Search Our Scientific Publications & Authors

J Pediatr Surg 2018 Nov 8;53(11):2279-2289. Epub 2018 May 8.

Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR 72202.

Purpose: Pediatric surgeon performed bedside ultrasound (PSPBUS) is a targeted examination that is diagnostic or therapeutic. The aim of this paper is to review literature involving PSPBUS.

Methods: PSPBUS practices reviewed in this paper include central venous catheter placement, physiologic assessment (volume status and echocardiography), hypertrophic pyloric stenosis diagnosis, appendicitis diagnosis, the Focused Assessment with Sonography for Trauma (FAST), thoracic evaluation, and soft tissue infection evaluation. Read More

Pediatr Dermatol 2018 Mar 16;35(2):e138-e139. Epub 2018 Jan 16.

Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.

A 2-year-old girl presented with a 2-month history of an erythematous, indurated plaque with well-defined borders on the third toe of the right foot. Bedside high-resolution ultrasonography demonstrated a thickened epidermis overlying a hyperechoic focus within the dermis. Her clinical and sonographic presentation was in keeping with a foreign body causing hair-thread tourniquet syndrome. Read More

J Spec Oper Med Winter 2017;17(4):72-75

Background: Soft-tissue occult foreign bodies are a concerning cause of morbidity in the emergency department. The identification of wooden foreign bodies is a unique challenge because they are often not detectable by plain radiography. The purpose of this study was to determine the diagnostic accuracy of emergency physician-performed ultrasonography to detect wooden foreign bodies of varying sizes. Read More

Anaesthesiol Intensive Ther 2017;49(5):373-381. Epub 2017 Nov 28.

President of the World Society of the Abdominal Compartment, University of Campinas, Department of Surgery, Division of Trauma, Campinas, Brazil; Severino Sombra University, Post Graduation Program, Vassouras, Brazil.

Background: Intra-abdominal hypertension is a common complication in critically ill patients. Recently the Abdominal Compartment Society (WSACS) developed a medical management algorithm with a stepwise approach according to the evolution of the intra-abdominal pressure and aiming to keep IAP ≤ 15 mm Hg. With the increased use of ultrasound as a bedside modality in both emergency and critical care patients, we hypothesized that ultrasound could be used as an adjuvant point-of-care tool during IAH management. Read More

Brain 2017 Sep;140(9):2399-2414

Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA 02129, USA.

See Schiff (doi:10.1093/awx209) for a scientific commentary on this article. Patients with acute severe traumatic brain injury may recover consciousness before self-expression. Read More

Clin Neurol Neurosurg 2017 Nov 3;162:101-107. Epub 2017 Oct 3.

Surgical Department, Neurosurgical Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Via Venezia 16, 15121, Alessandria, Italy. Electronic address:

Objective: The incidence of chronic Subdural hematoma (cSDH) is increasing and its rate of recurrence varies from 5 to 33%. A postoperative brain midline-shift (MLS) on computed tomography (CT) equal or larger than 5mm is a risk factor for recurrence. Transcranial color-coded duplex sonography (TCCDS) is a noninvasive bedside reproducible technique useful to detect MLS. Read More

Am J Emerg Med 2017 Nov 18;35(11):1653-1656. Epub 2017 May 18.

Emergency Medicine Clinic, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.

A comparison of the sensitivity and specificity of bedside ultrasonography with conventional radiography for the evaluation of nasal fractures.

Introduction - Purpose: There is increasing use of ultrasonography in the Emergency Dept (ED) and other areas. The purpose of the present study was to evaluate the sensitivity and specificity of bedside ultrasonography with conventional radiographs in the evaluation of nasal fractures in the ED. Read More

Rev Mal Respir 2017 Jun 12;34(6):645-660. Epub 2017 May 12.

