scholarly journals P107: Does the use of bedside ultrasound to identify intrauterine pregnancy in the emergency department shorten the length of stay of patients presenting with 1st trimester vaginal bleeding or pelvic pain?

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S114-S114
Author(s):  
M. Ravichandiran ◽  
S. Ramkissoon
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Point Of Care ◽  
First Trimester ◽  
Control Group ◽  
Point Of Care Ultrasound ◽  
Intrauterine Pregnancy ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy ◽  
Experimental Group

Introduction: The use of point of care ultrasound (POCUS) has increased rapidly in the emergency department (ED) over the last 10 years. This study seeks to determine whether the use of POCUS to identify intrauterine pregnancy in the ED shortens the length of stay of patients presenting with first trimester pregnancy-related complaints at The Scarborough Hospital (TSH). Methods: A prospective chart review of women seen at TSH ED for first trimester pregnancy-related complaints was conducted from March 1, 2014 to December 30, 2014. ED physicians were asked to record the names of patients assessed using POCUS in the ED along with their findings during the study period (experimental group). Health Records data was used to find all patients seen in the emergency department during the study period with the chief triage complaint of “Pregnancy Issues < 20 weeks” (control group). Results: A total of 378 patients were identified in the control group and 61 patients were recorded in the experimental group. The outliers were removed from both groups. The POCUS identified an intra-uterine pregnancy (POS IUP) in 47.5% and no definite intrauterine pregnancy (NDIUP) in 52.5%.In the control group, 82.0% proceeded to obtain a formal ultrasound (FUS) after the POCUS. Patients found to have a POS IUP on the POCUS spent 141.48±100.95 minutes in hospital, while patients found to have NDIUP spent 197.10±132.48 minutes in hospital (p=0.07). The POS IUP group spent statistically significantly less time in hospital when compared to the control group (p=0.001). In the POCUS group, patients seen between 1700 and 0800 (i.e. when FUS is not available) spent significantly less time (p=0.02) in hospital (113.13±118.07 minutes, n=24) when compared to patients seen between 0800 and 1700 (208.28±106.35 minutes, n=36). Conclusion: For first-trimester pregnancy-related complaints, POCUS has been shown to be effective in reducing the time that patients spend in hospital at TSH. This difference was especially apparent when POCUS was used at times when FUS was not available. Despite the apparent reluctance of many ED physicians to discharge patients without a FUS, even after identifying a POS IUP on the POCUS, it was evident that this technology was saving time for both physicians and patients.

Early pregnancy and pelvic ultrasound

2019 ◽  
pp. 107-116
Author(s):  
Ryan Henneberry ◽  
Chris Cox ◽  
Beatrice Hoffmann ◽  
Paul Atkinson
Keyword(s):  
Abdominal Pain ◽  
Early Pregnancy ◽  
Vaginal Bleeding ◽  
Point Of Care ◽  
First Trimester ◽  
Clinical Findings ◽  
Point Of Care Ultrasound ◽  
Clinical Parameters ◽  
Intrauterine Pregnancy ◽  
First Trimester Pregnancy

Point-of-care ultrasound (PoCUS) has an important role in the management of vaginal bleeding and/or abdominal pain in early pregnancy. When combined with other clinical parameters, PoCUS enables the treating physician to accurately confirm the presence of an early intrauterine pregnancy (IUP). This chapter provides a suggested algorithm for the use of bedside ultrasound and clinical findings to safely assess patients with first-trimester pregnancy pain or bleeding and rule out an ectopic pregnancy. Both trans-abdominal and trans-vaginal approaches are described in detail.

scholarly journals Pitfalls in Emergency Department Focused Bedside Sonography of First Trimester Pregnancy

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Kerri Layman ◽  
Michael Antonis ◽  
Jonathan E. Davis
Keyword(s):  
Emergency Department ◽  
Clinical Decision Making ◽  
Case Reports ◽  
Clinical Decision ◽  
First Trimester ◽  
Intrauterine Pregnancy ◽  
Diagnostic Modality ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy ◽  
First Trimester Of Pregnancy

Background. Bedside sonography performed by emergency physicians is frequently utilized for real-time clinical decision-making in the emergency department (ED) setting. This includes the sonographic evaluation of pain or bleeding in the first trimester of pregnancy. The detection of intrauterine pregnancy (IUP) or life-threatening conditions, including ectopic pregnancy, is critical.Objectives. This paper will review several important pearls and avoidable pitfalls of this diagnostic modality by brief presentation of illustrative cases followed by discussion of key principles.Case Reports. Three patients evaluated in the ED for bleeding or pain occurring during the first trimester of pregnancy will be presented.Conclusions. When conducting emergency bedside ultrasound for the evaluation of first trimester pregnancy, it is important to avoid common pitfalls that can place your patient at risk.

