scholarly journals Point-of-Care Ultrasound is Associated With Decreased Length of Stay in Children Presenting to the Emergency Department With Soft Tissue Infection

2018 ◽  
Vol 54 (1) ◽  
pp. 96-101 ◽  
Author(s):  
Margaret J. Lin ◽  
Mark Neuman ◽  
Rachel Rempell ◽  
Michael Monuteaux ◽  
Jason Levy
Keyword(s):  
Emergency Department ◽  
Soft Tissue ◽  
Length Of Stay ◽  
Soft Tissue Infection ◽  
Point Of Care ◽  
Tissue Infection ◽  
Point Of Care Ultrasound

Case Report: When all claims that it is necrotizing fasciitis but Point of care ultrasound (POCUS) proves the opposite!

POCUS Journal ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 13-14
Author(s):  
Hadiel Kaiyasah, MD, MRCS (Glasgow), ABHS-GS ◽  
Maryam Al Ali, MBBS
Keyword(s):  
Emergency Department ◽  
Critical Care ◽  
Case Report ◽  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Critical Care Unit ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Soft Tissue Infections

Soft tissue ultrasound (ST-USS) has been shown to be of utmost importance in assessing patients with soft tissue infections in the emergency department or critical care unit. It aids in guiding the management of soft tissue infection based on the sonographic findings.

Parasitic Soft Tissue Infection Diagnosed by Point-of-Care Ultrasound

2020 ◽  
Vol 59 (6) ◽  
pp. 940-942
Author(s):  
Amir Aminlari ◽  
Ian Grover ◽  
Stephen Hayden ◽  
Bryan Bisanz ◽  
Cole Nelson ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Point Of Care ◽  
Tissue Infection ◽  
Point Of Care Ultrasound

scholarly journals Outcome of Pediatric Emergency Point-of-Care Ultrasound (POCUS) for Management of Skin and Soft Tissue Infection Prior to Ultrasound Program Implementation

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Whitney Phillips, BS ◽  
Benjamin Nti, MD, MSc
Keyword(s):  
Emergency Department ◽  
Soft Tissue ◽  
Program Implementation ◽  
Point Of Care ◽  
International Classification Of Diseases ◽  
Pediatric Emergency ◽  
Point Of Care Ultrasound ◽  
Pediatric Emergency Department ◽  
Implementation Period ◽  
Classification Of Diseases

Background and Hypothesis: Point-of-care ultrasound (POCUS) is underutilized for evaluation of skin and soft tissue infections (SSTI) in the pediatric emergency department (ED). This study seeks to determine the utilization of POCUS compared to formal radiology ultrasound for SSTI in the pediatric ED prior to an ultrasound program implementation. We hypothesize that POCUS utilization will be low but can lead to a decreased length of stay (LOS) and cost for patients with SSTI.  Experimental Design or Project Methods: This is a retrospective EMR chart review covering pre-implementation (July 2016-June 2017) and post-implementation (July 2018-June 2019) of a POCUS program curriculum. Patients (<18 years old) were included based on screening for diagnoses via the international classification of diseases 9th and 10th revision codes for abscesses and cellulitis. We excluded patients who required admission and subspecialty consult or had other non-SSTI evaluation.   Results: Pre-Implementation period included 160 patients who met inclusion and exclusion criteria. Of these, 16 (10%) received POCUS evaluation and 8 (5%) received a radiology image evaluation. The majority of patients had cellulitis (80%) when compared to abscess (20%). The average LOS for POCUS ultrasound was 173 minutes compared to 304 minutes for radiology evaluation. The total cost for visit was $3,503 for patients evaluated by POCUS compared to $8,875.56 for patients who received radiology imaging.  Conclusion and Potential Impact: Taken together, the pre-implementation assessment of POCUS utilization in the pediatric emergency department was low but associated with decreased LOS and lower total ED cost when applied to SSTI management.

scholarly journals Comprehensive residency-based point-of-care ultrasound training program increases ultrasound utilization in the emergency department

2020 ◽  
Author(s):  
Wei-Lung Chen ◽  
Chan-Peng Hsu ◽  
Po-Han Wu ◽  
Jiann-Hwa Chen ◽  
Chien-Cheng Huang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Soft Tissue ◽  
Training Program ◽  
Test Score ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Ultrasound Studies ◽  
Training Course ◽  
Hemodynamic Assessment ◽  
Procedural Guidance

