Search Our Scientific Publications & Authors

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

Am J Emerg Med 2019 Dec 20. 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

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

Clin Med Res 2019 Jul 19. Epub 2019 Jul 19.

University of Central Florida College of Medicine, Department of Internal Medicine, 6850 Lake Nona Blvd, Orlando, FL 32827; Email:

Background: Percussion and auscultation are derived from the Latin words to touch and hear respectively. Covered are abdominal percussion signs and ausculatory sign 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

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

Trauma Surg Acute Care Open 2018 1;3(1):e000165. Epub 2018 Oct 1.

Department of Surgery, University of Texas Health Science Center at Houston, Memorial Hermann Hospital Red Duke Trauma Institute, Houston, Texas, USA.

Resuscitative endovascular balloon occlusion of the aorta (REBOA) has become an increasingly popular alternative to emergency thoracotomy and aortic cross-clamping in patients with exsanguinating hemorrhage.1 This new capability is increasingly being used in non-trauma situations.2 3 This report demonstrates another novel use of REBOA for iatrogenic intra-abdominal hemorrhage. Read More

Med Klin Intensivmed Notfmed 2018 11 9;113(8):638-648. Epub 2018 Oct 9.

Sektion Interdisziplinäre Intensivmedizin, Sana Kliniken Lübeck GmbH, Kronsforder Allee 71-73, 23560, Lübeck, Deutschland.

Point-of-care ultrasound is a fundamental part of diagnostic and therapeutic management in emergency and intensive care medicine. The availability of high-resolution mobile ultrasound systems allows high-quality imaging at the bedside of the patient. Point-of-care ultrasound is not a comprehensive differential diagnostic abdominal ultrasound examination. Read More

Z Gastroenterol 2018 09 17;56(9):1063-1076. Epub 2018 Sep 17.

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

At the time of primary diagnosis, hematological diseases often present with unspecific symptoms, and abdominal sonography is performed as part of the initial diagnostic work-up. The detection of an enlarged spleen, of pathological lymph nodes or of other findings may help to suspect hematological diseases. Also, in case of suspected lymph node enlargement, sonography may be a first step. Read More

Nutrition 2019 01 24;57:225-230. Epub 2018 May 24.

Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada. Electronic address:

Objectives: Precise measures of adiposity are difficult to obtain in clinical settings due to a lack of access to accurate and reliable techniques. The aim of this study was to develop and internally validate a bedside-applicable ultrasound protocol to estimate fat mass index.

Methods: We conducted an observational cross-sectional study of 94 university and community dwelling adults who attended a single data-collection session. Read More

BMJ Case Rep 2018 Aug 29;2018. Epub 2018 Aug 29.

Emergency Medicine, Logan Hospital, Meadowbrook, Queensland, Australia.

A 34-year-old woman presented to hospital in shock 8 hours after a spontaneous home vaginal delivery. She is a known carrier of haemophilia A. Examination revealed a tender but firm, central and contracted uterus. Read More

Adv Pediatr 2018 08 15;65(1):121-142. Epub 2018 Jun 15.

Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Maimonides Medical Center, 4082 10th Avenue, Brooklyn, NY 11219, USA. Electronic address:

Biomed Eng Online 2018 Jul 13;17(1):95. Epub 2018 Jul 13.

Department of Urology, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany.

Background: Continuous non-invasive urinary bladder volume measurement (cystovolumetry) would allow better management of urinary tract disease. Electrical impedance tomography (EIT) represents a promising method to overcome the limitations of non-continuous ultrasound measurements. The aim of this study was to compare the measurement accuracy of EIT to standard ultrasound in healthy volunteers. Read More

Eur J Pediatr 2018 Oct 3;177(10):1459-1470. Epub 2018 Jul 3.

Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Contrast-enhanced ultrasound (CEUS) is a versatile imaging modality that improves the diagnostic potential of conventional ultrasound. It allows for portable imaging at the bedside. In this paper, we illustrate how CEUS can be used in evaluating several focal lesions in the pediatric population, including liver hemangioma, telangiectasias, splenic hamartomas, and bladder lesions. Read More

Oman Med J 2018 Mar;33(2):171-175

Department of Obstetrics and Gynecology, Dubai Hospital, Dubai, UAE.

Abdominal pregnancy is a rare, life-threatening condition defined as pregnancy in the peritoneal cavity exclusive of tubal, ovarian, or intraligamentary locations. It can be primarily located in the peritoneal cavity or secondary to a ruptured ectopic pregnancy or tubal abortion. We present two cases of abdominal pregnancy, one primary and another secondary, both diagnosed and successfully managed in our institution. Read More

Perfusion 2018 09 12;33(6):438-444. Epub 2018 Mar 12.

1 Department of Intensive Care, Royal Brompton Hospital, London, UK.

Introduction: Comprehensive clinical examination can be compromised in patients on veno-venous extracorporeal membrane oxygenation (VV-ECMO). Adjunctive diagnostic imaging strategies range from bedside imaging only to routine computed tomography (CT). The risk-benefit of either approach remains to be evaluated. Read More

Clin Chest Med 2018 03;39(1):79-97

Section of Interventional Pulmonology, Division of Pulmonary, Critical Care and Sleep Medicine, Ohio State University Wexner Medical Center, 201 DHLRI, 473 West 12th Avenue, Columbus, OH 43210, USA. Electronic address:

Spreading beyond the realm of tertiary academic medical centers, point-of-care ultrasound in the intensive care unit is an important diagnostic tool. The real-time feedback garnered can lead to critical and clinically relevant changes in management and decrease potential complications. Bedside ultrasound evaluation in the intensive care setting with a small, portable equipment is well-suited for placement of central lines, lumbar puncture, thoracentesis or other bedside ICU procedures and in the evaluation of cardiac activity, pleural and abdominal cavity and the overall fluid volume. Read More

Dtsch Med Wochenschr 2018 02 6;143(3):161-164. Epub 2018 Feb 6.

Klinik III für Innere Medizin, Herzzentrum, Universität zu Köln, Köln.

The use of Point-of-care ultrasonography (POC Ultrasonography) is getting more and more important in the bedside care of patients, especially in emergency- and intensive care units. In addition to the focused sonography of the heart, lungs and abdomen, the POC Ultrasonography recently includes also cases in prehospital care. Increasingly special applications in intensive care, e. Read More

Anaesthesiol Intensive Ther 2018 5;50(1):40-48. Epub 2018 Jan 5.

Obstetric Intensive Care Unit Coordinator of the Mexico´s General Hospital Dr. Eduardo Liceaga, Mexico City, Mexico.

There is currently a lack of universally accepted criteria for gastrointestinal (GI) failure or dysfunction in critical care. Moreover, the clinical assessment of intestinal function is notoriously difficult and thus often goes unrecognized, contributing to poor outcomes. A recent grading system has been proposed to define acute gastrointestinal injury (AGI) in conjunction with other organ function scores (e. Read More

BMJ Case Rep 2017 Dec 13;2017. Epub 2017 Dec 13.

Department of Radiology, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, Scunthorpe, UK.

Colorectal foreign bodies (FBs) are not unheard of in the province of surgery. They are commonly seen in men ranging from 20 to 90 years of age with a bimodal age distribution. A variety of objects have been described and reported in literature. Read More

Med Klin Intensivmed Notfmed 2017 Nov 23;112(8):741-758. Epub 2017 Oct 23.

Klinik III für Innere Medizin, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.