The effect of point-of-care ultrasound on length of stay in the emergency department in children with neck swelling

2021 ◽  
Author(s):  
Mary Kate Claiborne ◽  
Carrie Ng ◽  
Kristen A. Breslin ◽  
James Chamberlain ◽  
Rosemary Thomas-Mohtat
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Neck Swelling

scholarly journals Female with Vaginal Bleeding

2020 ◽  
Vol 4 (4) ◽  
pp. 636-637
Author(s):  
Mark Quilon ◽  
Alec Glucksman ◽  
Gregory Emmanuel ◽  
Josh Greenstein ◽  
Barry Hahn
Keyword(s):  
Emergency Department ◽  
Emergency Physician ◽  
Vaginal Bleeding ◽  
Point Of Care ◽  
First Trimester ◽  
Yolk Sac ◽  
Pregnant Female ◽  
Point Of Care Ultrasound ◽  
Fetal Demise ◽  
Case Presentation

Case Presentation: A 24-year-old pregnant female presented to the emergency department with lower abdominal cramping and vaginal bleeding. A point-of-care ultrasound demonstrated a calcified yolk sac. Discussion: When identified, calcification of the yolk sac in the first trimester is a sign of fetal demise. It is important for an emergency physician to be aware of the various signs and findings on point-of-care ultrasound and be familiar with the management of these pathologies.

Emergency Department Patient Perceptions of Transvaginal Ultrasound for Complications of First-Trimester Pregnancy

2018 ◽  
Vol 37 (8) ◽  
pp. 1965-1975 ◽  
Author(s):  
Nova Panebianco ◽  
Frances Shofer ◽  
Katie O'Conor ◽  
Tristan Wihbey ◽  
Lakeisha Mulugeta ◽  
...  
Keyword(s):  
Emergency Department ◽  
Transvaginal Ultrasound ◽  
Emergency Department Patient ◽  
First Trimester ◽  
Patient Perceptions ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy

scholarly journals The Retrospective Analysis on the Influence of Taking Mifepristone and Misoprostol During First-trimester Pregnancy and Its Following Impact on Tissue Residual After Induced Abortion

2021 ◽  
Author(s):  
Hai Xia xie ◽  
Xiao Li Liu ◽  
Jun Jie Sun ◽  
Jian Rong Huang
Keyword(s):  
Gestational Age ◽  
Uterine Cavity ◽  
Test Group ◽  
First Trimester ◽  
Induced Abortion ◽  
Control Group ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy ◽  
Women And Children ◽  
Residual Tissue

Abstract Objective: To explore the application of mifepristone in the stream of Residual tissue after abortion . Methods: A retrospective study of 1067 women who selected induced abortion in first-trimester pregnancy(gestational age ≤ 70 days) between January 1st，2018 and May 31st，2019 in Chongqing Health Center For Women and Children . Inclusion criteria: the first pregnancy patients, aged 18-30 years, gestational age ≤ 70 days. Test group (mifepristone + misoprostol) 467 cases. Control group(misoprostol) 600 cases. Analyzing the incidence of residual tissue after induced abortion. Evaluating the preventive effect of preoperative oral mifepristone on abortion incompleteness. Results: a total of 9 in test group occur residual tissue in uterine cavity，the incidence is 1.93%. In the controlled group, the number of residual tissue is 25,the incidence is 4.16%(P<0.05)，there was statistic difference between two groups. The uterine residue diameter in the test group(1.1±0.31cm) was lower than that in the control group(1.24±0.64cm)，but there was no statistical difference between the two groups of residue diameter (P>0.05)Conclusion: Oral mifepristone before operation can significantly reduce the incidence of tissue residual after induced abortion.

scholarly journals Point-of-care ultrasound versus radiology department pelvic ultrasound on emergency department length of stay

2016 ◽  
Vol 7 (3) ◽  
pp. 178 ◽  
Author(s):  
Sean P. Wilson ◽  
Kiah Connolly ◽  
Shadi Lahham ◽  
Mohammad Subeh ◽  
Chanel Fischetti ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Point Of Care ◽  
Radiology Department ◽  
Point Of Care Ultrasound ◽  
Pelvic Ultrasound
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