67 results match your criteria Bedside Ultrasonography Central Line Placement


Ultrasound-guided vascular access in the neonatal intensive care unit: a nationwide survey.

Eur J Pediatr 2022 Jun 17;181(6):2441-2451. Epub 2022 Mar 17.

Working Group On Ultrasound, Spanish Society of Neonatology (SENeo), Valencia, Spain.

Ultrasound-guided vascular access (USG-VA) is recommended by international practice guidelines but information regarding its use in the neonatal intensive care unit (NICU) is lacking. Our objective was to assess neonatologist's perceptions and current implementation of USG-VA in Spain. This was a nationwide online survey. Read More

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Electrocardiographic localization of peripherally inserted central catheter tip position in critically ill patients with advanced cancer: An application study.

Ann Noninvasive Electrocardiol 2022 03 24;27(2):e12918. Epub 2021 Dec 24.

Department of Oncology, Hebei General Hospital For Veterans, Xingtai, China.

Background: We compared the methods of electrocardiogram (ECG) and X-ray localization of the peripherally inserted central catheter (PICC) tip position, in order to find a more convenient, practical, and safe method.

Objective: To investigate the value of applying electrocardiographic localization of the PICC tip position in critically ill patients with advanced cancer in Hebei Province, China.

Method: Enrolled 137 advanced cancers requiring PICC placement. Read More

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Utility and futility of central venous catheterization.

Ann Card Anaesth 2021 Jul-Sep;24(3):378-380

Department of Anaesthesiology, Pain and Palliative Care and Critical Care Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.

Central venous access is useful for monitoring central venous pressure, inserting pulmonary artery catheter and administering vasoactive drugs in hemodynamically unstable patients. Central venous catheter (CVC) insertion through internal jugular vein may cause major vessel injury, inadvertent arterial catheterization, brachial plexus injury, phrenic nerve injury, pneumothorax, and haemothorax. We describe unusual presentation of hemothorax following CVC placement in a patient undergoing vestibular schwannoma excision. Read More

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November 2021

Procedural Applications of Point-of-Care Ultrasound in Pediatric Emergency Medicine.

Emerg Med Clin North Am 2021 Aug 11;39(3):529-554. Epub 2021 Jun 11.

Department of Emergency Medicine, Stanford School of Medicine, 300 Pasteur Drive, Room M121, Alway Building MC 5768, Stanford, CA 94305, USA.

Point-of-care ultrasound can improve efficacy and safety of pediatric procedures performed in the emergency department. This article reviews ultrasound guidance for the following pediatric emergency medicine procedures: soft tissue (abscess incision and drainage, foreign body identification and removal, and peritonsillar abscess drainage), musculoskeletal and neurologic (hip arthrocentesis, peripheral nerve blocks, and lumbar puncture), vascular access (peripheral intravenous access and central line placement), and critical care (endotracheal tube placement, pericardiocentesis, thoracentesis, and paracentesis). By incorporating ultrasound, emergency physicians caring for pediatric patients have the potential to enhance their procedural scope, confidence, safety, and success. Read More

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Confirmatory radiographs have limited utility following ultrasound-guided tunneled femoral central venous catheter placements by interventional radiology.

Pediatr Radiol 2021 Jun 5;51(7):1253-1258. Epub 2021 Feb 5.

Division of Interventional Radiology, Department of Radiology, University of Washington, Seattle, WA, USA.

Background: Ultrasonography may reliably visualize both appropriately positioned and malpositioned femoral-approach catheter tips. Radiography may be used to confirm catheter tip position after placement, but its utility following intraprocedural ultrasound (US) catheter tip verification is unclear.

Objectives: To report the utility of confirmatory radiographs after US-guided tunneled femoral central venous catheter (CVC) placements by interventional radiology in pediatric patients. Read More

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Safety of bedside placement of tunneled dialysis catheter in COVID-19 patients.

J Vasc Access 2022 Jan 3;23(1):145-148. Epub 2020 Dec 3.

Department of Nephrology and Hypertension, Glickman Urological & Kidney Institute, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.

COVID-19 patients admitted to the ICU have high incidence of AKI requiring prolonged renal replacement therapy and often necessitate the placement of a tunneled dialysis catheter (TDC). We describe our experience with two cases of COVID-19 patients who underwent successful bedside placement of TDC under ultrasound guidance using anatomical landmarks without fluoroscopy guidance. Tunneled dialysis catheter placement under direct fluoroscopy remains the standard of care; but in well selected patients, placement of tunneled dialysis catheter at the bedside using anatomic landmarks without fluoroscopy can be safely and successfully performed without compromising the quality of care and avoid transfer of COVID-19 infected patients outside the ICU. Read More

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January 2022

Perioperative Point-of-Care Ultrasound in Children.

