Experience of Snakebite Envenomation by a Desert Viper in Qatar

Crotaline and elapid snakebites are reported all over the world as well as in the Middle East and other countries around this region. However, data regarding snakebites and their treatment in Qatar are limited. This review paper is going to investigate the presentation and treatment of snakebite in Qatar. A good assessment helps to decide on the management of the snakebites envenomation. Antivenom and conservative management are the mainstays of treatment for crotaline snakebite. Point-of-care ultrasound (POCUS) has been suggested to do early diagnosis and treatment of soft tissue problems, such as edema and compartment syndrome, after a snakebite. The supporting data are not sufficient regarding the efficiency of POCUS in diagnosing the extent and severity of tissue involvement and its ultimate effect on the outcome. Further research is suggested in this case. Systemic complications, such as bleeding diathesis, can be managed by administering clotting factors and platelets.

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

POCUS Journal ◽

10.24908/pocus.v3i1.13310 ◽

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.

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The role of point-of-care ultrasound in the diagnosis and management of necrotizing soft tissue infections

The Ultrasound Journal ◽

10.1186/s13089-020-0153-4 ◽

2020 ◽

Vol 12 (1) ◽

Cited By ~ 1

Author(s):

Luís Magalhães ◽

Sara Raquel Pereira Martins ◽

Ramon Nogué

Keyword(s):

Soft Tissue ◽

Point Of Care ◽

Point Of Care Ultrasound ◽

Soft Tissue Infections ◽

Diagnosis And Management ◽

Necrotizing Soft Tissue Infections

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2092216 Point-Of-Care Ultrasound in the Evaluation Of Intravenous Drug Users With Soft Tissue Infection

Ultrasound in Medicine & Biology ◽

10.1016/j.ultrasmedbio.2014.12.653 ◽

2015 ◽

Vol 41 (4) ◽

pp. S171

Author(s):

Srikar Adhikari ◽

Lori Stolz ◽

Richard Amini ◽

Albert Fiorello

Keyword(s):

Soft Tissue ◽

Soft Tissue Infection ◽

Drug Users ◽

Point Of Care ◽

Tissue Infection ◽

Intravenous Drug ◽

Point Of Care Ultrasound ◽

Intravenous Drug Users

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

Proceedings of IMPRS ◽

10.18060/22745 ◽

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.

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

10.21203/rs.3.rs-27350/v1 ◽

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.

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