Service de pneumologie, centre hospitaliser de la région de Saint-Omer, route de Blendecques, BP 60357, 62570 Helfaut, France. Electronic address:

The diaphragm is the muscle most implicated in breathing. Its morphological exploration usually depends on pulmonary radiography, fluoroscopy, CT-scanning and MRI. Its function is evaluated by the classical respiratory functional tests, the measurement of maximum inspiratory and expiratory pressures, the transdiaphragmatic pressure and even an electromyogram. Read More

J Crit Care 2017 08 7;40:145-148. Epub 2017 Apr 7.

Division of Pulmonary and Critical Care, University of Maryland School of Medicine, 110 S. Paca St., 2nd Floor, Baltimore, MD 21201, United States; University of Maryland School of Medicine, Department of Emergency Medicine, 110 S. Paca St., 6th Floor, Baltimore, MD 21201, United States. Electronic address:

Purpose: Ultrasound (US) is a burgeoning diagnostic tool and is often the only available imaging modality in low- and middle-income countries (LMICs). However, bedside providers often lack training to acquire or interpret US images. We conducted a study to determine if a remote tele-intensivist could mentor geographically removed LMIC providers to obtain quality and clinically useful US images. Read More

Emerg (Tehran) 2017 9;5(1):e15. Epub 2017 Jan 9.

Department of Statistics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

Introduction: Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures.

Methods: This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture. Read More

Am J Emerg Med 2017 Jun 26;35(6):855-859. Epub 2017 Jan 26.

Ankara University School of Medicine, Department of Emergency Medicine, Ankara, Turkey.

Study Objective: Our aim was to determine the efficiency of ultrasound (US) scanning in patients with wrist trauma admitted to the emergency department and to compare US diagnostic usage with other radiological imaging methods.

Methods: Patients who presented to the emergency department with wrist injury and who met the inclusion criteria and exclusion criteria were eligible. For all patients, US evaluation of the whole wrist was performed by an emergency physician before other radiological imaging methods (radiographies, computed tomography (CT) and magnetic resonance (MR) imaging). Read More

Am J Emerg Med 2017 May 11;35(5):720-724. Epub 2017 Jan 11.

Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Road, Boston, MA 02215, United States. Electronic address:

Background: Esophageal foreign body (EFB) and impaction are common gastrointestinal emergencies. Detection with standard imaging can be challenging. Computed tomography is a commonly used non-invasive imaging modality, but is not 100% sensitive and not always feasible. Read More

J Pediatr Surg 2017 May 30;52(5):874-880. Epub 2016 Dec 30.

Pediatric Surgery, Department of Surgery, Duke University Medical Center, Durham, NC 27710, United States.

Objective: Systematic review of blunt pediatric laryngeal and tracheal trauma and development of proposed evaluation and management strategy.

Study Design: Systematic review and proposed clinical consideration algorithm.

Data Sources: PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. Read More

Ulus Travma Acil Cerrahi Derg 2016 Sep;22(5):449-456

Department of Emergency Medicine, Ege University Faculty of Medicine, İzmir-Turkey.

Background: The purpose of our study was to retrospectively evaluate traumatic aortic transection patients and their bedside plain chest radiographs for signs of aortic injury.

Methods: Emergency department (ED) patients from a 5-year period with traumatic aortic transection who were over 18 years of age were included in the study. Demographic characteristics, mechanism of trauma, Revised Trauma Score, Glasgow Coma Score, vital signs, physical exam findings, laboratory parameters, length of stay in the ED, and patient outcomes were documented. Read More

West J Emerg Med 2016 Nov 29;17(6):814-816. Epub 2016 Sep 29.

Stanford University School of Medicine, Department of Emergency Medicine, Stanford, California.

Traumatic injuries to the knee are common in emergency medicine. Bedside ultrasound (US) has benefits in the rapid initial detection of injuries to the patella. In addition, US can also quickly detect injuries to the entire knee extensor mechanism, including the quadriceps tendon and inferior patellar ligament, which may be difficult to diagnose with plain radiographs. Read More

Radiographics 2016 Oct;36(6):1759-1775

From the Department of Radiology, Division of Musculoskeletal Imaging, University of Michigan Health System, 2910 S Taubman Center, SPC 5326, 1500 E Medical Center Dr, Ann Arbor, MI 48109.

