Introduction and clinical scenarios

2019 ◽  
pp. 1-32
Author(s):  
Paul Atkinson ◽  
Bob Jarman ◽  
Tim Harris ◽  
Rip Gangahar ◽  
David Lewis ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Critical Care ◽  
Clinical Skills ◽  
Point Of Care ◽  
Clinical Care ◽  
Critical Care Medicine ◽  
Everyday Practice ◽  
Point Of Care Ultrasound ◽  
Clinical Scenarios ◽  
Clinical Questions

Point-of-Care Ultrasound in Emergency Medicine and Resuscitation provides a curriculum-based guide to the integration of ultrasound into everyday practice for clinicians in emergency medicine and critical care medicine and for resuscitation. In addition to describing commonly used protocols, we focus on how ultrasound can be used to help to answer specific clinical questions and provide guidance for procedures at the point of care, augmenting traditional clinical skills. This chapter introduces the general concepts of using ultrasound at the bedside, describes how to use point-of-care ultrasound (PoCUS), and provides clinical scenarios as examples of where PoCUS can improve clinical care.

scholarly journals Cardiac Point-of-Care Ultrasound Publication Trends

2021 ◽  
Author(s):  
Andrew Pattock ◽  
Michelle Kim ◽  
Cooper Kersey ◽  
Linda Liu ◽  
James Kirkpatrick ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Critical Care ◽  
Point Of Care ◽  
Temporal Trends ◽  
Senior Author ◽  
Annual Number ◽  
Original Research ◽  
Point Of Care Ultrasound ◽  
Publication Type ◽  
Over Time

Introduction: Cardiac point-of-care ultrasound (c-POCUS) is an increasingly implemented diagnostic tool with the potential to guide clinical management. We sought to characterize and analyze the existing c-POCUS literature with a focus on the temporal trends and differences across specialties. Methods: A literature search for c-POCUS and related terms was conducted using Ovid (MEDLINE and Embase) and Web of Science databases through 2020. Eligible publications were classified by publication type and topic, author specialty, geographical region of senior author, and journal specialty. Results: The initial search produced 1761 potential publications. A strict definition of c-POCUS yielded a final total of 574 cardiac POCUS manuscripts. A yearly increase in c-POCUS publications was observed. Nearly half of publications were original research (48.8%) followed by case report or series (22.8%). Most publications had an emergency medicine senior author (37.5%), followed by cardiology (20.2%), anesthesiology (12.2%), and critical care (12.2%). The proportion authored by emergency medicine and cardiologists has decreased over time while those by anesthesiology and critical care has generally increased, particularly over the last decade. First authorship demonstrated a similar trend. Articles were published at similar numbers in emergency medicine journals (23.0%) and cardiology journals (19.9%). Conclusion: The annual number of c-POCUS publications has steadily increased over time reflecting the increased recognition and utilization of c-POCUS. This study can help inform clinicians of the current state of c-POCUS and augment the discussion surrounding barriers to continued adoption across all specialties.

scholarly journals Development and Validation of an Assessment Tool for Competency in Critical Care Ultrasound

2015 ◽  
Vol 7 (4) ◽  
pp. 567-573 ◽  
Author(s):  
Paru Patrawalla ◽  
Lewis Ari Eisen ◽  
Ariel Shiloh ◽  
Brijen J. Shah ◽  
Oleksandr Savenkov ◽  
...  
Keyword(s):  
Critical Care ◽  
Delphi Method ◽  
Assessment Tool ◽  
Point Of Care ◽  
Critical Care Medicine ◽  
Competency Assessment ◽  
Point Of Care Ultrasound ◽  
Modified Delphi Method ◽  
Modified Delphi ◽  
Critical Care Ultrasound

ABSTRACT Background Point-of-care ultrasound is an emerging technology in critical care medicine. Despite requirements for critical care medicine fellowship programs to demonstrate knowledge and competency in point-of-care ultrasound, tools to guide competency-based training are lacking. Objective We describe the development and validity arguments of a competency assessment tool for critical care ultrasound. Methods A modified Delphi method was used to develop behaviorally anchored checklists for 2 ultrasound applications: “Perform deep venous thrombosis study (DVT)” and “Qualify left ventricular function using parasternal long axis and parasternal short axis views (Echo).” One live rater and 1 video rater evaluated performance of 28 fellows. A second video rater evaluated a subset of 10 fellows. Validity evidence for content, response process, and internal consistency was assessed. Results An expert panel finalized checklists after 2 rounds of a modified Delphi method. The DVT checklist consisted of 13 items, including 1.00 global rating step (GRS). The Echo checklist consisted of 14 items, and included 1.00 GRS for each of 2 views. Interrater reliability evaluated with a Cohen kappa between the live and video rater was 1.00 for the DVT GRS, 0.44 for the PSLA GRS, and 0.58 for the PSSA GRS. Cronbach α was 0.85 for DVT and 0.92 for Echo. Conclusions The findings offer preliminary evidence for the validity of competency assessment tools for 2 applications of critical care ultrasound and data on live versus video raters.