The so-called point-of-care ultrasound (POCUS) is of increasing importance for diagnostics and therapy control in intensive care medicine. Based on focused thorax sonography, echocardiography, and abdominal sonography, the most important working and differential diagnoses can be demonstrated or excluded depending on the leading symptom. Sonographic-based algorithms allow a structured evaluation especially of patients with the common leading symptoms dyspnea and thoracic pain. Read More

Am J Surg 2018 08 3;216(2):304-309. Epub 2017 Jun 3.

Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 Zhongshan East Road, Nanjing, 210002, China. Electronic address:

Object: Acute pancreatitis (AP) keeps as severe medical diagnosis and treatment problem. Early evaluation for severity and risk stratification in patients with AP is very important. Some scoring system such as acute physiology and chronic health evaluation-II (APACHE-II), the computed tomography severity index (CTSI), Ranson's score and the bedside index of severity of AP (BISAP) have been used, nevertheless, there're a few shortcomings in these methods. Read More

BMJ Case Rep 2017 Aug 7;2017. Epub 2017 Aug 7.

Department of Pulmonary & Critical Care, Brooke Army Medical Center, Fort Sam Houston, Texas, USA.

Atraumatic rupture of the normal spleen is a rare entity. Often, a triggering factor or minor physical event can be ascribed as the aetiology for rupture, including coughing, vomiting or minor medical procedures not involving the spleen. A 65-year-old man who was hospitalised for eosinophilic pneumonia developed haemodynamically unstable atrial flutter that necessitated urgent synchronised direct current cardioversion (DCCV). Read More

Neonatology 2017 14;112(3):238-245. Epub 2017 Jul 14.

Division of Neonatology, University and Polytechnic Hospital, Valencia, Spain.

Background: The therapeutic decision to close patent ductus arteriosus in preterm infants entails great uncertainty. Near-infrared spectroscopy is a noninvasive bedside technique used to monitor mixed regional oxygen saturation. We hypothesized that near-infrared spectroscopy could identify preterm infants at risk of mesenteric hypoperfusion associated with hemodynamically significant ductus arteriosus. Read More

Ultraschall Med 2017 Oct 20;38(5):538-543. Epub 2017 Jun 20.

Nephrology and Dialysis Unit, San Giovanni di Dio Hospital, Agrigento, Italy.

 Malfunction of the peritoneal dialysis catheter is frequently caused by dislocation. The diagnostic approach is classically based on abdomen X-ray together with detailed case history and physical examination. Despite being rarely applied in clinical practice to evaluate catheter misplacement, ultrasound is a noninvasive, radiation-free technique that is potentially useful also to explore reasons for catheter malfunction. Read More

Surgery 2017 08 24;162(2):377-384. Epub 2017 May 24.

Department of Surgery, Division of Trauma, Critical Care and Burn, The Ohio State University Wexner Medical Center, Columbus, OH. Electronic address:

Background: Age-related loss of muscle mass and function (sarcopenia) is linked to poor outcomes after operation and trauma. Here we evaluate computed tomography measured psoas muscle density and area using quick and simple tools available to the bedside clinician. We hypothesize these measures will predict poor outcomes after blunt traumatic injury. Read More

J Ultrasound Med 2017 Jun 28;36(6):1195-1202. Epub 2017 Feb 28.

Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway.

Objectives: We aimed to study the feasibility and diagnostic performance of bedside ultrasound by examination of the liver, gallbladder, kidneys, and abdominal aorta performed by medical residents with limited experience in ultrasound, on emergency admissions using pocket-sized imaging devices (PSIDs).

Methods: A total of 199 patients admitted acutely to the medical department at the non-university Levanger Hospital, Norway, during the period from April 4 to June 23, 2011, were consecutively included. Six medical residents, selected by drawing, examined these patients with a PSID at admission. Read More

Indian J Gastroenterol 2017 Jan 9;36(1):43-49. Epub 2017 Feb 9.

Sri Ramachandra Medical College, 1, Ramachandra Nagar, Porur, Chennai, 600 116, India.

