Point-of-care ultrasound evaluation and puncture simulation of the internal jugular vein by medical students

Background: Hemodynamic monitoring its early stabilization is very important in critically ill patients. Evaluating the Internal jugular vein diameter during respiratory cycles by the means of Point-of care ultrasound provides an important, easily available and precise index for monitoring hemodynamic status; a new method which is called Internal Jugular Vein Collapsibility Index (IJV-CI). Any events that alters intrathoracic volumes and pressures may affect this index. In this study we investigate the effects of various levels of positive end-expiratory pressure on this index. Methods: Thirty mechanically ventilated patients were studied. We used three different PEEP levels (0, 5 and 10 cmH2o) and point-of-care ultrasound evaluation of IJV (Internal Jugular Vein) diameter to determine the IJV-CI. The analysis were performed using SPSS V.25.0. Results: Patients were included men (76.6%) and women (33.3%). The mean age of patients was 39.65±3.4 for men and 42.71± 9.34 for women. The IJV-CI were 20.71±11.77 and 24.25±11.46 in PEEP=0 and PEEP=10 cmH20 groups respectively. In 5cmH20-PEEP group median and interquartile range were 16.45(14.8). The IJV-CI in three different PEEP levels were not statistically significantly different. Conclusion: According to the finding of this study, we found no evidence of an optimal PEEP level to measure The IJV-CI.

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Point-of-Care Ultrasound Identification of Internal Jugular Vein Thrombosis in Newly Diagnosed Lymphoma

Pediatric Emergency Care ◽

10.1097/pec.0000000000001333 ◽

2017 ◽

Vol 33 (12) ◽

pp. 800-802

Author(s):

Joanna C. Ekstrom ◽

Valerie Whitcomb ◽

Kelly R. Bergmann

Keyword(s):

Internal Jugular Vein ◽

Jugular Vein ◽

Point Of Care ◽

Point Of Care Ultrasound ◽

Newly Diagnosed ◽

Jugular Vein Thrombosis ◽

Vein Thrombosis ◽

Internal Jugular Vein Thrombosis

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Ultrasonography of a Helical Left Common Carotid Artery

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2020.2.46272 ◽

2020 ◽

Vol 4 (2) ◽

pp. 230-231

Author(s):

Bethany Busack ◽

Vy Tran ◽

Christopher Busack ◽

Christine Butts

Keyword(s):

Carotid Artery ◽

Internal Jugular Vein ◽

Common Carotid Artery ◽

Jugular Vein ◽

Point Of Care ◽

Standard Of Care ◽

Central Venous Line ◽

Point Of Care Ultrasound ◽

Central Venous ◽

Central Lines

Case Presentation: An 83-year-old woman was admitted to the intensive care unit for septic shock at which point an internal jugular central venous line was placed. The patient’s common carotid artery was visualized in an atypical location, lateral to the internal jugular vein. Further inspection revealed the common carotid artery travelling in a rotational trajectory around the internal jugular vein. Discussion: For at least two decades, point-of-care ultrasound has become the standard of care for placing central venous lines. This surprising anatomical orientation is rare and cautions physicians to fully explore a patient’s anatomy prior to placing central lines.

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Longitudinal Ultrasound Curriculum Improves Long-Term Retention Among Internal Medicine Residents

Journal of Graduate Medical Education ◽

10.4300/jgme-14-00284.1 ◽

2015 ◽

Vol 7 (3) ◽

pp. 454-457 ◽

Cited By ~ 30

Author(s):

Diana J. Kelm ◽

John T. Ratelle ◽

Nabeel Azeem ◽

Sara L. Bonnes ◽

Andrew J. Halvorsen ◽

...