Fifteen-minute consultation: Using point of care ultrasound to assess children with respiratory failure

2018 ◽  
Vol 104 (1) ◽  
pp. 2-10 ◽  
Author(s):  
Helen L Ord ◽  
Michael J Griksaitis
Keyword(s):  
Emergency Medicine ◽  
Critical Care ◽  
Respiratory Failure ◽  
Respiratory Distress ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Diagnostic Features ◽  
Paediatric Practice ◽  
The Impact ◽  
Indications For Use

Point of care ultrasound (POCUS) is well established in adult emergency medicine and critical care. It is used for immediate diagnosis and evaluation of the impact of bedside interventions in the acutely unwell child. This article highlights how ultrasound can be helpful in paediatric practice when dealing with the neonate, infant or older child with undifferentiated respiratory distress, respiratory failure or ventilation problems. It highlights indications for use, key diagnostic features of common pathology and outlines the benefits of POCUS in everyday practice.

scholarly journals Point-of-Care Airway Ultrasonography Prior to an Emergency Cricothyroidotomy: Case report

2018 ◽  
Vol 18 (2) ◽  
pp. 219 ◽  
Author(s):  
Mohamad Iqhbal ◽  
Julina M. Noor ◽  
Nur A. Karim ◽  
Izzat Ismail ◽  
Halim Sanib ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Critical Care ◽  
Case Report ◽  
Imaging Technique ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Vocal Cords ◽  
Emergency Tracheostomy ◽  
Airway Ultrasound

The use of ultrasonography in acute and critical care medicine is becoming increasingly common. However, use of an airway ultrasound as an adjunct to determine the type of intervention needed and assess complications is not common practice. We report a 56-year-old male who presented to the Emergency Department of the Sungai Buloh Hospital, Selangor, Malaysia, in 2015 with hoarseness, stridor and impending respiratory failure. A point-of-care ultrasound performed to assess the neck and vocal cords indicated a heterogeneous echogenic mass in the larynx, thus ruling out a cricothyroidotomy. The patient was therefore referred for an emergency tracheostomy. This case highlights the importance of point-of-care airway ultrasonography in the assessment of patients with stridor. This imaging technique not only helps to detect the cause of the stridor, but also to determine the feasibility of a cricothyroidotomy in emergency cases.Keywords: Emergency Medicine; Stridor; Ultrasonography; Airway Management; Tracheostomy; Case Report; Malaysia.

scholarly journals LO098: Education innovation: implementing a point-of-care ultrasound curriculum for emergency medicine residents

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S64-S64
Author(s):  
D. Leung ◽  
J. Chenkin
Keyword(s):  
Emergency Medicine ◽  
Test Scores ◽  
Point Of Care ◽  
Clinical Care ◽  
Journal Article ◽  
Curriculum Evaluation ◽  
Standard Of Care ◽  
Clinical Encounter ◽  
Point Of Care Ultrasound ◽  
Post Test

Introduction / Innovation Concept: Point-of-care ultrasound (POCUS) is becoming standard of care in Canadian emergency departments. However, its integration in Emergency Medicine (EM) residency training is poorly studied. If a four-week curriculum can successfully teach POCUS skills to residents, this program could have potential application across specialties and across Canada. Methods: A four-week curriculum was designed, implemented, and evaluated. EM residents registered for the Introductory Ultrasound Rotation at Sunnybrook Health Sciences Centre were invited to participate. Curriculum evaluation included resident feedback, pre-rotation and post-rotation knowledge and skill testing, and a delayed post-rotation survey. Comparison of pre-test and post-test scores were calculated using the paired t-test. Curriculum, Tool, or Material: Residents were scheduled for both dedicated ultrasound scanning shifts and clinical shifts with an emphasis on POCUS in patient care. Residents also reviewed the Canadian Emergency Ultrasound Society Emergency Department Echo DVD and manual, completed weekly readings and assignments, and completed a “clinical encounter worksheet” describing how POCUS impacted clinical care in a patient encounter. Other rotation activities included Ultrasound Rounds where residents presented a critical appraisal of a POCUS-related journal article, Pediatric Ultrasound Rounds at The Hospital for Sick Children, and an advanced POCUS workshop day. Of 13 eligible residents, 12 (92%) completed at least one study assessment. However, only 8 residents (62%) completed both the pre-test and post-test, 8 residents (62%) completed the end-of-rotation survey, and even fewer residents (42%) completed the delayed post-rotation survey. Residents felt the quality of the ultrasound rotation was excellent (mean score 4.7 on 5-point Likert scale). There was an increase in test scores from a baseline of 51.5% to 70.8% on the post-rotation test (p=0.02). Three months after the rotation, 100% of residents reported feeling either comfortable or extremely comfortable teaching and using the core POCUS topics covered in the curriculum. All residents reported that they would recommend the rotation to their colleagues without hesitation. All residents passed the national ultrasound certification examination at the end of the rotation. Conclusion: A four-week curriculum was effective in teaching EM residents POCUS skills. Further study is required to determine the ideal method for teaching POCUS skills in this group.