Authors:
Karen Boretsky

Children (Basel) 2020 Nov 6;7(11). Epub 2020 Nov 6.

Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.

Anesthesiologists and other acute care physicians perform and interpret portable ultrasonography-point-of-care ultrasound (POCUS)-at a child's bedside, in the perioperative period. In addition to the established procedural use for central line and nerve block placement, POCUS is being used to guide critical clinical decisions in real-time. Diagnostic point-of-care applications most relevant to the pediatric anesthesiologist include lung ultrasound for assessment of endotracheal tube size and position, pneumothorax, pleural effusion, pneumonia, and atelectasis; cardiac ultrasound for global cardiac function and hydration status, and gastric ultrasound for aspiration risk stratification. Read More

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November 2020

A retrospective analysis of the clinical effectiveness of subcutaneously tunneled femoral vein cannulations at the bedside: A low risk central venous access approach in the neonatal intensive care unit.

J Vasc Access 2021 Nov 5;22(6):926-934. Epub 2020 Nov 5.

St. Joseph's Children's Hospital, Paterson, NJ, USA.

Objective: The purpose of this retrospective analysis was to evaluate the clinical efficacy and safety of ultrasound (US)-guided, subcutaneously tunneled, femoral inserted central catheters (ST-FICCs) in the neonatal intensive care unit (NICU).

Methods: Following clinical success with ST-FICCs in adults, we expanded this practice to the neonatal population. In an 18-month retrospective cohort analysis (2018-2020) of 82 neonates, we evaluated the clinical outcome for procedural success, completion of therapy, and incidence of early and late complications for insertion of US-guided ST-FICCs in the NICU. Read More

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November 2021

Diagnostic accuracy among trainees to safely confirm peripherally inserted central catheter (PICC) placement using bedside ultrasound.

Br J Nurs 2020 Oct;29(19):S20-S28

MD, University of Utah School of Medicine, Department of Medicine, Division of Pulmonary and Critical Care, Salt Lake City, UT.

Background: Real-time utilization of ultrasound to confirm peripherally inserted central catheter (PICC) placement improves efficacy and reduces patient radiation exposure. We evaluated if novice ultrasound users could accurately confirm appropriate PICC tip location via ultrasound assessment.

Methodology: A prospective data collection study was conducted in an academic center with an established PICC team. Read More

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October 2020

Ultrasound-Guided Peripheral Intravenous Catheter Insertion: The Nurse's Manual.

Crit Care Nurse 2020 Oct;40(5):38-46

Mark Bowers is a bedside nurse, 7 East Medical-Surgical, Lakeland Regional Health.

Peripheral intravenous catheter placement is a skill that is used daily in the hospital. However, many nurses face the challenge of cannulating increasingly complex and difficult-to-access vasculature. Although emergency department clinicians have been using ultrasound to facilitate this procedure for the last 18 years, ultrasound-guided peripheral intravenous catheter placement has not been as rapidly adopted in the critical and acute care nursing realms. Read More

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October 2020

Role of point of care ultrasound in COVID-19 pandemic: what lies beyond the horizon?

Med Ultrason 2020 11 22;22(4):461-468. Epub 2020 Jul 22.

Department of Anesthesia and Reanimation, Hospital Universitario Mostoles, Madrid, Spain.

The pandemic of COVID-19 requires rapid and easy access to reliable imaging modalities for diagnosis and follow up. Considering the cost-effectiveness of the imaging used, ultrasound is a non-ionizing, portable and bedside imaging modality with a high diagnostic impact in emergencies and intensive care units in pandemics, but it is operator dependent. In our article, we provide a comprehensive review of the role of point-of-care ultrasound in the diagnosis of COVID-19 infection and its impact on the lungs, cardiovascular system, eyes and abdominal organs. Read More

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November 2020

Venous catheter at alternate exit site in a 2-year-old requiring long-term antibiotics for osteomyelitis: A case report.

J Vasc Access 2021 Nov 30;22(6):1013-1016. Epub 2020 Aug 30.

St. Joseph's University Medical Center, Paterson, NJ, USA.