Background: Acute pancreatitis is a disease with variable outcome; the course of the disease can be modified by early aggressive management in patients with severe pancreatitis. Easily calculable pancreatic scores and investigations can help to triage these patients. We aimed to determine the role of bedside index for severity in acute pancreatitis (BISAP), harmless acute pancreatitis score (HAPS), and systemic inflammatory response syndrome (SIRS) scores on day of admission and C-reactive protein (CRP) at 48 h for predicting the presence of pancreatic fluid collection (PFC) and necrosis on CT scans done at 72 h. Read More

Am J Emerg Med 2017 Jun 15;35(6):935.e5-935.e8. Epub 2016 Dec 15.

Department of Emergency Medicine, Madigan Army Medical Center, 9040 Jackson Ave., Tacoma, WA 98431, USA.

Case Presentation: A pregnant woman at 22+5/7weeks gestation presented to the emergency department (ED) from an outpatient clinic, hypotensive after experiencing a syncopal episode. On arrival to the ER she was tachycardic, tachypneic and complaining of abdominal pain. A bedside FAST was performed and noted free fluid in the abdomen. Read More

J Emerg Med 2017 Apr 18;52(4):e101-e104. Epub 2016 Dec 18.

Department of Medicine, Long Island Jewish Medical Center, New Hyde Park, New York.

Background: Ovarian hyperstimulation syndrome (OHSS) occurs when ovaries are overstimulated and enlarged due to fertility treatments resulting in a shift of serum from the intravascular space to the third space, mainly the abdominal cavity. It is the most serious complication of ovarian hyperstimulation for assisted reproduction.

Case Report: We present the case of a 40-year-old woman who presented with abdominal bloating and nausea 2 weeks after undergoing in vitro fertilization (IVF); she was diagnosed by an outside radiology ultrasound as having a ruptured ovarian cyst. Read More

Brain Dev 2017 Apr 14;39(4):356-360. Epub 2016 Nov 14.

Department of Pediatrics, Juntendo University, Faculty of Medicine, Japan; Department of Pediatrics, Aichi Medical University, Japan. Electronic address:

The outcome of mild encephalitis/encephalopathy with reversible splenial lesion (MERS) is favorable whether or not specific treatment is performed. We report a patient with MERS treated with methylprednisolone, complicated by gastric perforation followed by critical illness polyneuropathy. The patient was a 14-year-old male with mildly impaired consciousness and hyponatremia who was treated with methylprednisolone pulse therapy. Read More

Surg Endosc 2017 04 23;31(4):1947-1951. Epub 2016 Aug 23.

Department of Surgery, University of Kentucky College of Medicine, 800 Rose Street, UKMC C-222, Lexington, KY, 40536-0298, USA.

Background: To provide adequate workspace between the viscera and abdominal wall, insufflation with carbon dioxide is a common practice in laparoscopic surgeries. An insufflation pressure of 15 mmHg is considered to be safe in patients, but all insufflation pressures create perioperative and postoperative physiologic effects. As a composition of viscoelastic materials, the abdominal wall should distend in a predictable manner given the pressure of the pneumoperitoneum. Read More

Injury 2016 Oct 2;47(10):2110-2116. Epub 2016 Jul 2.

First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece. Electronic address:

Holistic ultrasound is a total body examination using an ultrasound device aiming to achieve immediate patient care and decision making. In the setting of trauma, it is one of the most fundamental components of care of the injured patients. Ground-breaking imaging software allows physicians to examine various organs thoroughly, recognize imaging signs early, and potentially foresee the onset or the possible outcome of certain types of injuries. Read More

Emerg (Tehran) 2016 ;4(2):101-5

Department of Emergency Medicine, George Washington University Medical Center, Washington DC, USA.