Keyword(s):

Internal Medicine ◽

Pleural Effusion ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Point Of Care ◽

Vena Cava ◽

Knowledge Retention ◽

Point Of Care Ultrasound ◽

Ultrasound Images

ABSTRACT Background Point-of-care ultrasound is a rapidly evolving component of internal medicine (IM) residency training. The optimal approach for teaching this skill remains unclear. Objective We sought to determine whether the addition of a longitudinal ultrasound curriculum to a stand-alone workshop for ultrasound training improved knowledge retention in IM residents. Methods We conducted an observational cohort study from July to December 2013. All postgraduate year (PGY)-1 IM residents attended an ultrasound workshop during orientation. Ability to identify static images of ascites, kidney, thyroid, pleural fluid, inferior vena cava, and internal jugular vein was assessed immediately after the workshop. An ultrasound curriculum, including morning report and ultrasound rounds, was initiated during the inpatient medicine rotation. PGY-1 residents were randomly assigned to participate in the longitudinal curriculum. Six months later, we conducted a follow-up survey with all PGY-1 residents. Results Forty-eight PGY-1 residents (67%) completed the postworkshop test and the 6-month follow-up test. Of these, 50% (24 of 48) had participated in the ultrasound curriculum. Residents not exposed to the curriculum showed a decline in the identification of ascites, pleural effusion, and internal jugular vein at 6 months (P < .05), whereas those who participated in the curriculum maintained their performance (P < .05). Conclusions Six months after exposure to a longitudinal ultrasound curriculum, residents were more likely to correctly identify ultrasound images of ascites, kidney, and pleural effusion. The addition of a longitudinal ultrasound curriculum may result in improved knowledge retention in IM residents.

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Idiopathic Bilateral Internal Jugular Vein Thrombosis Diagnosed by Point-of-Care Ultrasound

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2019.11.44855 ◽

2020 ◽

Vol 4 (1) ◽

pp. 101-102

Author(s):

Victor Aquino-Jose ◽

Jennifer Johnson ◽

Tina Dulani

Keyword(s):

Internal Jugular Vein ◽

Jugular Vein ◽

Point Of Care ◽

Point Of Care Ultrasound ◽

Jugular Vein Thrombosis ◽

Vein Thrombosis ◽

Unusual Condition ◽

Arm Swelling ◽

Internal Jugular Vein Thrombosis ◽

Pitting Edema

Internal jugular vein (IJV) thrombosis is an unusual condition, especially when it develops bilaterally. This is a case of bilateral IJV thrombosis in a 77-year old female who presented to the emergency department with neck and arm swelling after discontinuing apixaban and undergoing an oropharyngeal procedure. The diagnosis of bilateral IJV thrombosis was made with the use of point-of-care ultrasound to evaluate bilateral jugular vein distention and bilateral upper extremity pitting edema found on her physical examination.

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Pilot Project: Does formal bedside training of medical students with a FAST exam increase their knowledge and comfort level with ultrasound use in a community family medicine practice setting?

POCUS Journal ◽

10.24908/pocus.v2i2.13279 ◽

2017 ◽

Vol 2 (2) ◽

pp. 15-17

Author(s):

Rimi Sambi, MD ◽

Heather Sawula, MD ◽

Brent Wolfrom, MD ◽

Joseph Newbigging, MD

Keyword(s):

Medical Students ◽

Family Medicine ◽

Point Of Care ◽

Training Session ◽

Undergraduate Curriculum ◽

Knowledge Retention ◽

Comfort Level ◽

Point Of Care Ultrasound ◽

Medical Undergraduate ◽

Fast Exam

As point of care ultrasound (PoCUS) becomes increasingly popular and a standard of care in many clinical settings, the interest for integration in medical undergraduate curriculum is also growing [1]. This project aims to assess whether formal bedside Focused Abdominal Scan for Trauma (FAST) exam training of medical students increases their knowledge and comfort with the use of bedside ultrasound in a family medicine setting at Queen’s University. Third year medical students (n=18) were recruited to participate in a training session involving a 1-hour online video and 2-hour hands-on session. Knowledge based surveys were completed before and after the training. A survey was completed 4 months after the teaching session evaluating knowledge retention, comfort, and application of skills. Student knowledge of PoCUS and FAST increased and was maintained (pre-training 56%±20%, post-training 82%±10%, p<0.001). Self-evaluation of comfort performing a FAST examination (5-point Likert scale) similarly increased post-training session (pre-training 1.4±0.8, post-training 3.8±0.9, p<0.005), but decreased 4 months later (3±1.2, p<0.005). Students in this study were unanimously interested in ultrasound training and the methods used effectively increased theoretical knowledge and comfort with use. Students did not retain their comfort levels with FAST exam 4 months after the training session, nor did they have the opportunity to utilize the skills learned. Further evidence is required to identify the applicability of these results to undergraduate curriculum development.

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