In the pediatric population, vascular access is often challenging to secure and to maintain, especially for long-term intravenous (IV) treatment. The traditional approach for patients who require long-term IV antibiotics is placement of a peripherally inserted central catheter (PICC). The challenge in the pediatric population is the high risk of dislodgement after PICC placement, as these patients tend to pull their line out accidentally or purposefully. Read More

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November 2021

Off-label use of Proglide percutaneous closure device in iatrogenic arterial catheterizations: Our experience.

Vascular 2020 Dec 21;28(6):756-759. Epub 2020 May 21.

Department of Angiology and Vascular Surgery, Hospital Álvaro Cunqueiro, Vigo, Spain.

Introduction: Incidental arterial puncture is one of the main complications associated with central venous catheter placement. Manual compression to achieve hemostasis in subclavian and carotid artery punctures is often ineffective because of the anatomical arterial position. Accidental cannulation has traditionally been treated with open surgery or endovascular treatment, but such procedures are not exempt from complications. Read More

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December 2020

Transthoracic echocardiography as bedside technique to verify tip location of central venous catheters in patients with atrial arrhythmia.

J Vasc Access 2020 Nov 4;21(6):861-867. Epub 2020 Mar 4.

Department of Anesthesia, Central Hospital of Bolzano, Bolzano, Italy.

Introduction: Transthoracic echocardiography with bubble test is an accurate, reproducible, and safe technique to verify the location of the tip of the central venous catheter. The aim of this study is to confirm the effectiveness of this method for tip location in patients with atrial arrhythmia.

Methods: Transthoracic echocardiography with bubble test was adopted as a method of tip location in patients with atrial arrhythmia requiring central venous catheter. Read More

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November 2020

Point-of-Care Ultrasonography.

Am Fam Physician 2020 03;101(5):275-285

Naval Hospital Jacksonville, Jacksonville, FL, USA.

Point-of-care ultrasonography (POCUS) is performed by a physician at the bedside and is standard practice in obstetric, emergency, and musculoskeletal medicine. When compared with formal sonography, POCUS is equivalent in screening for abdominal aortic aneurysm and as accurate in diagnosing deep venous thrombosis. POCUS has high accuracy for diagnosing pneumonia and detecting acute decompensated heart failure but is less accurate than computed tomography for identifying pulmonary embolism. Read More

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Cost Comparison of In-Suite Versus Portable Tunneled Femoral Central Line Placements in Children Using Time-Driven Activity-Based Costing.

J Am Coll Radiol 2020 Apr 2;17(4):462-468. Epub 2019 Dec 2.

Department of Radiology, Children's Hospital of Wisconsin, Milwaukee, Wisconsin.

Objective: Compare the cost of placing tunneled femoral central lines in the interventional radiology suite to portable bedside placement using time-driven activity-based costing.

Methods: Detailed process maps were created using information generated from interviews with frontline staff, direct shadowing of patient procedures (19 patients-8 in-suite, 11 portable; patient age 4 days to 37 months; 6 males, 13 females), and electronic medical record review (80 patients-44 in-suite, 36 portable; patient age 1 day to 20 months; 42 males, 38 females) who underwent a tunneled femoral central line placement at a tertiary care pediatric hospital from January 1, 2018, to June 30, 2018. Procedures were conducted in-suite using fluoroscopy guidance or portably at the patient's bedside using ultrasound. Read More

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From the simulation center to the bedside: Validating the efficacy of a dynamic haptic robotic trainer in internal jugular central venous catheter placement.

Am J Surg 2020 02 21;219(2):379-384. Epub 2019 Oct 21.

Department of Industrial and Manufacturing Engineering, Pennsylvania State University, University Park, PA, 16802, USA; Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, 17033, USA; School of Engineering Design, Technology, and Professional Programs, Pennsylvania State University, University Park, PA, 16802, USA. Electronic address:

Background: The objective of this study was to validate the transfer of ultrasound-guided Internal Jugular Central Venous Catheterization (US-IJCVC) placement skills from training on a Dynamic Haptic Robotic Trainer (DHRT), to placing US-IJCVCs in clinical environments. DHRT training greatly reduces preceptor time by providing automated feedback, standardizes learning experiences, and quantifies skill improvements.

Methods: Expert observers evaluated DHRT-trained (N = 21) and manikin-trained (N = 36) surgical residents on US-IJCVC placement in the operating suite using a US-IJCVC evaluation form. Read More

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February 2020

Safety and feasibility of ultrasound-guided placement of peripherally inserted central catheter performed by neurointensivist in neurosurgery intensive care unit.

PLoS One 2019 31;14(5):e0217641. Epub 2019 May 31.

Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

We evaluated the safety and feasibility of ultrasound-guided peripherally-inserted central venous catheters (PICC) by a neurointensivist at the bedside compared to fluoroscopy-guided PICC and conventional central venous catheter (CCVC). This was a retrospective study of adult patients who underwent central line placement and were admitted to the neurosurgical intensive care unit (ICU) between January 2014 and March 2018. In this study, the primary endpoint was central line-induced complications. Read More

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January 2020

Development and Implementation of a Bedside Peripherally Inserted Central Catheter Service in a PICU.

Pediatr Crit Care Med 2019 01;20(1):71-78

Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA.

Objectives: To create a bedside peripherally inserted central catheter service to increase placement of bedside peripherally inserted central catheter in PICU patients.

Design: Two-phase observational, pre-post design.

Setting: Single-center quaternary noncardiac PICU. Read More

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January 2019

Use of Bedside Ultrasonography and Saline Flush Technique for Evaluation of Central Venous Catheter Placement in Children.

Artif Organs 2018 Dec 22;42(12):1157-1163. Epub 2018 Aug 22.

Department of Pediatric Radiology, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey.

Our study investigated the reliability of appearance of rapid atrial swirl flow (RASF) by ultrasonography (US) in the right atrium (RA), which occurred as a result of rapid isotonic saline infusion (RISI) into the central venous catheter (CVC), in predicting catheter tip position. This prospective observational study included 95 CVC procedures performed on 77 pediatric patients (41 boys and 36 girls) with a median age of 0.6 (0. Read More

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December 2018

Real-time ultrasound-guided placement of peripherally inserted central venous catheter without fluoroscopy.

J Vasc Access 2018 Nov 21;19(6):609-614. Epub 2018 Mar 21.

2 Division of Cardiology, JCHO Tokyo Takanawa Hospital, Tokyo, Japan.

Background And Aim:: Malposition of peripherally inserted central catheters placed at the bedside is a well-recognized phenomenon. We report the success rate of the placement of peripherally inserted central catheters with ultrasound guidance for tip positioning and describe the knacks and pitfalls.

Materials And Methods:: We retrospectively reviewed the medical case charts of 954 patients who received peripherally inserted central catheter procedure. Read More

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November 2018

Bedside ultrasound to detect central venous catheter misplacement and associated iatrogenic complications: a systematic review and meta-analysis.

Crit Care 2018 Mar 13;22(1):65. Epub 2018 Mar 13.

Department of Intensive Care Medicine, Research VUmc Intensive Care (REVIVE), VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.

Background: Insertion of a central venous catheter (CVC) is common practice in critical care medicine. Complications arising from CVC placement are mostly due to a pneumothorax or malposition. Correct position is currently confirmed by chest x-ray, while ultrasonography might be a more suitable option. Read More

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Ultrasound-guided central venous catheter placement in children: what is a really good practice?

Intensive Care Med 2018 04 6;44(4):546-547. Epub 2018 Mar 6.

Paediatric and Emergency Care Department, Complejo Hospitalario Universitario de Santiago de Compostela, Travesía de Choupana, s/n, 15706, Santiago De Compostela, Spain.

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Semi-automated ultrasound guidance applied to nasogastrojejunal tube replacement for enteral nutrition in critically ill adults.

Biomed Eng Online 2018 Feb 7;17(1):21. Epub 2018 Feb 7.

Department of Critical Care Medicine, Second People's Hospital of Shenzhen, Shenzhen, 518035, People's Republic of China.

Background And Objective: At present, the enteral nutrition approaches via nose and duodenum (or nose and jejunum) are the preferred method of nutritional support in the medical engineering field, given the superiority of in line with physiological processes and no serious complication. In this study, the authors adopted saline as the acoustic window, and gave enteral nutrition support to critically ill patients, via the nasogastrojejunal approach guided by semi-automated ultrasound. These above patients benefited a lot from this kind of nutrition support treatment, and we aimed to report the detailed information. Read More

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February 2018

Incidental finding of persistent left superior vena cava after 'bubble study' verification of central venous catheter.

BMJ Case Rep 2017 Jul 31;2017. Epub 2017 Jul 31.

Department of Medicine, Jackson Memorial Hospital, Miami, Florida, USA.

We report a case of a patient with septic shock who underwent central venous catheter placement in the left internal jugular vein, and a bedside ultrasound 'bubble study' revealed venous cannulation. A chest X-ray postprocedure revealed concern for arterial system catheterisation. However, the possibility of a persistent left superior vena cava was discussed and confirmed with a formal transthoracic echocardiogram and CT. Read More

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Simulation-based training program with deliberate practice for ultrasound-guided jugular central venous catheter placement.

