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J Clin Monit Comput 2021 Apr 20. Epub 2021 Apr 20.

Department of Intensive Care, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey.

This study aimed to evaluate the relationship between ultrasonographic gastric antral measurements and aspirated gastric residual volume (GRV) in mechanically ventilated critically ill patients receiving enteral nutrition (EN). This prospective observational study included 56 enterally-fed critically ill patients in one-year period. All imaging procedures were done at 30-degree head-of-bed elevation and supine position on epigastric region of abdomen with 2. Read More

Am J Case Rep 2021 Apr 17;22:e928889. Epub 2021 Apr 17.

5G Law Firm, PLLC, Woodward, OK, USA.

BACKGROUND We report the case of a patient undergoing a colonoscopy during which pressure applied on the abdomen by a nurse assisting in the procedure caused an extraluminal mesenteric tear. Mesenteric tears can be life-threating and need to be managed appropriately. This is the first case reported in the literature describing abdominal counter-pressure applied in the endoscopic procedure room as the cause of traumatic bowel injury. Read More

Pediatr Emerg Care 2021 Apr;37(4):226-229

From the Children's Emergency, KK Women's and Children's Hospital, Singapore.

Background: Tuberculosis of the abdomen is one of the most common extrapulmonary manifestations of tuberculosis. Even in areas where tuberculosis is endemic, intra-abdominal tuberculous can pose a diagnostic and management challenge because of the lack of presence of overt clinical signs and availability of expertise for point of care diagnostics. Point-of-care ultrasound (POCUS) of the abdomen performed by emergency physicians is increasingly being used for a variety of clinical presentations to facilitate accurate diagnoses in the emergency department. Read More

AJR Am J Roentgenol 2021 05 11;216(5):1392-1399. Epub 2021 Mar 11.

Instituto de Radiologia (InRad), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av Dr. Enéas Carvalho de Aguiar, 255, Sao Paulo, Brazil 05403-000.

Yellow fever is a hemorrhagic disease caused by an arbovirus endemic in South America; outbreaks have occurred in recent years. The purpose of this study was to describe abdominal ultrasound findings in patients with severe yellow fever and correlate them with clinical and laboratory data. A retrospective cohort study was performed between January and April 2018. Read More

Can J Anaesth 2021 Mar 24;68(3):376-386. Epub 2020 Nov 24.

Department of Anesthesia, University of Western Ontario, London, ON, Canada.

Point-of-care ultrasound (POCUS) uses ultrasound at the bedside to aid decision-making in acute clinical scenarios. The increased use of ultrasound for regional anesthesia and vascular cannulation, together with more anesthesiologists trained in transesophageal echocardiography have contributed to the widespread use of POCUS in perioperative care. Despite the support of international experts, the practice of POCUS in perioperative care is variable as Canadian guidelines for anesthesiologists do not currently exist. Read More

Ultraschall Med 2020 Aug 4;41(4):362-386. Epub 2020 Aug 4.

Internal Medicine, Luigi Sacco University Hospital, Milano, Italy.

As the availability of portable echocardiographic equipment is becoming more and more widespread, physicians can add a powerful tool to their bedside examination skills, thus helping them to more effectively face the growing complexity of patients admitted to internal medicine departments or the emergency room. Focused cardiac ultrasound (FoCUS) can be defined as a goal-directed, simplified, qualitative examination performed at the bedside using portable echocardiographic devices. FoCUS is not meant to be a substitute for a standard 2D color Doppler echocardiographic examination. Read More

Rev Recent Clin Trials 2020;15(4):269-277

Department of Anesthesiology and Emergency Sciences-Emergency Medicine Division, Policlinico Gemelli/IRCCSUniversity of Catholic of Sacred Heart, Rome, Italy.

Background: In the last years, ultrasound technology has entered clinical practice as a tank and today, it has also allowed no-cardiologists to extend their medical examination without needing to call the consultant and having a good profile of diagnostic accuracy. The ultrasound bedside does not replace the consultant, but it allows not to perform inappropriate consultations with more savings for hospitals.