scholarly journals Patient Care in Emergency and Critical Care Medicine: An Interview with Dr. Robert Arntfield

2021 ◽  
Author(s):  
Brintha Sivajohan ◽  
Himani Dhar
Keyword(s):  
Critical Care ◽  
Point Of Care ◽  
Health Sciences ◽  
Medical Director ◽  
Critical Care Medicine ◽  
Point Of Care Ultrasound ◽  
Trauma Unit ◽  
London Health ◽  
Critical Care Ultrasonography ◽  
Canadian Healthcare

Dr. Robert Arntfield is a critical care intensivist and traumatologist at London Health Sciences Center where he also acts as the medical director of the Critical Care Trauma Unit. Originally interested in emergency medicine, he then carved his pathway to enter the realm of critical care. Dr. Arntfield is a world-renowned expert in critical care ultrasonography and lectures globally on the topic. He is currently working in collaboration with multiple artificial intelligence and technology companies to advance the applications of Point-of-Care Ultrasound (POCUS). We had the opportunity to talk to Dr. Arntfield about the field of critical care medicine at LHSC, in Canadian healthcare, and the significance of the POCUS within the field.

scholarly journals A survey demonstrating that the procedural experience of residents in internal medicine, critical care and emergency medicine is poor: training in ultrasound is required to rectify this

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Mamdouh Souleymane ◽  
Rajkumar Rajendram ◽  
Naveed Mahmood ◽  
Amro M. T. Ghazi ◽  
Yousuf M. S. Kharal ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Emergency Medicine ◽  
Critical Care ◽  
Improve Patient Safety ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Ultrasound Guided ◽  
Procedural Skills ◽  
Skill Gaps ◽  
Residency Programme

Abstract Background Training in procedural skills is often suboptimal. The aim of this study was to quantify the needs of residents in internal medicine (IM), critical care (CC), and emergency medicine (EM) for instruction in ultrasound-guided procedures. Methods All IM, EM and CC residents (n = 200) at King Abdulaziz Medical City, Riyadh, Saudi Arabia, were invited to participate in a questionnaire-based survey to identify skill and experience gaps. The contribution of procedural skills to patient care (i.e. applicability) and proficiency in the sterile technique required to perform ultrasound-guided procedures were rated on Likert scales. Data on training, accreditation, and experience with and without ultrasound were collected. Results The overall response rate was 72% (IM 91%, CC 100%, EM 40%). Although the sample reported that procedural skills were very applicable, 19% (IM n = 25, EM n = 2) had not performed any procedures. However, five residents were accredited in point-of-care ultrasound, 61% of the sample had performed ultrasound-guided procedures and 65% had used landmark techniques. Whilst more internists had performed procedures using landmark techniques, CC and EM residents had performed more ultrasound-guided procedures. Whilst CC residents had not missed any opportunities to perform procedures because supervisors were less available, EM (6) and IM (89) residents had. Whilst skill gaps were only identified in the IM residency programme, experience gaps were present in all three residency programmes. The IM residency programme had larger experience gaps than the CC and EM programmes for all procedural skills. Discussion Residents in IM, CC and EM perceive that ultrasound-guided procedures are relevant to their practice. However, the IM residents performed fewer procedures than CC residents and EM residents at least partly because internists also lack skills in ultrasound. Training in ultrasound-guided procedures may reduce the use of landmark techniques and improve patient safety. Residents in IM, CC and EM therefore require training in ultrasound-guided procedures.

Sign in / Sign up

Export Citation Format

Share Document