Point of care ultrasonography: And now, where shall we go in perioperative medicine?

2021 ◽  
pp. 101014
Author(s):  
Laurent Zieleskiewicz ◽  
Clemens Ortner ◽  
Vincent Bruckert ◽  
Gabriele Via ◽  
Lionel Bouvet
Keyword(s):  
Point Of Care ◽  
Perioperative Medicine ◽  
Point Of Care Ultrasonography

Use of Point-of-Care Ultrasonography in Simulation-Based Advanced Cardiac Life Support Scenarios

2018 ◽  
Vol 5 (2) ◽  
pp. 53-60 ◽  
Author(s):  
Stephanie Cha ◽  
Allan Gottschalk ◽  
Erik Su ◽  
Adam Schiavi ◽  
Adam Dodson ◽  
...  
Keyword(s):  
Life Support ◽  
Point Of Care ◽  
Advanced Cardiac Life Support ◽  
Simulation Based ◽  
Point Of Care Ultrasonography

scholarly journals Utilisation of musculoskeletal ultrasonography for the evaluation of septic arthritis in a patient presenting to the emergency department with fever during the era of COVID-19

2021 ◽  
Vol 14 (4) ◽  
pp. e242370
Author(s):  
Jiodany Perez ◽  
Stefani Sorensen ◽  
Michael Rosselli
Keyword(s):  
Emergency Department ◽  
Septic Arthritis ◽  
Glenohumeral Joint ◽  
Imaging Modality ◽  
Point Of Care ◽  
Significant Morbidity ◽  
Anchoring Bias ◽  
Septic Bursitis ◽  
Musculoskeletal Ultrasonography ◽  
Point Of Care Ultrasonography

Prompt recognition and treatment of septic arthritis are crucial to prevent significant morbidity and mortality in affected patients. During the current COVID-19 pandemic, anchoring bias may make an already challenging diagnosis like septic arthritis more difficult to diagnose quickly and efficiently. Musculoskeletal (MSK) point of care ultrasonography (POCUS) is an imaging modality that can be used to quickly and efficiently obtain objective findings that may help a clinician establish the diagnosis of septic arthritis. We report a case where MSK POCUS was a key element in establishing the diagnosis of glenohumeral joint septic arthritis and subdeltoid septic bursitis for a patient that presented to the emergency department with a fever during the era of the COVID-19 pandemic.

scholarly journals Point of Care Ultrasonography for Objective Assessment of Heart Failure: Integration of Cardiac, Vascular, and Extravascular Determinants of Volume Status

2021 ◽  
pp. 1-13
Author(s):  
Abhilash Koratala ◽  
Amir Kazory
Keyword(s):  
Heart Failure ◽  
Point Of Care ◽  
Objective Assessment ◽  
Prognostic Significance ◽  
Volume Status ◽  
Lung Water ◽  
Ultrasound Evaluation ◽  
Reliable Assessment ◽  
Poor Outcomes ◽  
Point Of Care Ultrasonography

<b><i>Background:</i></b> Lingering congestion portends poor outcomes in patients with heart failure (HF) and is a key target in their management. Studies have shown that physical exam has low yield in this setting and conventional methods for more precise assessment and monitoring of volume status (e.g., body weight, natriuretic peptides, and chest radiography) have significant inherent shortcomings. <b><i>Summary:</i></b> Point of care ultrasonography (POCUS) is a noninvasive versatile bedside diagnostic tool that enhances the sensitivity of conventional physical examination to gauge congestion in these patients. It also aids in monitoring the efficacy of decongestive therapy and bears prognostic significance. In this narrative review, we discuss the role of focused sonographic assessment of the heart, venous system, and extravascular lung water/ascites (i.e., the pump, pipes, and the leaks) in objective assessment of fluid volume status. <b><i>Key Messages:</i></b> Since each of the discussed components of POCUS has its limitations, a combinational ultrasound evaluation guided by the main clinical features would be the key to reliable assessment and effective management of congestion in patients with HF.

scholarly journals Non-Invasive Intracranial Pressure Evaluation in an Emergency Room – Point-of-Care Ultrasonography

2016 ◽  
Vol 38 (04) ◽  
pp. 279-283
Author(s):  
Daniel Damiani ◽  
Durval Damiani
Keyword(s):  
Intracranial Pressure ◽  
Randomized Trials ◽  
Point Of Care ◽  
Current Data ◽  
Point Of Care Ultrasound ◽  
Medical Specialties ◽  
Non Invasive ◽  
Nerve Sheath ◽  
Invasive Method ◽  
Point Of Care Ultrasonography