Acta Anaesthesiol Scand 2017 Oct 6;61(9):1184-1191. Epub 2017 Jul 6.

Department of Anesthesiology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.

Background: Current evidence supports the utility of simulation training for bedside procedures such as ultrasound-guided jugular central venous catheter (CVC) insertion. However, a standardized methodology to teach procedural skills has not been determined yet. The aim of this study was to evaluate the effectiveness of a simulation-based training program for improving novice technical performance during ultrasound-guided internal jugular CVC placement. Read More

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October 2017

Report of Modification for Peripherally Inserted Central Catheter Placement: Subcutaneous Needle Tunnel for High Upper Arm Placement.

J Infus Nurs 2017 Jul/Aug;40(4):232-237

Vascular Access Department, St Joseph's Regional Medical Center, Paterson, New Jersey (Mr Ostroff); PICC Excellence, Inc, Hartwell, Georgia (Ms Moureau); Greenville Memorial University Medical Center, Greenville, South Carolina (Ms Moureau); Griffith University, School of Nursing and Midwifery, Brisbane, Australia (Ms Moureau); and Alliance for Vascular Access Teaching and Research, Brisbane, Australia (Ms Moureau). Matthew D. Ostroff, MSN, RN, AGACNP, CRNI®, CPUI, VA-BC, CEN, recently completed an acute care adult and geriatric nurse practitioner certification and a master's degree from Drexel University. He is currently an advanced practice nurse at St. Joseph's Regional Medical Center, Paterson, New Jersey, where he performs ultrasound-guided peripheral and central vascular access device placement. Nancy L. Moureau, BSN, RN, CRNI®, CPUI, VA-BC, is a researcher in conjunction with Griffith University, where she is pursuing a doctorate in nursing research. She is also a vascular access staff nurse with Greenville Memorial University Medical Center, where she places ultrasound-guided peripheral and peripherally inserted central catheters. The owner of PICC Excellence, Inc, Ms Moureau also is an educator, consultant, and legal expert on vascular access.

The majority of peripherally inserted central catheters (PICCs) are currently inserted with the aid of ultrasound guidance in the middle third of the upper arm. A growing patient population is presenting with challenging vessel access requiring placement of the PICC in the high upper third of the arm. To avoid this suboptimal exit site, a subcutaneous tunneling of the PICC is established away from the axilla to a more appropriate skin exit site. Read More

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September 2017

A Missing Guide Wire After Placement of Peripherally Inserted Central Venous Catheter.

Am J Case Rep 2016 Dec 6;17:925-928. Epub 2016 Dec 6.

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Bronx Lebanon Hospital Center Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY, USA.

BACKGROUND Central venous catheterization is a common tool used in critically ill patients to monitor central venous pressure and administer fluids and medications such as vasopressors. Here we present a case of a missing guide wire after placement of peripherally inserted central catheter (PICC), which was incidentally picked up by bedside ultrasound in the intensive care unit.  CASE REPORT A 50-year-old Hispanic male was admitted to the intensive care unit for alcohol intoxication. Read More

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December 2016

Two successful insertions of peripherally inserted central catheter in a super elderly patient with bilateral pacemaker placement.

J Vasc Access 2017 Jan 18;18(1):e1-e2. Epub 2017 Jan 18.

Department of Parenteral and Enteral Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing - China.

Peripherally inserted central catheters (PICCs) have been placed through the peripheral veins, and the best location for the tip of the PICCs is the lower third of the superior vena cava (SVC) and cavo-atrial junction. PICCs are commonly used in intravenous administration, parenteral nutrition therapy, chemotherapy, as well as in critical care units. The success rates in venipuncture are enhanced when ultrasonographic guides are used by the bedside PICC teams. Read More

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January 2017

12th WINFOCUS world congress on ultrasound in emergency and critical care.

Crit Ultrasound J 2016 Sep;8(Suppl 1):12

Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.

Table Of Contents: A1 Point-of-care ultrasound examination of cervical spine in emergency departmentYahya Acar, Onur Tezel, Necati SalmanA2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasoundYahya Acar, Necati Salman, Onur Tezel, Erdem CevikA3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures?Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA4 Ultrasound-guided supraclavicular subclavian vein catheterization. A novel approach in emergency departmentMargarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA5 Clinical ultrasound in a septic and jaundice patient in the emergency departmentMargarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA6 Characterization of the eyes in preoperative cataract Saudi patients by using medical diagnostic ultrasoundMustafa Z. Read More

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September 2016