laursen, L. S. Teglbjærg, E. Rancinger, P. B. Pedersen, S. M. Luef, J. H. Clausen, O. Graumann, A. T. Lassen and G. Baatrup

A road map for point-of-care ultrasound training in internal medicine residency

Ever-expanding uses have been developed for ultrasound, including its focused use at the bedside, often referred to as point-of-care ultrasound (POCUS). POCUS has been well developed and integrated into traini...

Authors: Charles M. LoPresti, Daniel J. Schnobrich, Renee K. Dversdal and Frank Schembri

Changes in speckle-tracking-derived mechanical dispersion index are associated with 30-day readmissions in acute heart failure

The objective of the present study was to evaluate the relationship between speckle-tracking-derived parameters left ventricular (LV) mechanical dispersion index (MDI), defined as the standard deviation of the...

Authors: Mark Favot, Robert Ehrman, Laura Gowland, Ashley Sullivan, Brian Reed, Aiden Abidov and Phillip Levy

Cardiac A-lines in fast scan as a sign of pneumopericardium

Traumatic pneumopericardium is rare and usually results from blunt injury. Diagnosis through clinical and chest X-ray is often difficult. Ultrasound findings of A-line artifacts in the cardiac window may sugge...

Authors: Julina Md Noor and Elisa A. Eddie

Basic critical care echocardiography training of intensivists allows reproducible and reliable measurements of cardiac output

Although pulmonary artery catheters (PACs) have been the reference standard for calculating cardiac output, echocardiographic estimation of cardiac output (CO) by cardiologists has shown high accuracy compared...

Authors: Christian Villavicencio, Julen Leache, Judith Marin, Iban Oliva, Alejandro Rodriguez, María Bodí and Nilam J. Soni

Temporary transvenous pacing guided by the combined use of ultrasound and intracavitary electrocardiography: a feasible and safe technique

Temporary transvenous pacing is a crucial procedure in emergency and critical care medicine. While fluoroscopy guidance is considered the gold-standard to place the temporary pacing electrode catheter (EC), it...

Authors: Pablo Blanco

Persistent hypoxemia after an asthma attack

The presence of an unknown intracardiac shunt due to a patent foramen ovale may be an unusual cause of hypoxemia. We report the case of a patient who presented persistent hypoxemia after an adequate treatment ...

Authors: Cristian Deana, Laura Conangla, Luigi Vetrugno, Massimiliano Saltarini, Stefania Buttera, Tiziana Bove, Flavio Bassi and Amato De Monte

Correlation of OSCE performance and point-of-care ultrasound scan numbers among a cohort of emergency medicine residents

Point-of-care ultrasound (POCUS) is an important clinical tool for a growing number of medical specialties. The current American College of Emergency Physicians (ACEP) Ultrasound Guidelines recommend that trai...

Authors: Youyou Duanmu, Patricia C. Henwood, Sukhjit S. Takhar, Wilma Chan, Joshua S. Rempell, Andrew S. Liteplo, Viktoria Koskenoja, Vicki E. Noble and Heidi H. Kimberly

A narrative review of diaphragm ultrasound to predict weaning from mechanical ventilation: where are we and where are we heading?

The use of ultrasound to visualize the diaphragm is well established. Over the last 15 years, certain indices of diaphragm function, namely diaphragm thickness, thickening fraction and excursion have been esta...

Authors: Peter Turton, Sondus ALAidarous and Ingeborg Welters

Fat embolism in right internal jugular vein: incidental ultrasound finding during internal jugular vein cannulation

We report a case study of fat embolism seen on ultrasound at right internal jugular vein during central venous cannulation in a patient diagnosed with fat embolism syndrome. This case demonstrates the importan...

Authors: Osman Adi, Chan Pei Fong, Azlizawati Azil and Shaik Farid Abdul Wahab

Clinical measurements obtained from point-of-care ultrasound images to assess acquisition skills

Current methods of assessing competence in acquiring point-of-care ultrasound images are inadequate. They rely upon cumbersome rating systems that do not depend on the actual outcome measured and lack evidence...

Authors: Brian P. Lucas, Antonietta D’Addio, Clay Block, Harold L. Manning, Brian Remillard and James C. Leiter

Point-of-care ultrasound evaluation and puncture simulation of the internal jugular vein by medical students

To show that medical students can evaluate the internal jugular vein (IJV) and its anatomical variations after rapid and focused training. We also aimed to evaluate the success rate of IJV puncture in simulati...