Objective: The aim was to review the recently published literature to inform the clinician about the most up to date management of use bedside echography in the emergency setting. Read More

Mil Med 2020 12;185(11-12):2171-2172

Department of Family Medicine, Mike O'Callaghan Military Medical Center, Nellis Air Force Base, 4700 N Las Vegas Blvd, Las Vegas, NV 89191.

We report a case of acute urinary retention in an adolescent female secondary to hematocolpos. A 13-year-old female presented to the emergency department with acute urinary retention and suprapubic abdominal pain for 24 hours. She denied menstruation or sexual history. Read More

Cureus 2020 Jun 8;12(6):e8503. Epub 2020 Jun 8.

Emergency Medicine, Hospital Corporation of America West Florida Graduate Medical Education Consortium/Brandon Regional Hospital, University of South Florida Morsani College of Medicine, Brandon, USA.

Prompt and accurate diagnostic evaluation of the nontraumatic acute abdomen in the emergency department (ED) is crucial to lessen mortality burden. In patients with perforated viscus and pneumoperitoneum, point-of-care ultrasound (POCUS) can assist the emergency physician (EP) in the rapid bedside diagnosis. This report describes a case in which EP-performed POCUS led to the early detection and timely management of an atypical presentation of pneumoperitoneum. Read More

Clin Hemorheol Microcirc 2020 ;75(1):19-26

Institute of Biotechnology, Brandenburg University of Technology, Senftenberg, Germany.

Aim: Use of contrast enhanced ultrasound (CEUS) in severe cases of COVID-19 infection to assess pulmonary changes near the pleura.

Material And Methods: Bedside examinations by an experienced intensive care unit examiner using a multi-frequency probe (C1-6 MHz) with B-mode and CEUS to assess pleural-near changes in severe cases of COVID-19 infection with respiratory failure. CEUS with bolus delivery via a central venous catheter of 2. Read More

J Ultrasound 2020 Jun 2;23(2):175-181. Epub 2020 May 2.

Interventional Ultrasound Unit, Pineta Grande Hospital, SS Domitiana, KM 30,00, 81030, Castel Volturno, CE, Italy.

Purpose: To assess the role of intracavitary contrast-enhanced ultrasound (IC-CEUS) as a focused ultrasound (US) examination aimed at supporting a single physician in the management of interventional procedures for abdominal fluid collections/abscesses.

Methods: In 43 patients (27 M/16 F, median age 68 years, range 35-91), a single physician performed catheter drainage (42) or needle aspiration (3) for the following: 14 infected abdominal fluid collections, 11 non-infected abdominal fluid collections, 9 pyogenic liver abscesses, 8 gallbladder empyema, and 3 infected pancreatic fluid collections. IC-CEUS (0. Read More

Clin Hemorheol Microcirc 2020 ;74(4):353-361

Institute of Biotechnology, Brandenburg University of Technology, Senftenberg, Germany.

In the hands of experienced examiners, the contrast enhanced sonography (CEUS) offers the possibility to analyze dynamic microcirculatory disturbances in real time dynamically without any risk for kidneys and thyroid gland even in severe progressing disease bedside. Based on severe COVID-19 infections, first experiences with abdominal CEUS examinations are presented. In the stage of an imminent organ failure with significantly reduced kidney and liver function, CEUS can be used to show a narrowing of the organ-supplying arteries, as well as a delayed capillary filling of vessels near the capsule, a regional reduced parenchymal perfusion or an inflammatory hyperemia with capillary hypercirculation. Read More

JPEN J Parenter Enteral Nutr 2021 01 15;45(1):136-145. Epub 2020 Apr 15.

Nutrition Department, Alfred Health, Melbourne, Australia.

Introduction: The development of bedside methods to assess muscularity is an essential critical care nutrition research priority. We aimed to compare ultrasound-derived muscle thickness at 5 landmarks with computed tomography (CT) muscle area at intensive care unit (ICU) admission. Secondary aims were to (1) combine muscle thicknesses and baseline covariates to evaluate correlation with CT muscle area and (2) assess the ability of the best-performing ultrasound model to identify patients with low CT muscle area. Read More

Cureus 2020 Mar 7;12(3):e7199. Epub 2020 Mar 7.