Pain and other disorders of the knee are a common presenting complaint in the ambulatory setting. Although the cornerstones of imaging evaluation of the knee are radiographs and magnetic resonance (MR) imaging, ultrasonography (US) is less expensive than MR imaging, easily available, and of comparable accuracy in the evaluation of certain pathologic conditions of the knee. The benefits of US include portability, low cost, high spatial resolution, dynamic imaging, and ability to guide percutaneous interventions when indicated. Read More

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

Anaesthesiology Department, University Science of Malaysia, Kota Bharu, Malaysia.

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

Crit Care 2016 08 15;20(1):227. Epub 2016 Aug 15.

Hofstra Northwell School of Medicine, Long Island Jewish Medical Center, 270-05 76th Avenue, New Hyde Park, NY, 11040, USA.

Point-of-care ultrasonography (POCUS) is a useful imaging technique for the emergency medicine (EM) physician. Because of its growing use in EM, this article will summarize the historical development, the scope of practice, and some evidence supporting the current applications of POCUS in the adult emergency department. Bedside ultrasonography in the emergency department shares clinical applications with critical care ultrasonography, including goal-directed echocardiography, echocardiography during cardiac arrest, thoracic ultrasonography, evaluation for deep vein thrombosis and pulmonary embolism, screening abdominal ultrasonography, ultrasonography in trauma, and guidance of procedures with ultrasonography. Read More

Clin Teach 2017 Jun 27;14(3):170-174. Epub 2016 Jun 27.

University of Oxford Clinical Medical School, Oxford, UK.

Background: Bedside ultrasonography has an increasing role in medicine yet medical students have limited exposure. Although countless hours are devoted to plain radiograph and electrocardiogram (ECG) interpretation, ultrasound is frequently glossed over. Yet this imaging modality could enhance students' understanding of anatomy, physiology and pathology, and may increase their integration into hospital teams. Read More

Int J Pediatr Otorhinolaryngol 2016 Jun 28;85:84-90. Epub 2016 Mar 28.

Former Professor, Department of ENT, Christian Medical College, Vellore, India.

Study Objectives: To identify acute laryngeal injuries among pediatric patients intubated for more than 48hours, and to correlate these injuries with clinical variables.

Setting: Pediatric Intensive Care Unit (PICU) of a tertiary level hospital in India.

Patients And Methods: Prospective, observational study. Read More

Crit Care Med 2016 Jun;44(6):1206-27

1Division of Pulmonary and Critical Care Medicine Eastern Virginia Medical School, Norfolk, VA. 2Los Angeles, CA. 3Department of Emergency Medicine, St Francis Hospital, University of South Carolina School of Medicine, Columbus, GA. 4Foothills Medical Centre and the University of Calgary, Calgary, AB, Canada. 5Department of Anesthesiology and Critical Care Medicine The Johns Hopkins University School of Medicine, Baltimore, MD. 6Emergency Ultrasound, Department of Emergency Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA. 7Aerospace and Critical Care Medicine, Mayo Clinic, Rochester, MN. 8Renown Health Reno, Nevada. 9Department of Anesthesiology, University Hospital of the Sarrland, Homburg-Saar, Germany. 10Clinics of Anesthesiology, Intensive Care and Pain Therapy, Hospital of the Goethe University, Frankfurt, Germany. 11Royal Brompton Hospital, London, United Kingdom. 12Division of Pulmonary and Critical Care Medicine, Eastern Virginia Medical School, Norfolk, VA. 13King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia. 14Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.

Objective: To establish evidence-based guidelines for the use of bedside cardiac ultrasound, echocardiography, in the ICU and equivalent care sites.

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

Emerg Med Pract 2016 Jun 1;18(6):1-20. Epub 2016 Jun 1.

Department of Emergency Medicine, Stony Brook Medicine, Stony Brook, NY.

