scholarly journals Rural point-of-care ultrasound of the kidney and bladder: quality and effect on patient management

2018 ◽  
Vol 10 (4) ◽  
pp. 324 ◽  
Author(s):  
Garry Nixon ◽  
Katharina Blattner ◽  
Jill Muirhead ◽  
Ngaire Kerse
Keyword(s):  
Patient Care ◽  
Urinary Retention ◽  
Point Of Care ◽  
Renal Stones ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
Positive Contribution ◽  
Diagnostic Certainty ◽  
Negative Effect ◽  
Clinical Records

ABSTRACT INTRODUCTION Point-of-care ultrasound (POCUS) of the kidney and bladder are among the most commonly performed POCUS scans in rural New Zealand (NZ). AIM To determine the quality, safety and effect on patient care of POCUS of the kidney and bladder in rural NZ. METHODS Overall, 28 doctors in six NZ rural hospitals completed a questionnaire both before and after undertaking a POCUS scan over a 9-month period. The clinical records and saved ultrasound images were reviewed by a specialist panel. RESULTS The 28 participating doctors undertook 138 kidney and 60 bladder scans during the study. POCUS of the bladder as a test for urinary retention had a sensitivity of 100% (95% CI 88–100) and specificity of 100% (95% CI 93–100). POCUS of the kidney as a test for hydronephrosis had a sensitivity 90% (95% CI 74–96) and specificity of 96% (95% CI 89–98). The accuracy of other findings such as renal stones and bladder clot was lower. POCUS of the bladder appeared to have made a positive contribution to patient care in 92% of cases without evidence of harm. POCUS of the kidney benefited 93% of cases, although in three cases (2%), it may have had a negative effect on patient care. DISCUSSION POCUS as a test for urinary retention and hydronephrosis in the hands of rural doctors was technically straightforward, improved diagnostic certainty, increased discharges and overall had a positive effect on patient care.

512 Bedside Transthoracic echography volume Assessment in the BICU

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S103-S103
Author(s):  
Michael G Chambers ◽  
Britton Garrett ◽  
Leopoldo C Cancio
Keyword(s):  
Point Of Care ◽  
Injured Patient ◽  
Bedside Ultrasound ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
Advanced Practice ◽  
Multidisciplinary Rounds ◽  
Volume Assessment ◽  
Us Findings ◽  
Image Repository

Abstract Introduction Point-of-Care Ultrasound (POCUS) has been shown to be a useful adjunct in assessment of various shock states and utilized to guide resuscitative and post-resuscitation de-escalation efforts. POCUS use for guiding resuscitation in burn injured patient has not be described. Objectives characterize the use of bedside ultrasound examinations performed by advance practice providers and treating physicians in a regional burn intensive care unit Methods Daily beside ultrasound examinations were performed utilizing a bedside ultrasound device by an advanced practice provider prior to rounds POCUS examinations consist of: Ultrasound images were archived to a centralized image repository and reviewed daily during multi-disciplinary rounds. Ultrasonographic volume assessment compared to clinical volume assessment made during daily multidisciplinary rounds. Results 100 examinations were performed of those 32 were within the initial 72 hour window: Conclusions Our results demonstrate that bedside ultrasound aides in guidance of both resuscitative and post-resuscitative efforts. We identified a cohort of patients who appeared hypervolemic clinically but US findings supported hypovolemia, we refer to as pseudohypervolemia US volume assessment provides information that changes management. We believe point of care ultrasound is a viable tool in preventing over-resuscitation as well as to guide post-resuscitative diuresis.

scholarly journals Thoracic Point-of-Care Ultrasound: A SARS-CoV-2 Data Repository for Future Artificial Intelligence and Machine Learning

2021 ◽  
pp. 155335062110186
Author(s):  
Abdel-Moneim Mohamed Ali ◽  
Emran El-Alali ◽  
Adam S. Weltz ◽  
Scott T. Rehrig
Keyword(s):  
Artificial Intelligence ◽  
Machine Learning ◽  
Point Of Care ◽  
Prognostic Indicators ◽  
Data Repository ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
Clinical Protocol ◽  
Improved Outcomes ◽  
Current Experience

Current experience suggests that artificial intelligence (AI) and machine learning (ML) may be useful in the management of hospitalized patients, including those with COVID-19. In light of the challenges faced with diagnostic and prognostic indicators in SARS-CoV-2 infection, our center has developed an international clinical protocol to collect standardized thoracic point of care ultrasound data in these patients for later AI/ML modeling. We surmise that in the future AI/ML may assist in the management of SARS-CoV-2 patients potentially leading to improved outcomes, and to that end, a corpus of curated ultrasound images and linked patient clinical metadata is an invaluable research resource.