Emergency Medicine, Hamad Medical Corporation, Doha, QAT.

A 73-year-old man with a history of follicular lymphoma ten years ago with complete remission presented to the emergency room with a large unilateral left-leg swelling as the only symptom. Doppler ultrasonography ruled out deep vein thrombosis. Bedside point-of-care ultrasound (PoCUS) revealed left moderate hydronephrosis. Read More

Med Biol Eng Comput 2020 May 24;58(5):943-965. Epub 2020 Feb 24.

Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK.

Post-void alarm systems to monitor bedwetting in nocturnal enuresis (NE) have been deemed unsatisfactory. The aim of this study is to develop a safe, comfortable and non-invasive pre-void wearable alarm and associated technologies using advanced mechatronics. Each stage of development includes patient and public involvement and engagement (PPI). Read More

Am J Emerg Med 2020 05 20;38(5):1044.e1-1044.e2. Epub 2019 Dec 20.

Department of Emergency Medicine, Bridgeport Hospital, 267 Grant St, Bridgeport, CT 06610, USA.

Novel oral anticoagulants (NOACs) are increasingly popular. Spontaneous splenic rupture is rare and life-threatening, especially if it is not immediately recognized. Prior work has demonstrated an association with NOAC use and spontaneous splenic rupture in unusual clinical circumstances. Read More

BMC Emerg Med 2019 11 21;19(1):70. Epub 2019 Nov 21.

Department of Emergency Medicine Ha-Refu'a St 7, Samson Assuta Ashdod Medical Center, 7747629, Ashdod, Israel.

Background: Occult hemorrhagic shock secondary to uterine rupture represents a true obstetric emergency and can result in significant morbidity and mortality for both the patient and the fetus. Multiparity and prior cesarean sections are known risk factors. Typically, these patients present late in gestation, often secondary to the physiologic stresses on the uterus related to contractions. Read More

Ultraschall Med 2020 Feb 19;41(1):36-43. Epub 2019 Nov 19.

AG Medizindidaktik, Heinrich-Heine-University, Duesseldorf, Germany.

Background:  Diagnostic ultrasound has a crucial importance in clinical settings, especially in intensive care medicine where bedside ultrasound has become indispensable. Medical students as well as residents therefore have a strong interest in learning this useful skill. Since staff resources are limited, more and more universities are using student tutors in a peer-assisted learning concept (PAL) to teach medical students early in their training. Read More

Adv Emerg Nurs J 2019 Oct/Dec;41(4):290-305

University of Miami School of Nursing and Health Studies, Coral Gables, Florida. (Drs González, Ortega, Crenshaw, de Tantillo); and Jacksonville University, Keigwin School of Nursing, Jacksonville, Florida (Dr de Tantillo).

Use of bedside ultrasonography to identify life-threatening injuries for patients with blunt and penetrating trauma is the standard of care in the emergency department. The "FAST" examination-focused assessment with sonography for trauma-ultrasound scan of the chest and abdomen allows clinicians to assess critical regions for free fluid without use of invasive procedures as quickly and as often as needed. In addition, ultrasonography has a high degree of sensitivity and specificity and is safe during pregnancy. Read More

Medicina (Kaunas) 2019 Oct 28;55(11). Epub 2019 Oct 28.

Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.

Background And Objectives: Ultrasonography is useful in evaluating patients with renal colic and it has high sensitivity and specificity for diagnosing ureter stones by revealing hydronephrosis. We evaluated the efficacy of point-of-care ultrasonography protocol in managing patients with acute renal colic who visited the emergency department (ED).

Materials And Methods: Between March 2019 and July 2019, patients who visited the ED because of renal colic were randomly assigned by date of visit either to the conventional group (CG), who underwent routine diagnostic work-up without ultrasonography, or to the ultrasonography group (UG), who underwent bedside ultrasonography as an initial diagnostic testing. Read More

Chest 2020 03 18;157(3):574-579. Epub 2019 Oct 18.

Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY.