The majority of blunt chest injuries are minor contusions or abrasions; however, life-threatening injuries, including tension pneumothorax, hemothorax, and aortic rupture can occur and must be recognized early. This review focuses on the diagnosis, management, and disposition of patients with blunt injuries to the ribs and lung. Utilization of decision rules for chest x-ray and computed tomography are discussed, along with the emerging role of bedside lung ultrasonography. Read More

J Miss State Med Assoc 2016 Feb;57(2):35-8

Introduction: Differentiating the severity of acute ankle injuries is a common problem in the emergency department (ED). The Ottawa Foot and Ankle Rules (OFAR) were designed to obviate the need for unnecessary x-rays. Although these rules have been determined to be very sensitive, they lack the specificity necessary to make them practically useful for a condition in which a misdiagnosis could result in a significant disability. Read More

Radiographics 2016 May-Jun;36(3):640-59. Epub 2016 Apr 1.

From the Departments of Diagnostic and Therapeutic Radiology (S.W., R.K.) and Emergency Medicine (S.S.), Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, Thailand 10400; and Department of Radiology, Prince of Songkla University Hospital, Songkhla, Thailand (R.S.).

Acute thoracic symptoms are common among adults visiting emergency departments in the United States. Adults with these symptoms constitute a large burden on the overall resources used in the emergency department. The wide range of possible causes can make a definitive diagnosis challenging, even after clinical evaluation and initial laboratory testing. Read More

Emerg (Tehran) 2016 ;4(1):29-33

Department of Emergency medicine , Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Introduction: Application of chest radiography for all multiple trauma patients is associated with a significant increase in total costs, exposure to radiation, and overcrowding of the emergency department. Ultrasound has been introduced as an alternative diagnostic tool in this regard. The aim of the present study is to compare the diagnostic accuracy of chest ultrasonography and radiography in detection of traumatic intrathoracic injuries. Read More

Am J Emerg Med 2016 May 12;34(5):809-12. Epub 2016 Jan 12.

Department of Orthopedics and Traumatology, Tepecik Training and Research Hospital, Izmir, Turkey.

Objective: Diagnosis of bone fractures by ultrasonography is becoming increasingly popular in emergency medicine practice. We aimed to determine the diagnostic sensitivity and specificity of point-of-care ultrasonography (PoCUS) compared with plain radiographs in proximal and middle phalanx fractures.

Methods: Between August 2012 and July 2013, adult patients presenting to our emergency department with a possible (by clinical evaluation) proximal or middle phalanx fracture of finger were invited to participate in this prospective cohort study. Read More

Cochrane Database Syst Rev 2015 Oct 29(10):CD010826. Epub 2015 Oct 29.

Department of Obstetrics and Gynaecology, Women's and Childrens Hospital, 55 King William Road, North Adelaide, Adelaide, SA, Australia, 5006.

Background: During childbirth, many women sustain trauma to the perineum, which is the area between the vaginal opening and the anus. These tears can involve the perineal skin, the pelvic floor muscles, the external and internal anal sphincter muscles as well as the rectal mucosa (lining of the bowel). When these tears extend beyond the external anal sphincter they are called 'obstetric anal sphincter injuries' (OASIS). Read More

Radiology 2015 Nov;277(2):607-11

From the Departments of Radiology (A.G.O., V.G., J.K.) and Otolaryngology (G.O.A.), Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL 33331.

A 71-year-old man with a history of atrial fibrillation refractory to medical therapy and lung cancer status after left upper lobectomy presented to our hospital for elective cardioversion and rate control with tikosyn. Overnight, the patient became unresponsive and was found to be in a state of cardiogenic shock. A code was called, and he was stabilized after cardioversion and bedside intubation. Read More

Emerg Med Pract 2015 Nov 1;17(11):1-21; quiz 21-2. Epub 2015 Nov 1.

Assistant Program Director, Assistant Professor, Sinai-Grace Emergency Department, Wayne State University, Detroit, MI.

