Point of Care Ultrasound as Performed by the Clinician for the Enhancement of Physical Examination: A Technique Guide for Developmental Hip Dysplasia

2021 ◽  
Author(s):  
Christina Herrero ◽  
Neha Jejurikar ◽  
Ajay Kanakalamedala ◽  
Yhan Colon Iban ◽  
Pablo Castañeda
Keyword(s):  
Physical Examination ◽  
Hip Dysplasia ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Developmental Hip Dysplasia

scholarly journals Lung Point-of-Care Ultrasound for Unexpected Hypoxemia during Anesthesia

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1727
Author(s):  
Jui-Ting Wang ◽  
I-Min Su ◽  
Hsiang-Ning Luk ◽  
Phil B. Tsai
Keyword(s):  
Case Report ◽  
Physical Examination ◽  
Chest Radiography ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
First Case ◽  
Portable Chest ◽  
Lung Point

This is a case report showing acute hypoxemia during anesthesia. Immediate differentiation using lung POCUS (point-of-care ultrasound), in addition to physical examination and portable chest radiography, was made. This is the first case report of sputum impaction due to pneumonia causing hypoxemia that has been detected by lung POCUS during anesthesia.

scholarly journals Conventional physical examination extended by bedside ultrasound: a new paradigm in nephrological practice

2020 ◽  
Author(s):  
Ana Cláudia da Silva ◽  
Fabiana Oliveira Bastos Bonato ◽  
Marcus Gomes Bastos
Keyword(s):  
Nephrotic Syndrome ◽  
Urinary Tract ◽  
Physical Examination ◽  
Cardiac Amyloidosis ◽  
Cardiac Involvement ◽  
Point Of Care ◽  
Al Amyloidosis ◽  
Point Of Care Ultrasound ◽  
Pulmonary Congestion ◽  
New Paradigm

ABSTRACT Point-of-Care Ultrasound (POCUS) has been gaining momentum as an extension to physical examination in several specialties. In nephrology, POCUS has generally been used in a restricted way in urinary tract evaluation. We report the case of a patient with nephrotic syndrome secondary to amyloidosis, previously diagnosed by renal biopsy, who was oligosymptomatic when seen the an outpatient clinic, where the POCUS, focused on the heart, lung and abdomen, revealed anasarca, pulmonary congestion and cardiac changes suggestive of cardiac amyloidosis. After evaluation by the cardiology and hematology services, the diagnosis of AL amyloidosis with cardiac involvement was confirmed. This case emphasizes the importance of extending the physical examination using POCUS, which, ideally, should not be restricted to the urinary tract.

scholarly journals Occult Vascular Transection Identified by Point-of-care Ultrasound Demonstrating Evidence of Retrograde Flow

2019 ◽  
Vol 3 (4) ◽  
pp. 372-375
Author(s):  
Nadia Villarroel ◽  
William Wagner ◽  
Elizabeth Schoenfeld
Keyword(s):  
Physical Examination ◽  
Vascular Injury ◽  
Point Of Care ◽  
Penetrating Trauma ◽  
Point Of Care Ultrasound ◽  
Retrograde Flow ◽  
Radial Pulse ◽  
Palmar Arch ◽  
High Clinical Suspicion ◽  
Significant Disability

Acute vascular injury can be a cause of significant disability and morbidity. High clinical suspicion and a thorough physical examination are key components to facilitate a timely diagnosis. We present a case of acute vascular injury after isolated penetrating trauma. Physical examination demonstrated a strong distal radial pulse; however, point-of-care ultrasound facilitated an evaluation of the directionality of arterial flow, demonstrating that flow was retrograde via the palmar arch. We subsequently identified a proximal and complete arterial laceration.

Point-of-care ultrasound augments physical examination learning by undergraduate medical students

2020 ◽  
Vol 97 (1143) ◽  
pp. 10-15
Author(s):  
Chun Ka Wong ◽  
JoJo Hai ◽  
Kwong Yue Eric Chan ◽  
Ka Chun Un ◽  
Mi Zhou ◽  
...  
Keyword(s):  
Medical Students ◽  
Physical Examination ◽  
Medical Curriculum ◽  
Instant Messaging ◽  
Point Of Care ◽  
Group Discussion ◽  
Point Of Care Ultrasound ◽  
Undergraduate Medical Students ◽  
Significant Difference ◽  
The Impact

BackgroundLittle is known about the impact of the provision of handheld point-of-care ultrasound (POCUS) devices on physical examination skills of medical students.MethodsWe describe an educational initiative that comprised a POCUS workshop followed by allocation of a POCUS device to medical students for use over the subsequent 8 weeks. They were encouraged to scan patients and correlate their physical examination findings. A mobile instant messaging group discussion platform was set to provide feedback from instructors. Physical examination skills were assessed by means of clinical examination.Results210 final-year medical students from the University of Hong Kong participated in the programme. 46.3% completed the end of programme electronic survey: 74.6% enjoyed using the POCUS device, 50.0% found POCUS useful to validate physical examination findings and 47.7% agreed that POCUS increased their confidence with physical examination. 93.9% agreed that the programme should be incorporated into the medical curriculum and 81.9% would prefer keeping the device for longer time from 16 weeks (45.6%) to over 49 weeks (35.3%). Medical students who participated in the POCUS programme had a higher mean score for abdominal examination compared with those from the previous academic year with no POCUS programme (3.65±0.52 vs 3.21±0.80, p=0.014), but there was no statistically significant difference in their mean score for cardiovascular examination (3.62±0.64 vs 3.36±0.93, p=0.203).ConclusionThe POCUS programme that included provision of a personal handheld POCUS device improved students’ attitude, confidence and ability to perform a physical examination.