“To Do or Not To Do?” Clinical Integration of Point-Of-Care Ultrasound After Training: A Prospective Study

2020 ◽  
Author(s):  
Wan-Ching Lien ◽  
Chih-Heng Chang ◽  
Kah-Meng Chong ◽  
Meng-Che Wu ◽  
Cheng-Yi Wu ◽  
...  
Keyword(s):  
Image Quality ◽  
Prospective Study ◽  
Patient Care ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Global Rating ◽  
Clinical Integration ◽  
Valuable Adjunct ◽  
Global Ratings ◽  
Group 1

Abstract Background: Point-of-care ultrasound (PoCUS) can serve as a valuable adjunct for patient care. This study aimed to investigate the clinical integration of PoCUS of the first post-graduate year (PGY-1) residents after a PoCUS curriculum.Methods: The prospective study was conducted at the emergency department (ED) of the National Taiwan University Hospital between July 2015 and October 2017. Every PGY-1 resident had one-month ED training and a PoCUS curriculum was implemented during the first week. The post-training objective structured clinical examination global ratings were obtained, as well as the sonographic examinations the residents performed on shifts. Four groups could be identified: group 1 performed PoCUS before and after the curriculum; group 2 performed only after the curriculum; group 3 performed only before the curriculum; the last did not perform any examinations.Results: 239 residents participated. The median global rating was 4 (interquartile ranges, 4-5). After the curriculum, an increasing number of residents integrated PoCUS into patient care (64 vs. 170, p=0.037) with acceptable image quality. No differences existed in the global ratings between 4 groups, however, nearly 30% of residents did not use PoCUS during their shifts. Group 1 performed more cases with better image quality and using ≥2 US applications (8/100 vs. 82/359, p=0.0009), compared with those before the curriculum. Comparing with those in groups 1 and 2, group 1 performed more cases (p<0.0001) with better image quality (p=0.03). “No suitable cases” (25/69), and “choosing other imaging priorities” (43/69) were the main feedbacks in groups 3 and 4.Conclusions: A short focused US training had an immediate positive impact on OSCE global ratings and integration of PoCUS of PGY-1 residents in the ED. The global ratings could not predict whether to use PoCUS in the ED practice. Although the working climate was designated to be friendly for utilizing US, a substantial percentage of residents did not use PoCUS. Further longitudinal studies would be needed for the sustained effects of the curriculum.Trial registration: NCT03738033.

scholarly journals POINT: Should the Use of Diagnostic Point-of-Care Ultrasound in Patient Care Require Hospital Privileging/Credentialing? Yes

CHEST Journal ◽  
2020 ◽  
Vol 157 (3) ◽  
pp. 496-498 ◽  
Author(s):  
James M. Walter ◽  
Lewis Satterwhite ◽  
Kenneth E. Lyn-Kew
Keyword(s):  
Patient Care ◽  
Point Of Care ◽  
Point Of Care Ultrasound

scholarly journals Clinical measurements obtained from point-of-care ultrasound images to assess acquisition skills

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Brian P. Lucas ◽  
Antonietta D’Addio ◽  
Clay Block ◽  
Harold L. Manning ◽  
Brian Remillard ◽  
...  
Keyword(s):  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
Clinical Measurements

scholarly journals Model Point-of-Care Ultrasound Curriculum in an Intensive Care Unit Fellowship Program and Its Impact on Patient Management

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Keith Killu ◽  
Victor Coba ◽  
Michael Mendez ◽  
Subhash Reddy ◽  
Tanja Adrzejewski ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Care ◽  
Patient Management ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Fellowship Program ◽  
Icu Patients ◽  
Surgical Icu ◽  
New Diagnosis

Objectives. This study was designed to assess the clinical applicability of a Point-of-Care (POC) ultrasound curriculum into an intensive care unit (ICU) fellowship program and its impact on patient care.Methods. A POC ultrasound curriculum for the surgical ICU (SICU) fellowship was designed and implemented in an urban, academic tertiary care center. It included 30 hours of didactics and hands-on training on models. Minimum requirement for each ICU fellow was to perform 25–50 exams on respective systems or organs for a total not less than 125 studies on ICU. The ICU fellows implemented the POC ultrasound curriculum into their daily practice in managing ICU patients, under supervision from ICU staff physicians, who were instructors in POC ultrasound. Impact on patient care including finding a new diagnosis or change in patient management was reviewed over a period of one academic year.Results. 873 POC ultrasound studies in 203 patients admitted to the surgical ICU were reviewed for analysis. All studies included were done through the POC ultrasound curriculum training. The most common exams performed were 379 lung/pleural exams, 239 focused echocardiography and hemodynamic exams, and 237 abdominal exams. New diagnosis was found in 65.52% of cases (95% CI 0.590, 0.720). Changes in patient management were found in 36.95% of cases (95% CI 0.303, 0.435).Conclusions. Implementation of POC ultrasound in the ICU with a structured fellowship curriculum was associated with an increase in new diagnosis in about 2/3 and change in management in over 1/3 of ICU patients studied.

Lung Ultrasound as a New Technique for Diagnosis of Neonatal Respiratory Diseases

2018 ◽  
Vol 37 (4) ◽  
pp. 224-232 ◽  
Author(s):  
Yasser N. Elsayed
Keyword(s):  
Lung Disease ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
X Ray ◽  
The Past ◽  
Neonatal Lung ◽  
Chest X Ray ◽  
A New Technique

Point-of-care ultrasound in the NICU is becoming more commonplace and is now used for a number of indications. Over the past ten years, the use of ultrasound as an alternative to a chest x-ray for the diagnosis of neonatal lung disease has been explored, and protocols were developed to refine the interpretation of ultrasound images in neonatal lung disease. The purpose of this column is to briefly explain the physics of ultrasound and describe the application of ultrasound to neonatal lung assessment.

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