Ocular injuries are common in the emergency department, and they are the most frequent cause of noncongenital monocular blindness in children and adults. This review provides evidence-based recommendations for the diagnosis, treatment, and disposition of patients with all types of ocular trauma, including pain management, the use of antibiotics, cycloplegics, steroids, antifibrinolytics, and patching. Bedside ocular ultrasound has profoundly expanded diagnostic capability, particularly for the multiply injured patient, and routine management and disposition of patients with corneal abrasions has evolved significantly as well. Read More

Ulus Travma Acil Cerrahi Derg 2015 Sep;21(5):366-72

Department of Radiology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.

Background: Pneumothorax (PNX) is the collection of air between parietal and visceral pleura, and collapsed lung develops as a complication of the trapped air. PNX is likely to develop spontaneously in people with risk factors. However, it is mostly seen with blunt or penetrating trauma. Read More

Ulus Travma Acil Cerrahi Derg 2015 Jul;21(4):248-55

Department of General Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Background: This study aimed to evaluate injury patterns of patients admitted to the emergency department with gunshot wounds, results of imaging studies, treatment modalities, outcomes, mortality ratios, and complications.

Methods: A retrospective descriptive study was carried out including a total number of one hundred and forty-two patients admitted to Hacettepe University Emergency Department with gunshot injuries between January 1, 1999 and December 31, 2013. The Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), Injury Severity Score (ISS), and the Trauma and Injury Severity Score (TRISS) probability of survival for penetrating trauma were calculated for all patients. Read More

J Ultrasound Med 2015 Oct 11;34(10):1873-82. Epub 2015 Sep 11.

University of California Irvine School of Medicine, Irvine, California USA.

Objectives: Medical students' time is limited, so efficiency in medical education is valued. This research project aimed to determine the most effective means to teach bedside ultrasound to medical students in a 1-week training course. We hypothesized that the best method would include a combination of podcasts and hands-on teaching; therefore, there would be a statistically significant difference among the various methods of teaching. Read More

J Crit Care 2015 Oct 9;30(5):871-5. Epub 2015 Jun 9.

Division of Pulmonary and Critical Care, University of Maryland School of Medicine, 110 S. Paca St., 2nd Floor, Baltimore, MD, 21201, United States. Electronic address:

Purpose: Intensive care unit telemedicine (tele-ICU) uses audiovisual systems to remotely monitor and manage patients. Intensive care unit ultrasound can augment an otherwise limited bedside evaluation. To date, no studies have utilized tele-ICU technology to assess the quality and clinical use of real-time ultrasound images. Read More

Eur J Trauma Emerg Surg 2016 Apr 10;42(2):127-38. Epub 2015 Jun 10.

Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, USA.

The widespread availability of ultrasound (US) technology has increased its use for point of care applications in many health care settings. Focused (point of care) US is defined as the act of bringing US evaluation to the bedside for real-time performance. These images are collected immediately by the practitioner, allowing for direct integration into the physician's medical decision-making process. Read More

Eur J Trauma Emerg Surg 2016 Apr 14;42(2):119-26. Epub 2015 Mar 14.

St Luke's Regional Level I Resource Trauma Center, Bethlehem, PA, USA.

Ultrasound is a ubiquitous and versatile diagnostic tool. In the setting of acute injury, ultrasound enhances the basic trauma evaluation, influences bedside decision-making, and helps determine whether or not an unstable patient requires emergent procedural intervention. Consequently, continued education of surgeons and other acute care practitioners in performing focused emergency ultrasound is of great importance. Read More

J Emerg Med 2015 Aug 23;49(2):231-5. Epub 2015 May 23.

Department of Emergency Medicine, University of California San Francisco, San Francisco, California.

Background: Although x-ray studies provide important diagnostic information during trauma resuscitations, they may also lead to significant interruptions in care.

Objectives: We sought to determine the frequency and duration of interruptions for chest x-ray studies (CXR) and pelvic x-ray studies (PXR) and the frequency of lead apron use among providers who exited trauma rooms during resuscitation.