Arterial catheterization is frequently performed in ICUs to facilitate hemodynamic monitoring and frequent blood sampling. Overall, arterial catheterization has high success and low complication rates, but in patients who are critically ill, the incidence of failure is higher because of hypotension, peripheral edema, and obesity. Ultrasound guidance significantly increases the likelihood of successful cannulation and decreases complications compared with traditional landmark-based techniques. Read More

Ultrasound J 2019 Sep 30;11(1):24. Epub 2019 Sep 30.

Intensive Care Unit, Asociación Española Primera de Socorros Mutuos, Montevideo, Uruguay.

Background: 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.

Objective: To measure the impact of POCUS on resource utilization, diagnostic accuracy, and clinical management in medical-surgical intensive care units (ICUs).

Methods: Prospective, controlled study, in two polyvalent ICUs. Read More

Pediatr Transplant 2019 11 31;23(7):e13565. Epub 2019 Aug 31.

Department of Pediatric Radiology, University Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

IAH after LTX can impair perfusion and threaten graft viability. This study aimed to assess the feasibility of longitudinal IAP measurements as an IAH screening method in children after LTX. A cohort of 23 children with a mean age (range) 3. Read More

Clin Med Res 2020 08 19;18(2-3):102-108. Epub 2019 Jul 19.

Marshfield Clinic Research Institute, 1000 North Oak Avenue, Marshfield, Wisconsin, USA.

Background: Percussion and auscultation are derived from the Latin words to touch and hear, respectively. Covered are abdominal percussion signs and ausculatory signs discovered from 1924 to 1980. Signs ascribed as medical eponyms pay homage to these physicians who provided new and unique insights into disease. Read More

Ultraschall Med 2020 Jun 26;41(3):308-316. Epub 2019 Apr 26.

Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany.

Purpose:  The aim of the current study was to evaluate point of care ultrasound (POCUS) in geriatric patients by echoscopy using a handheld ultrasound device (HHUSD, VScan) at bedside in comparison to a high-end ultrasound system (HEUS) as the gold standard.

Materials And Methods:  Prospective observational study with a total of 112 geriatric patients. The ultrasound examinations were independently performed by two experienced blinded examiners with a portable handheld device and a high-end ultrasound device. Read More

Indian J Radiol Imaging 2019 Jan-Mar;29(1):94-97

Children's Hospital Cardiology Center, Women's and Children's Hospital, University of Missouri Health Care, Columbia, USA.

Ultrasonographic (US) guided procedures have wide range of application in the abdomen and pelvis, however their role is somewhat limited in the chest due to complete reflection of the ultrasound beam by the air in the lungs, preventing the direct imaging of the tissues deep to the air-sound interface. Most of the chest procedures, other than the exception of thoracentesis, rely on the use of CT (computed tomography) scan. The disadvantages of using CT scan is the cost, lack of portability, and most importantly the radiation involved, particularly in case of infants and children, whose tissues are more radiosensitive than the adults. Read More

Malar J 2018 Dec 4;17(1):448. Epub 2018 Dec 4.

Malaria Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia.

Background: Plasmodium knowlesi, a malaria parasite typically found in long-tailed and pig-tailed macaques, is the most common cause of human malaria in Malaysian Borneo. Infections in humans result in a spectrum of disease, including fatal outcomes. Spontaneous splenic rupture is a rare, but severe complication of malaria and has not been reported previously for knowlesi malaria. Read More

Cureus 2018 Sep 17;10(9):e3320. Epub 2018 Sep 17.

Emergency Medicine, Saint John Regional Hospital, Saint John, CAN.

Introduction Self-directed learning in medical professions is established as an effective method of training in certain modalities. Furthermore, simulation technology is becoming widely used and accepted as a valid method of training for various medical skills, with ultrasound being one of the best studied. The use of point-of-care ultrasound (PoCUS) in the practice of emergency medicine is well established, and PoCUS is a core competency of the Royal College of Physicians and Surgeons of Canada emergency medicine standards. Read More

Crit Ultrasound J 2018 Nov 23;10(1):31. Epub 2018 Nov 23.

Anesthesiology and Critical Care Department, Toulouse University Hospital, University Toulouse III Paul Sabatier, Toulouse, France.

Background: 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 which exposes the patient to ionizing radiation and implies delays. A bedside ultrasound performed by emergency physicians could avoid these issues. Read More