Early detection of free air in the peritoneal cavity is vital in diagnosis of life-threatening emergencies, and can play a significant role in expediting treatment. We present a series of cases in which bedside ultrasound (US) in the emergency department accurately identified evidence of free intra-peritoneal air and echogenic (dirty) free fluid consistent with a surgical final diagnosis of a perforated hollow viscus. In all patients with suspected perforated viscus, clinicians were able to accurately identify the signs of pneumoperitoneum including enhanced peritoneal stripe sign (EPSS), peritoneal stripe reverberations, and focal air collections associated with dirty shadowing or distal multiple reflections as ring down artifacts. Read More

J Med Case Rep 2016 May 29;10(1):132. Epub 2016 May 29.

Department of Traumatology, Oslo University Hospital Ullevål, Nydalen Postbox 4956, N-0424, Oslo, Norway.

Background: Life-threatening bleeding caused by liver injury due to chest compressions is a rare complication in otherwise successful cardiopulmonary resuscitation. Surgical intervention has been suggested to achieve bleeding control; however, reported mortality is high. In this report, we present a brief literature review and a case report in which use of a less invasive strategy was followed by an uneventful recovery. Read More

Clin Chest Med 2016 06 3;37(2):299-307. Epub 2016 Mar 3.

Intensive Care Unit, Section Thorax-Vascular Diseases-Abdomen-Metabolism, Hôpital Ambroise Paré, AP-HP, University Hospital Ambroise Paré, 9 Avenue Charles de Gaulle, Boulogne Billancourt 92104, France; Faculté de Médecine Paris Ile de France Ouest, Université de Versailles Saint Quentin en Yvelines, Versailles 78000, France; INSERM U-1018, CESP, Team 5 (EpReC, Renal and Cardiovascular Epidemiology), UVSQ, Villejuif 94807, France. Electronic address:

Echocardiography is a noninvasive and accurate tool used in the intensive care unit to assess cardiac function and monitor hemodynamics in shocked patients. During severe sepsis or septic shock, several mechanisms can lead to hemodynamic failure and have to be quickly and precisely diagnosed to propose adequate, personalized, and timely hemodynamic therapy. Echocardiography truly provides intensivists with this diagnostic possibility, whether or not there is fluid responsiveness, cardiac dysfunction, or persistent vasoplegia. Read More

Blood Coagul Fibrinolysis 2017 Jan;28(1):107-111

aEmergency Department, Hospital of Val d'Arda, Piacenza bDepartment of Internal medicine, Civil Hospital, Livorno cDepartment of Internal Medicine, University of Insubria, Varese, Italy.

It is well known that a number of patients affected by hemodynamic stable pulmonary embolism are admitted to the emergency department presenting chest pain without further symptoms of pulmonary embolism, such as dyspnea, cough, hemoptysis, syncope, and tachycardia, but in a few cases, the presenting symptoms are even more unusual. The gold standard for pulmonary embolism diagnosis is computed tomography pulmonary angiogram resulting in significant exposure to ionizing radiation and contrast, but recently bedside ultrasound has shown to be useful in diagnosing pulmonary embolism in the emergency department. We describe two cases of pulmonary embolism in young men evaluated in the emergency department for acute pain of the upper abdomen, preliminarily diagnosed as abdominal colic, in which bedside ultrasound ruled out abdominal diseases and showed basal pulmonary abnormalities consistent with infarction, suggesting the need of diagnostic completion with computed tomography pulmonary angiogram. Read More

J Surg Educ 2016 Mar-Apr;73(2):208-14

Department of Emergency Medicine, The George Washington University, Washington DC.

Objective: To examine the effects of an experiential learning model of ultrasound training on preclinical medical students' knowledge and practice of Focused Assessment with Sonography for Trauma (FAST) examination.

Methods: The study was conducted in 2 phases. In phase 1, first- and second-year medical students participated in a 45-minute didactic presentation and subsequent 1-hour hands-on practice followed by 3-5 precepted FAST examinations in the emergency department. Read More

Anaesthesiol Intensive Ther 2015 18;47(5):471-81. Epub 2015 Nov 18.