Diagnostic accuracy of point-of-care ultrasound (PoCUS) for shoulder dislocations and reductions in the emergency department: a diagnostic randomised control trial (RCT)

2021 ◽  
pp. emermed-2020-210947
Author(s):  
Mark Anthony Attard Biancardi ◽  
Robert David Jarman ◽  
Tania Cardona
Keyword(s):  
Physical Examination ◽  
Diagnostic Accuracy ◽  
Shoulder Dislocation ◽  
Null Hypothesis ◽  
Point Of Care ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Randomised Control Trial ◽  
Point Of Care Ultrasound ◽  
X Rays

BackgroundFollowing blunt trauma, diagnosis of shoulder dislocation based on physical examination alone is difficult due to possible concurrent proximal humeral fractures. X-rays are therefore used to confirm diagnosis. Results from recent observational studies comparing diagnostic accuracy of point-of-care ultrasound (PoCUS) with X-rays for shoulder dislocation have been encouraging. The aim of this study was to determine whether PoCUS improves diagnostic accuracy when used with physical examination for the diagnosis of shoulder dislocation, proximal humeral fracture and ascertaining successful reduction in the ED.MethodsA prospective, single-centre, open, parallel randomised control study over a 6-month period was used to answer the research question and test the null hypothesis. Consecutive eligible adult patients attending the ED of Mater Dei Hospital in Malta were randomised to either the control (C) (physical examination only) or experimental group (E) (physical examination and a two-point PoCUS scan). The study objectives were to measure diagnostic accuracy for both examinations for detecting shoulder dislocation, any associated proximal humeral fractures and confirming reduction. X-rays were used as reference standard for both groups.Results1206 patients were enrolled in this study (C n=600, E n=606). 290 dislocations (C n=132 and E n=158), 332 proximal humeral fractures (C n=154 and E n=178) and 278 reductions (C n=130 and E n=148) were analysed. A statistically significant difference (p<0.001) was found between the two groups for diagnostic accuracy in shoulder dislocation (C=65%, likelihood ratio (LR)+=2.03 and LR−=0.35 and E=100%, LR+=∞ and LR−=0), proximal humeral fractures (C=45.7%, LR+=1.23 and LR−=0.52 and E=98.3%, LR+=103.9 and LR−=0.03) and reduction (C=68.7%, E=100%). The null hypothesis for this study was thus rejected.ConclusionsThe addition of PoCUS to a physical examination significantly improves diagnostic accuracy for dislocations, proximal humeral fractures and reduction confirmation.Trial registration numberInternational Standard Randomised Controlled Trials Number Registry (ISRCTN17048126).

scholarly journals Point-of-Care Ultrasound, the New Musculoskeletal Physical Examination

2021 ◽  
Vol 20 (2) ◽  
pp. 109-112
Author(s):  
Sarah S. Jackson ◽  
Hung M. Le ◽  
Deanna L. Kerkhof ◽  
Gianmichel D. Corrado
Keyword(s):  
Physical Examination ◽  
Point Of Care ◽  
Point Of Care Ultrasound

scholarly journals Point-of-care Ultrasound Diagnosis of Emphysematous Cholecystitis

2020 ◽  
Vol 4 (1) ◽  
pp. 107-108
Author(s):  
Fadwa Al Hammadi ◽  
Rasha Buhumaid
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Mortality Rate ◽  
Physical Examination ◽  
Acute Cholecystitis ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Emphysematous Cholecystitis ◽  
Biliary Pathology ◽  
Biliary Ultrasound

A 49-year-old male presented to the emergency department with abdominal pain and generalized weakness. The physical examination was positive for right upper quadrant tenderness and positive Murphy’s sign. Point-of-care biliary ultrasound revealed signs of emphysematous cholecystitis. Emphysematous cholecystitis is a rare biliary pathology with a high mortality rate. It differs from acute cholecystitis is many ways. It has unique ultrasound characteristics. This case highlights the use of point-of-care ultrasound to diagnose a rare biliary condition.

Point-of-care ultrasound to evaluate volume status in severe hyponatremia

2020 ◽  
Vol 13 (6) ◽  
pp. e235304 ◽  
Author(s):  
Connor Evins ◽  
Aniel Rao
Keyword(s):  
Physical Examination ◽  
Inferior Vena ◽  
Point Of Care ◽  
Vena Cava ◽  
Volume Status ◽  
Point Of Care Ultrasound ◽  
Status Change ◽  
Severe Hyponatremia ◽  
Ultrasound Findings ◽  
Proper Volume

A 51-year-old man was hospitalised for severe hyponatremia. Initial history and physical examination suggested hypovolemia, and he was treated with normal saline at 100 mL/hour. After several days, his hyponatremia failed to improve, and then worsened without resolution of presenting ataxia and fatigue. He had no new complaints including no cough or orthopnea. He had no jugular venous distention or oedema, and his lungs were clear to auscultation. Point-of-care ultrasound was used, revealing a distended inferior vena cava, pulmonary oedema and pleural effusion, suggesting hypervolemia. Based on ultrasound findings, we treated with 60 mg oral torsemide two times per day. Hyponatremia resolved without complication within 48 hours. In this case, physical examination failed to recognise volume status change from hypovolemic to hypervolemic, increasing hospitalisation and morbidity. The point-of-care ultrasound proved to be an accurate tool for proper volume evaluation, and may be used as an adjunct to physical examination for hyponatremic patients.

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