Methods: Using a convenience sampling method, we conducted a prospective, observational study from August 2013 to March 2014, enrolling adult trauma patients at a Level I trauma center who received CXR and PXR in the first 30 min of evaluation. Read More

Mil Med 2015 Mar;180(3 Suppl):74-9

Department of Surgery, Division of Trauma and Surgical Critical Care, University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, 22 S. Greene Street, Baltimore, MD 21201.

Objectives: To determine whether comprehensive quantitative echocardiogram could be used as a resuscitation tool in critically ill surgical patients and to assess its effect on patient care.

Design: Prospective observational.

Setting: The Trauma and Surgical Intensive Care Units of the University of Maryland Medical Center. Read More

Am J Emerg Med 2015 Jul 26;33(7):986.e3-5. Epub 2014 Dec 26.

Highland Hospital, Oakland, CA; University of California, San Francisco, San Francisco, CA.

Trauma in the emergency department may present providers with amyriad of unforeseen clinical scenarios.We present an example of how an urgent nerve block facilitated rapid management of a luxatio erecta shoulder fracture-dislocation without sedation. A 20-year-old female pedestrian presented to our level II trauma center after being stuck bya motor vehicle. Read More

Am J Emerg Med 2015 Jan 22;33(1):67-71. Epub 2014 Oct 22.

Antalya Education and Research Hospital, Department of Emergency Medicine, Antalya, Turkey.

Objective: The aim of the study was to compare the effectiveness of point-of-care ultrasound (POCUS) with direct radiography in diagnosis and management of the patients with distal radius fractures (DRFs).

Methods: In this study, patients between ages 5 and 55 years admitted to the emergency department with low energy upper extremity trauma with suspected DRF were evaluated with POCUS and direct radiography by emergency physicians (EPs) trained in either musculoskeletal (MSK) imaging or x-ray interpretation of DRF. The EP performing the POCUS examination was blinded to the x-ray results. Read More

Radiographics 2014 Nov-Dec;34(7):1824-41

From the Department of Radiology, University of Washington School of Medicine, 325 9th Ave, Box 359728, Seattle, WA 98104.

Penetrating transmediastinal injuries (TMIs) are injuries that traverse the mediastinum. These injuries are most commonly caused by firearms and knives. The investigation and management algorithms for TMI have undergone changes in recent years due to increasing evidence that computed tomography (CT) in useful in the evaluation of hemodynamically stable TMI patients. Read More

Acad Emerg Med 2014 Sep;21(9):1058-61

The Department of Emergency Medicine, Izmir Tepecik Training and Research Hospital, Izmir, Turkey.

Objectives: Ultrasonography (US) has been shown to be helpful in diagnosing fractures in the emergency department (ED) setting. The aim of this study was to determine the diagnostic accuracy of US for fractures in patients presenting to the ED with foot and/or ankle sprain and positive Ottawa foot and ankle rules.

Methods: This was a prospective study of consecutive patients aged 18 years and over were admitted to the ED with acute foot and/or ankle sprain and positive Ottawa foot and ankle rules. Read More

J Trauma Acute Care Surg 2014 Sep;77(3):441-7

From the Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.

Background: The diagnosis of acute mesenteric ischemia among intensive care unit (ICU) patients continues to be difficult and carries high mortality, and yet, it is essential that it be made expeditiously such that lifesaving operative intervention can be offered. A recent study suggested that computed tomography (CT) scan delays operative intervention. Thus, we hypothesized that diagnostic peritoneal lavage (DPL), a rapidly performed bedside procedure of established high sensitivity, is associated with reduced operative intervention, time to operative intervention, and mortality. Read More

Am Surg 2014 Aug;80(8):783-6

Department of Surgery, Eastern Virginia Medical School, Norfolk, Virginia, USA.