Abstract Background: Point-of-care ultrasonography (POCUS) is a prompt and simple tool for the urgent diagnosis and treatment of patients in the emergency department (ED). It has contributed to improvements in patient treatment quality, procedural safety, timeliness of care, diagnostic accuracy, and cost reduction. We developed a comprehensive residency-based POCUS training program for ED residents and determined its effect on ultrasound utilization in the ED.Methods: We conducted a retrospective cohort study in the ED of a university-affiliated medical center, evaluating a centralized residency-based POCUS training course from July 2017 to June 2018 for ED residents that included 12 core ultrasound applications: trauma, intrauterine pregnancy, abdominal aortic aneurysm, echocardiography and hemodynamic assessment, hepatobiliary system, urinary tract, deep vein thrombosis, soft tissue and musculoskeletal, thoracic-airway, ocular, bowel, and procedural guidance. Each application comprised a combined lecture and hands-on practice session that lasted for 2 hours. Pre-tests and post-tests, including still image and video interpretation, were performed. Utilization of POCUS among ED residents before and after the POCUS training course (July 2016–June 2017 and July 2018–June 2019) was calculated and analyzed using the Wilcoxon signed-rank test.Results: In total, 16 residents participated and completed the entire training course. The post-test score improved significantly compared to the pre-test score by a median of 12 points (p = 0.04). Utilization of POCUS among the ED residents increased significantly from 0.15 ultrasound studies per patient per year to 0.41 ultrasound studies per patient per year (p < 0.01) after completion of the entire training course. Increased POCUS scanning percentages over the cardiac, soft tissue, abdominal region, vascular system, procedural guidance, and ocular regions were also noted after providing the curriculum.Conclusions: There was a significant increase in POCUS utilization among ED residents after a comprehensive residency-based POCUS training program.

scholarly journals Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus skin and soft tissue infection in a Canadian emergency department

CJEM ◽  
2009 ◽  
Vol 11 (05) ◽  
pp. 430-438 ◽  
Author(s):  
Robert Stenstrom ◽  
Eric Grafstein ◽  
Marc Romney ◽  
John Fahimi ◽  
Devin Harris ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Tissue Infection ◽  
Methicillin Resistant ◽  
Period Prevalence ◽  
Monthly Period ◽  
Mrsa Infection

ABSTRACT Objective: We sought to estimate the period prevalence of methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infection (SSTI) and evaluate risk factors for MRSA SSTI in an emergency department (ED) population. Methods: We carried out a cohort study with a nested case–control design. Patients presenting to our ED with a wound culture and a discharge diagnosis of SSTI between January 2003 and September 2004 were dichotomized as MRSA positive or negative. Fifty patients with MRSA SSTI matched by calendar time to 100 controls with MRSA-negative SSTI had risk factors assessed using multivariate conditional logistic regression. Results: Period prevalence of MRSA SSTI was 54.8% (95% confidence interval [CI] 50.2%–59.4%). The monthly period prevalence increased from 21% in January 2003 to 68% in September 2004 (p &lt; 0.01). Risk factors for MRSA SSTI were injection drug use (IDU) (odds ratio [OR] 4.6, 95% CI 1.4–16.1), previous MRSA infection and colonization (OR 6.4, 95% CI 2.1–19.8), antibiotics in 8 weeks preceding index visit (OR 2.6, 95% CI 1.2–8.1), diabetes mellitus (OR 4.1, 95% CI 1.4–12.1), abscess (OR 5.6, 95% CI 1.8–17.1) and admission to hospital in previous 12 months (OR 2.6, 95% CI 1.1–11.2). Conclusion: The period prevalence of MRSA SSTI between January 2003 and September 2004 was 54.8% at our institution. There was a marked increase in the monthly period prevalence from the beginning to the end of the study. Risk factors are IDU, previous MRSA infection and colonization, prescriptions for antibiotics in previous 8 weeks and admission to hospital in the preceding 12 months. On the basis of local prevalence and risk factor patterns, emergency physicians should consider MRSA as a causative agent for SSTI.

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