Authors: José Muniz Pazeli Jr., Ana Luisa Silveira Vieira, Rosimary Souza Vicentino, Luisa Jabour Pazeli, Bernardo Costa Lemos, Marinna Marques Rodrigues Saliba, Pedro Andrade Mello and Maurício Dutra Costa

Interpretation errors in focused cardiac ultrasound by novice pediatric emergency medicine fellow sonologists

Focused cardiac ultrasound (FOCUS) is a core competency for pediatric emergency medicine (PEM) fellows. The objectives of this study were (1) to evaluate test characteristics of PEM-fellow-performed FOCUS for ...

Authors: Rosemary Thomas-Mohtat, Craig Sable, Kristen Breslin, Jacqueline G. Weinberg, Aparna Prasad, Lauren Zinns and Joanna S. Cohen

Mitral valve velocity time integral and passive leg raise as a measure of volume responsiveness

Fluid responsiveness is an important topic for clinicians. Aggressive hydration has been shown to lead to worse outcomes. The aim of this study was to investigate the sensitivity and specificity of mitral valv...

Authors: Ralphe Bou Chebl, Gilbert Abou Dagher, Jeffrey Wuhantu, Rana Bachir and Jennifer Carnell

Diagnostic performance of abdominal point of care ultrasound performed by an emergency physician in acute right iliac fossa pain

Right iliac fossa abdominal pain is a common reason for emergency ward admissions, its etiology is difficult to diagnose. It can be facilitated by an imaging examination, such as a Computerized Tomography scan...

Authors: Jean-Eudes Bourcier, Emeric Gallard, Jean-Philippe Redonnet, Magali Majourau, Dominique Deshaie, Jean-Marie Bourgeois, Didier Garnier and Thomas Geeraerts

Strain analysis for the identification of hypertensive cardiac end-organ damage in the emergency department

Hypertensive emergency is a life-threatening state. End-organ damage affecting the heart accounts for up to 52% of hypertensive emergencies commonly encountered in the emergency department. Recent evidence ind...

Authors: Pavitra Kotini-Shah, Susana Cuadros, Felix Huang and Joseph S. Colla

Transient systolic anterior motion with junctional rhythm after mitral valve repair in the intensive care unit

Systolic anterior motion (SAM) after mitral valve repair (MVR) can adversely affect hemodynamics due to exacerbation of left ventricular outflow tract obstruction and mitral regurgitation. Intraoperative trans...

Authors: Yusuke Seino, Nobuo Sato, Kimiya Fukui, Junya Ishikawa, Masahi Nakagawa and Takeshi Nomura

Which ultrasound transducer type is best for diagnosing pneumothorax?

An accurate physical examination is essential in the care of critically ill and injured patients. However, to diagnose or exclude a pneumothorax, chest auscultation is unreliable compared to lung ultrasonograp...

Authors: R. Ketelaars, E. Gülpinar, T. Roes, M. Kuut and G. J. van Geffen

Ultrasound-guided thoracostomy site identification in healthy volunteers

Traditional landmark thoracostomy technique has a known complication rate up to 30%. The goal of this study is to determine whether novice providers could more accurately identify the appropriate intercostal s...

Authors: Lindsay A. Taylor, Michael J. Vitto, Michael Joyce, Jordan Tozer and David P. Evans

Diagnosis of diastolic dysfunction in the emergency department: really at reach for minimally trained sonologists? A call for a wise approach to heart failure with preserved ejection fraction diagnosis in the ER

Authors: Gabriele Via and Guido Tavazzi

Is point-of-care ultrasound disruptive innovation? Formulating why POCUS is different from conventional comprehensive ultrasound

Point-of-care ultrasound (PoCUS) is spreading throughout Emergency Medicine, Critical Care and Pre-hospital Care. However, there is an underlying inherited conflict with the established specialties performing ...

Authors: Jesper Weile, Jacob Brix and Anders Broens Moellekaer

Combined lung and brain ultrasonography for an individualized “brain-protective ventilation strategy” in neurocritical care patients with challenging ventilation needs

When intracranial hypertension and severe lung damage coexist in the same clinical scenario, their management poses a difficult challenge, especially as concerns mechanical ventilation management. The needs of...

