Articles

The role of point-of-care ultrasound in the diagnosis and management of necrotizing soft tissue infections

Necrotizing soft tissue infections are associated with high morbidity and mortality, even when the correct treatment is initiated. The diagnosis of these conditions is hard and the most sensitive methods are t...

Authors: Luís Magalhães, Sara Raquel Pereira Martins and Ramon Nogué

How POCUS picks up a rare mimickers of acute appendicitis in the emergency department

Appendicitis is the most common surgical abdominal emergency. Punctual diagnosis and rapid operative treatment of acute appendicitis are critically important, as it reduces the risk of complications, associate...

Authors: Shihab Al Sheikh, Mariam Al Ali, Dhanya Sochel Kiran and Mohsen Al Tabatabai

Feasibility of cardiac output measurements in critically ill patients by medical students

Critical care ultrasonography (CCUS) is increasingly applied also in the intensive care unit (ICU) and performed by non-experts, including even medical students. There is limited data on the training efforts n...

Authors: Geert Koster, Thomas Kaufmann, Bart Hiemstra, Renske Wiersema, Madelon E. Vos, Devon Dijkhuizen, Adrian Wong, Thomas W. L. Scheeren, Yoran M. Hummel, Frederik Keus and Iwan C. C. van der Horst

Bedside ultrasound in cardiac standstill: a clinical review

Patients with cardiac arrest present as a relatively frequent occurrence in the Emergency Department. Despite the advances in our understanding of the pathophysiology of cardiac arrest, managing the condition ...

Authors: Laila Hussein, Mohammad Anzal Rehman, Ruhina Sajid, Firas Annajjar and Tarik Al-Janabi

Cardiac ultrasound in resource-limited settings (CURLS): towards a wider use of basic echo applications in Africa

Point-of-care ultrasound is increasingly being used as a diagnostic tool in resource-limited settings. The majority of existing ultrasound protocols have been developed and implemented in high-resource setting...

Authors: Michaëla A. M. Huson, Dan Kaminstein, Daniel Kahn, Sabine Belard, Prakash Ganesh, Vanessa Kandoole-Kabwere, Claudia Wallrauch, Sam Phiri, Benno Kreuels and Tom Heller

Factors affecting perception of the normal pediatric appendix on sonography

To determine if an inherent perception skill along with sonographer experience, knowledge base, scanning time play a role in the identification of the normal appendix in the pediatric population. This is a ret...

Authors: Denise Castro, Joseph Yang, Prasan Patel, Eric Sauerbrei, Wilma Hopman, Mila Kolar and Don Soboleski

Sonographic features of carotid artery dissection due to extension of aortic dissection: a case report

Carotid artery dissection due to extension of aortic dissection (CAEAD) is a severe complication of acute aortic dissection. The risk of ischemic stroke is increased. Early sonographic detection and repeat eva...

Authors: Christian Boßelmann and Sven Poli

Point-of-care ultrasound in primary care: a systematic review of generalist performed point-of-care ultrasound in unselected populations

Both the interest and actual extent of use of point-of-care ultrasound, PoCUS, among general practitioners or family physicians are increasing and training is also increasingly implemented in residency program...

Authors: Bjarte Sorensen and Steinar Hunskaar

Hepatic and portal vein Dopplers in the clinical management of patients with right-sided heart failure: two case reports

Patients with right heart failure pose significant volume management challenges for hemodynamic optimization. We present two cases in which point of care ultrasound (POCUS) of the hepatic and portal veins cont...

Authors: Matthew Jefkins and Barry Chan

Diagnostic value of transcranial ultrasonography for selecting subjects with large vessel occlusion: a systematic review

A number of pre-hospital clinical assessment tools have been developed to triage subjects with acute stroke due to large vessel occlusion (LVO) to a specialised endovascular centre, but their false negative ra...

Authors: Daria Antipova, Leila Eadie, Ashish Stephen Macaden and Philip Wilson

The development of a provincial multidisciplinary framework of consensus-based standards for Point of Care Ultrasound at the University of Saskatchewan

The development and adoption of Point-of-Care Ultrasound (POCUS) across disciplines have created challenges and opportunities in implementing training and utilization standards. Within the context of a large, ...

Authors: Paul Olszynski, Daniel J. Kim, Irene W. Y. Ma, Michelle Clunie, Peggy Lambos, Tom Guzowski, Matthew Butz and Brent Thoma

Ultrasound-guided peripheral venous cannulation in critically ill patients: a practical guideline

Up to one-third of critically ill patients have difficult intravenous access (DIVA). This occurs often in obese patients, those with generalized edemas or in patients with previous venous cannulations. In DIVA...