Department of Intensive Care and High Care Burn Unit, Ziekenhuis Netwerk Antwerpen.

The use of ultrasound has gained its place in critical care as part of our day-to-day monitoring tools. A better understanding of ultrasound techniques and recent publications including protocols for the lungs, the abdomen and the blood vessels has introduced ultrasound to the bedside of our ICU patients. However, we will prove in this paper that early machines, dating back more than 25 years, were perfectly able to do the job as compared to modern laptop machines with more features but few additional advantages. Read More

J Trauma Acute Care Surg 2016 Feb;80(2):229-36

From the Department of Surgery (C.D.B., A.C., E.F., C.C.G., M.F.E., R.M., A.G., C.J.H.), Beth Israel Deaconess Medical Center, Harvard Medical School; and Department of Applied Mathematics (G.G.), Wentworth Institute of Technology, Boston, Massachusetts.

Background: Surgical site infections (SSIs) are important sources of morbidity, prolonged hospital stays, and readmissions, so they have become a major economic burden. We hypothesized that surgical wound assessment by sonography (SWATS) used at the bedside would detect wound fluid collections and that the presence of such collections would predict SSI better than standard clinical examination. If so, SWATS might be used to indicate early intervention that could prevent SSI morbidity. Read More

Crit Care Med 2015 Nov;43(11):2479-502

1Los Angeles, CA. 2Foothills Medical Centre and the University of Calgary, Calgary, AL, Canada. 3National and Gulf Center for Evidence Based Health Practice, Riyadh, Saudi Arabia. 4King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. 5Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. 6Professor of Medicine, University of South Carolina School of Medicine, Department of Emergency Medicine, St. Francis Hospital, Columbus, GA. 7Division of Pulmonary and Critical Care Medicine, Eastern Virginia Medical School, Norfolk, VA. 8Department of Emergency Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA. 9Aerospace and Critical Care Medicine, Mayo Clinic, Rochester, MN. 10President and CEO, Renown Health, Reno, NV. 11Department of Anesthesiology, University Hospital of the Sarrland, Homburg-Saar, Germany. 12Clinics of Anesthesiology, Intensive Care and Pain Therapy, Hospital of the Goethe University, Frankfurt, Germany. 13Royal Brompton Hospital, London, United Kingdom. 14Eastern Virginia Medical School, Norfolk, VA. 15Department of Anesthesia, Critical Care and Pain Medicine Beth Israel Deaconess Medical Center Harvard Medical School, Boston, MA.

Objective: To establish evidence-based guidelines for the use of bedside ultrasound by intensivists and specialists in the ICU and equivalent care sites for diagnostic and therapeutic purposes for organs of the chest, abdomen, pelvis, neck, and extremities.

Methods: The Grading of Recommendations, Assessment, Development and Evaluation system was used to determine the strength of recommendations as either strong or conditional/weak and to rank the "levels" of quality of evidence into high (A), moderate (B), or low (C) and thus generating six "grades" of recommendation (1A-1B-1C-2A-2B-2C). Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used for all questions with clinically relevant outcomes. Read More

Radiology 2015 Oct;277(1):298-302

From the Department of Radiology, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Suite M-335, Los Angeles, CA 90048.

History A 56-year-old woman presented to the emergency department after a cross-country flight. While in flight, she experienced sudden onset of epigastric and midsternal chest pain with shortness of breath. Her symptoms improved markedly after she received oxygen on board, and she finished the flight without further incident. Read More

Praxis (Bern 1994) 2015 Sep;104(19):1005-12

3 Translational Gastroenterology Unit, Oxford University Hospitals, Oxford OX3 9DU, UK.

The clinical use of pocket size ultrasound devices is still at an early stage. Its performance has been studied and proven in cardiology, gynecology, and gastroenterology. It is expected that the image quality will improve and that more techniques for miniaturized devices will be available in the near future. Read More