Authors: Francesco Corradi, Chiara Robba, Guido Tavazzi and Gabriele Via

Pre-hospital lung ultrasound for cardiac heart failure and COPD: is it worthwhile?

Pre-hospital ultrasound is a new challenge and lung ultrasound could be an interesting opportunity in the pre-hospital medical service. The aim of our study was to evaluate the efficacy of lung ultrasound in o...

Authors: Mirko Zanatta, Piero Benato, Sigilfredo De Battisti, Concetta Pirozzi, Renato Ippolito and Vito Cianci

Lung ultrasound training: a systematic review of published literature in clinical lung ultrasound training

Clinical lung ultrasound examinations are widely used in the primary assessment or monitoring of patients with dyspnoea or respiratory failure. Despite being increasingly implemented, there is no international...

Authors: Pia Iben Pietersen, Kristian Rørbæk Madsen, Ole Graumann, Lars Konge, Bjørn Ulrik Nielsen and Christian Borbjerg Laursen

Is it best to reFOCUS on basic echocardiography in the emergency department?

Authors: Pablo Blanco and Gabriela Bello

Today’s advanced is tomorrow’s basic

Authors: Joe Betcher, Al Majkrzak, Ross Kessler, Nik Theyyunni and Rob Huang

The implementation of a longitudinal POCUS curriculum for physicians working at rural outpatient clinics in Chiapas, Mexico

Medical care in resource limited settings is challenging, particularly with limited access to diagnostic and imaging studies. The most portable and cost effective diagnostic imaging in these areas is ultrasoun...

Authors: Annie Heffernan Rominger, Gerardo Antonio Aguilar Gomez and Patrick Elliott

ABCDE of prehospital ultrasonography: a narrative review

Prehospital point-of-care ultrasound used by nonradiologists in emergency medicine is gaining ground. It is feasible on-scene and during aeromedical transport and allows health-care professionals to detect or ...

Authors: Rein Ketelaars, Gabby Reijnders, Geert-Jan van Geffen, Gert Jan Scheffer and Nico Hoogerwerf

An easier and safe affair, pleural drainage with ultrasound in critical patient: a technical note

Thoracic ultrasound is a powerful diagnostic imaging technique for pleural space disorders. In addition to visualising pleural effusion, thoracic ultrasound also helps clinicians to identify the best puncture ...

Authors: Luigi Vetrugno, Giovanni Maria Guadagnin, Daniele Orso, Enrico Boero, Elena Bignami and Tiziana Bove

Application of robotic transcranial Doppler for extended duration recording in moderate/severe traumatic brain injury: first experiences

Authors: F. A. Zeiler and P. Smielewski

Icterus and abdominal pain: an unexpected, rare sonographic finding in a Peruvian Emergency Department

The use of point-of-care ultrasound (POCUS) has become increasingly important in resource-limited settings. It can rapidly diagnose both tropical infectious diseases and more common pathology at the bedside. I...

Authors: Stephanie J. Doniger and Alexander Wang

The impact of heart, lung and diaphragmatic ultrasound on prediction of failed extubation from mechanical ventilation in critically ill patients: a prospective observational pilot study

Failed extubation from mechanical ventilation in critically ill patients is multifactorial, complex and not well understood. We aimed to identify whether combined transthoracic echocardiography, lung and diaph...

Authors: Kavi Haji, Darsim Haji, David J. Canty, Alistair G. Royse, Cameron Green and Colin F. Royse

The Area method: a new method for ultrasound assessment of diaphragmatic movement

Ultrasound can be used to assess diaphragm movement. Existing methods focus on movement at a single point at the hemidiaphragm and may not consider the anatomic and functional complexity. We aimed to develop a...

Authors: Søren Helbo Skaarup, Anders Løkke and Christian B. Laursen

Lung and diaphragm ultrasound as predictors of success in weaning from mechanical ventilation

Lung and diaphragm ultrasound methods have recently been introduced to predict the outcome of weaning from mechanical ventilation (MV). The aim of this study is to assess the reliability and accuracy of these ...