Authors: Pablo Blanco

The use of an external ultrasound fixator (Probefix) on intensive care patients: a feasibility study

In critical care medicine, the use of transthoracic echo (TTE) is expanding. TTE can be used to measure dynamic parameters such as cardiac output (CO). An important asset of TTE is that it is a non-invasive te...

Authors: M. J. Blans, F. H. Bosch and J. G. van der Hoeven

Renal resistive index: a new reversible tool for the early diagnosis and evaluation of organ perfusion in critically ill patients: a case report

We reported a case of early detection of peripheral hypoperfusion trough the evaluation of a new index in intensive care: Renal Doppler Resistive Index (RRI).

Authors: Antonio Anile, Silvia Ferrario, Lorena Campanello, Maria Antonietta Orban and Giacomo Castiglione

Comparisons of two diaphragm ultrasound-teaching programs: a multicenter randomized controlled educational study

This study aims to ascertain whether (1) an educational program is sufficient to achieve adequate Diaphragm Ultrasound (DUS) assessments on healthy volunteers and (2) combining a video tutorial with a practica...

Authors: Eugenio Garofalo, Andrea Bruni, Corrado Pelaia, Giovanni Landoni, Alberto Zangrillo, Massimo Antonelli, Giorgio Conti, Daniele Guerino Biasucci, Giovanna Mercurio, Andrea Cortegiani, Antonino Giarratano, Luigi Vetrugno, Tiziana Bove, Francesco Forfori, Francesco Corradi, Rosanna Vaschetto…

Clinical use of renal point-of-care ultrasound after extracorporeal shock wave lithotripsy

Extracorporeal shock wave lithotripsy is widely used to treat symptomatic nephrolithiasis. Complications of this procedure can occur and point-of-care ultrasound can help to diagnose and manage some of these c...

Authors: Luís Magalhães and Ramon Nogué

Impact of an ultrasound-driven diagnostic protocol at early intensive-care stay: a randomized-controlled trial

Point-of-care ultrasound (POCUS) is a tool in increasing use, but there is still a lack of basics for its routine use and evidence of its impact in intensive care.

Authors: Julio Pontet, Christian Yic, José L. Díaz-Gómez, Pablo Rodriguez, Igor Sviridenko, Diego Méndez, Sylvia Noveri, Ana Soca and Mario Cancela

ACUTE ABDOMEN systemic sonographic approach to acute abdomen in emergency department: a case series

Acute abdomen is a medical emergency with a wide spectrum of etiologies. Point-of-care ultrasound (POCUS) can help in early identification and management of the causes. The ACUTE–ABDOMEN protocol was created b...

Authors: Maryam Al Ali, Sarah Jabbour and Salma Alrajaby

Routine lung ultrasound to detect postoperative pulmonary complications following major abdominal surgery: a prospective observational feasibility study

Postoperative pulmonary complications after major abdominal surgery are associated with adverse outcome. The diagnostic accuracy of chest X-rays (CXR) to detect pulmonary disorders is limited. Alternatively, l...

Authors: H. R. Touw, A. E. Schuitemaker, F. Daams, D. L. van der Peet, E. M. Bronkhorst, P. Schober, C. Boer and P. R. Tuinman

Impact of ultrasound on management for dyspnea presentations in a Rwandan emergency department

The complexity of diagnosis for critically ill dyspnea presentations in the emergency department remains a challenge. Accurate and rapid recognition of associated life-threatening conditions is paramount for t...

Authors: Olivier Felix Umuhire, Michael B. Henry, Adam Carl Levine, Giles N. Cattermole and Patricia Henwood

Subcostal TAPSE: a retrospective analysis of a novel right ventricle function assessment method from the subcostal position in patients with sepsis

Tricuspid annular plane systolic excursion (TAPSE) is frequently used as an objective measure of right-ventricular dysfunction. Abnormal TAPSE values are associated with poor prognosis in a number of disease s...

Authors: Alison B. Main, Rachel Braham, Daniel Campbell, Andrew J. Inglis, Anthony McLean and Sam Orde

A rare ultrasound case report: intramuscular tear of the sartorius muscle

We report a case of a 65-year-old male patient who presented with localized swelling and lump in the proximal third of the upper thigh. Most common upper thigh injuries involve the quadriceps muscle group asso...

Authors: Kathryn Malherbe

Sonographic presentation of rice bodies in subacromial-subdeltoid chronic bursitis

subacromial-subdeltoid chronic bursitis is one of the main causes of shoulder pain syndrome. There are various causes of shoulder pain syndrome including chronic bursitis. The sonographic appearances of chroni...

Authors: Raham Bacha, Iqra Manzoor and Syed Amir Gilani

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