An ultrasound (US) examination can be easily and rapidly performed at the bedside to aide in clinical decisions. Previously we demonstrated that US was safe and as effective as a chest x-ray (CXR) for removal of tube thoracostomy (TT) when performed by experienced sonographers. This study sought to examine if US was as safe and accurate for the evaluation of pneumothorax (PTX) associated with TT removal after basic US training. Read More

J Trauma Acute Care Surg 2014 Aug;77(2):256-61

From the Department of Surgery, Eastern Virginia Medical School, Norfolk, Virginia.

Background: Chest x-rays (CXRs) have been the mainstay for the management of thoracostomy tubes (TTs), but reports that ultrasound (US) may be more sensitive for detection of pneumothorax (PTX) continue to increase. The objective of this study was to determine if US is safe and effective for the detection of PTX following TT removal.

Methods: This was a retrospectively reviewed, prospective process improvement project involving patients who had a TT managed by the surgical team. Read More

Med Ultrason 2014 Jun;16(2):179-81

Department of Emergency Medicine, Mount Sinai St. Luke's Hospital, Mount Sinai Roosevelt Hospital, New York, NY, USA.

The "thoracic spine sign" is visualized when anechoic or hypoechoic fluid is present in the pleural space. Fluid serves as a medium through which the thoracic vertebral bodies are visualized above the diaphragm. We present three cases of emergency department patients with a thoracic spine sign identified on bedside ultrasound. Read More

Pediatr Emerg Care 2014 Apr;30(4):285-7

From the *Division of Pediatric Emergency Medicine, Johns Hopkins Children's Center, Johns Hopkins Medical School, Baltimore, MD; †Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA.

We present a case of a 3-year-old girl brought to the emergency department for evaluation of limp after falling off the monkey bars 1 day prior. X-rays of the entire left lower extremity were normal with no evidence of fracture, dislocation, or effusion. Point-of-care ultrasound of the left hip demonstrated a hip effusion, which prompted further imaging, ultimately revealing an occult fracture of the left proximal femoral metaphysis. Read More

Ann Emerg Med 2015 Feb 27;65(2):199-203.e1. Epub 2014 Mar 27.

Department of Emergency Medicine, University of Arkansas for Medical Sciences, Little Rock, AR.

The diagnostic accuracy of emergency department (ED) ocular ultrasonography may be sufficient for diagnosing retinal detachment. We systematically reviewed the literature to determine the diagnostic accuracy of ED ocular ultrasonography for the diagnosis of retinal detachment. This review conformed to the recommendations from the Meta-analysis of Observational Studies in Epidemiology statement. Read More

Emerg (Tehran) 2014 ;2(2):81-4

Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Introduction: Traumatic chest injuries (TCI) are one of the most common causes of referring to the emergency departments, with high mortality and disability. This study was designed to evaluate the diagnostic accuracy of ultrasonography versus chest X ray (CXR) in detection of hemo-pneumothorax for patients suffering penetrating TCI.

Methods: The present cross-sectional study was performed to evaluate the diagnostic accuracy of ultrasonography in penetrating TCI victims referred to the emergency department of Shahid Kashani and Alzahra Hospitals of Isfahan, Iran, from July 2012 to June 2013. Read More

Crit Care Clin 2014 Apr 18;30(2):243-73, v. Epub 2014 Jan 18.

University of Arizona College of Medicine-Phoenix, 550 E. Van Buren, Phoenix, AZ 85004, USA; Emergency Medicine Ultrasound Program & Fellowship, Maricopa Integrated Health Care System, 2601 East Roosevelt, Phoenix, AZ 85008, USA; Simulation Based Training Program & Fellowship, Maricopa Integrated Health Care System, 2601 East Roosevelt, Phoenix, AZ 85008, USA; Emergency Medicine Residency Program, Maricopa Medical Center, 2601 East Roosevelt, Phoenix, AZ 85016, USA.

Bedside sonography for the evaluation of soft tissue and musculoskeletal conditions has become indispensible for physicians caring for patients in critical, emergency, and urgent care settings. This article reviews indications, techniques, and imaging appearances of common conditions encountered in clinical practice. Read More