AbstractPoint-of-care ultrasound is modifying conducts in emergency care. The various medical specialties, in addition to traditional indications in cases of multiple trauma, are using this technique for rapid diagnosis at the bedside without patient mobilization and without radiation. Point-of-care ultrasound in neurocritical patients, through its transorbital window, can estimate the intracranial pressure by a non-invasive method. Through the measurement of the diameter of the optic nerve sheath 3 mm posterior to the retina, the intracranial pressure is estimated if the value of the diameter is > 5 mm, as it has been verified in other studies. The present article describes the most current data on this topic, and it also highlights the need for more multicentric and randomized trials to determine the correct cut-off points that represent the high sensibility and specificity of the method.

The Practice and Implications of Finding Fluid During Point-of-Care Ultrasonography

2017 ◽  
Vol 177 (12) ◽  
pp. 1818 ◽  
Author(s):  
Rachel B. Liu ◽  
Joseph H. Donroe ◽  
Robert L. McNamara ◽  
Howard P. Forman ◽  
Chris L. Moore
Keyword(s):  
Point Of Care ◽  
Point Of Care Ultrasonography

scholarly journals Point-of-care ultrasonography for risk stratification of non-critical COVID-19 patients on admission (POCUSCO): a study protocol of an international study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041118
Author(s):  
François Morin ◽  
Delphine Douillet ◽  
Jean-Francois Hamel ◽  
Josué Rakotonjanahary ◽  
Florence Dupriez ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Point Of Care ◽  
International Study ◽  
Ethics Committees ◽  
Good Clinical Practice ◽  
Lung Damage ◽  
Ordinal Scale ◽  
Initial Examination ◽  
Hospitalised Patients ◽  
Point Of Care Ultrasonography

IntroductionIn the context of the COVID-19 pandemic, early identification of patients who are likely to get worse is a major concern. Severity mainly depends on the development of acute respiratory distress syndrome (ARDS) with a predominance of subpleural lesions. Lung point-of-care ultrasonography (L-POCUS) is highly effective in detecting pulmonary peripheral patterns and may be appropriate for examining patients with COVID-19. We suggest that L-POCUS performed during the initial examination may identify patients with COVID-19 who are at a high risk of complicated treatment or unfavourable evolution.Methods and analysisPoint-of-care ultrasonography for risk stratification of non-critical COVID-19 patients on admission is a prospective, multicentre study. Adult patients visiting the emergency department (ED) of participating centres for suspected or confirmed COVID-19 are assessed for inclusion. Included patients have L-POCUS performed within 48 hours following ED admission. The severity of lung damage is assessed using the L-POCUS score based on 36 points for ARDS. Apart from the L-POCUS score assessment, patients are treated as recommended by the WHO. For hospitalised patients, a second L-POCUS is performed at day 5±3. A follow-up is carried out on day 14, and the patient’s status according to the Ordinal Scale for Clinical Improvement for COVID-19 from the WHO is recorded.The primary outcome is the rate of patients requiring intubation or who are dead from any cause during the 14 days following inclusion. We will determine the area under the ROC curve of L-POCUS.Ethics and disseminationThe protocol has been approved by the French and Belgian Ethics Committees and is carried out in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines. The study is funding by a grant from the French Health Ministry, and its findings will be disseminated in peer-reviewed journals and at scientific conferences.Trial registration numberNCT04338100.

Approach to the Patient with Abdominal Pain

2020 ◽  
Author(s):  
Dana Sajed
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Chronic Conditions ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Abdominal Ultrasonography ◽  
Pediatric Populations ◽  
Ed Visits ◽  
Point Of Care Ultrasonography

Abdominal pain is the most common presenting complaint in the emergency department (ED), accounting for nearly 8% of ED visits. Although many chronic conditions may cause pain in the abdomen, acute abdominal pain, defined as undiagnosed pain present for less than 1 week, is of greatest concern to the emergency practitioner. For many reasons, acute abdominal pain is often diagnostically challenging. Abdominal pain may be due to numerous causes, including gastrointestinal, genitourinary, cardiovascular, pulmonary, and other sources. Symptoms may fluctuate or change in nature, and the quality of pain can be difficult for the patient to describe. Physical examination findings, although important, are variable and can even be misleading. Despite being such a common presenting complaint, misdiagnosis is not uncommon and results in a high percentage of medicolegal actions in both and adult and pediatric populations. This review contains 5 figures, 8 tables, and 92 references Key words: abdominal computed tomography, abdominal pain, abdominal ultrasonography, pain management, point-of-care ultrasonography

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