Authors: Eva Tenza-Lozano, Ana Llamas-Alvarez, Enrique Jaimez-Navarro and Javier Fernández-Sánchez

Problems with interpretation of transient hyperemic response ratio (THRR)

Authors: Achyut Sharma and Diptesh Aryal

Feasibility study of advanced focused cardiac measurements within the emergency department

This study aims to compare the increased time needed to perform advanced focused cardiac measurements in the emergency department, including diastolic heart failure evaluation via E/E′, and cardiac output with...

Authors: Joe Betcher, Al Majkrzak, Jim Cranford, Ross Kessler, Nik Theyyunni and Rob Huang

Prospective evaluation of cardiac ultrasound performance by general internal medicine physicians during a 6-month faculty development curriculum

Point-of-care (POCUS) education is rapidly expanding within medical schools and internal medicine residency programs, but lack of trained faculty is a major barrier. While POCUS training can improve short-term...

Authors: Christopher J. Smith, Abdulrahman Morad, Christopher Balwanz, Elizabeth Lyden and Tabatha Matthias

Point-of-care lung ultrasound for diagnosis of Pneumocystis jirovecii pneumonia: notes from the field

Thoracic ultrasound is helpful to evaluate lung pathology in patients with acute dyspnea. Several studies have demonstrated the efficacy of point-of-care ultrasound in patients with extrapulmonary TB and HIV c...

Authors: Maria Teresa Giordani, Francesca Tamarozzi, Daniel Kaminstein, Enrico Brunetti and Tom Heller

eFAST for the diagnosis of a perioperative complication during percutaneous nephrolithotomy

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 anesthesi...

Authors: Achyut Sharma, Prajjwal Bhattarai and Apurb Sharma

Ultrasound assessment of visual loss during severe preeclampsia: a case report

Bilateral retinal detachments and cortical blindness are rare complications of preeclampsia and the association of the two pathologies is exceptional. We report the case of a preeclamptic patient who presented...

Authors: Fehmi Ferhi, Abdeljalil Khlifi, Feten Hachani, Khalil Tarmiz and Khaled Benjazia

Acute fissuration of a giant splenic artery aneurysm detected by point-of-care ultrasound: case report

Epigastric pain is frequent in Emergency Medicine and remains a challenging situation. Besides benign etiologies such as gastritis or uncomplicated cholelithiasis, it could reveal myocardial infarction or vasc...

Authors: Philippe Le Conte, David Trewick, Philippe Pes, Eric Frampas and Eric Batard

Emergency physician use of tissue Doppler bedside echocardiography in detecting diastolic dysfunction: an exploratory study

This study evaluates the agreement between emergency physician (EP) assessment of diastolic dysfunction (DD) by a simplified approach using average peak mitral excursion velocity (eʹ_A) and an independent cardiolo...

Authors: Marina Del Rios, Joseph Colla, Pavitra Kotini-Shah, Joan Briller, Ben Gerber and Heather Prendergast

Ultrasound evaluation of the airway in the ED: a feasibility study

Recognition of the difficult airway is a critical element of emergency practice. Mallampati score and body mass index (BMI) are not always predictive and they may be unavailable in critically ill patients. Ult...

Authors: Elizabeth A. Hall, Ibrahim Showaihi, Frances S. Shofer, Nova L. Panebianco and Anthony J. Dean

Transcranial Doppler ultrasound in the ICU: it is not all sunshine and rainbows

Authors: Pablo Blanco and Anselmo Abdo-Cuza

Early abnormal transient hyperemic response test can predict delayed ischemic neurologic deficit in subarachnoid hemorrhage

Early detection of vasospasm is crucial to prevent significant delayed ischemic neurological deficit post subarachnoid hemorrhage. The standard methods of detection, including cerebral angiogram and computed t...

Authors: Hosam Al-Jehani, Mark Angle, Judith Marcoux and Jeanne Teitelbaum

Abstracts from the 13th WINFOCUS World Congress on Ultrasound in Emergency & Critical Care

Authors: Stephen Alerhand, Adam Nevel, Bret Nelson, Michael Halperin, Felipe Serrano, Gregor Prosen, Tjaša Banović, Stephanie J. Doniger, Mirjana Brvar, Barbara Furman, P. Gallego Rodríguez, Tomas Villén Villegas, A. Trueba Vicente, L. W. Alba Muñoz, C. Guillén Astete, N. Díaz García…