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 ◽  
...  

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.

POCUS Journal ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 13-14
Author(s):  
Hadiel Kaiyasah, MD, MRCS (Glasgow), ABHS-GS ◽  
Maryam Al Ali, MBBS

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.


POCUS Journal ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 15-17
Author(s):  
Maryam Al Ali, MBBS ◽  
Abeeha Gardezi, MBBsch ◽  
Michael Jalal, MBBS ◽  
Shihab Al Sheikh, MB.ChB. CABS. MRCS.

Point of care ultrasound (POCUS) plays an important role in the Emergency Department or in any Critical Care Unit. In our case, we present how a POCUS mnemonic guided us in diagnosing two fatal conditions in a single case.


Author(s):  
Robert Farrow ◽  
Graham Becherer-Bailey ◽  
Daniel Mantuani ◽  
Arun Nagdev

Introduction: Coronavirus disease 2019 (COVID-19) is caused by the virus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several case series from Italy and China have highlighted the lung ultrasound findings of this disease process and may demonstrate its clinical utility during the current pandemic. Case Report: We present a case of a COVID-19 patient who presented to the emergency department twice within a 24-hour period with rapidly progressing illness. A multi-organ point-of-care ultrasound (POCUS) evaluation was used on the return visit and assisted clinical decision-making. Discussion: A multi-organ POCUS exam allows for quick assessment of acute dyspnea in the emergency department. As the lung involvement of COVID-19 is primarily a peripheral process it is readily identifiable via lung ultrasound. We believe that when applied efficiently and safely a POCUS exam can reduce clinical uncertainty and potentially limit the use of other imaging modalities when treating patients with COVID-19. Conclusion: This case highlights the utility of an early multiorgan point-of-care assessment for patients presenting with moderate respiratory distress during the severe SARS-CoV-2 pandemic.


Author(s):  
Andrew Pattock ◽  
Michelle Kim ◽  
Cooper Kersey ◽  
Linda Liu ◽  
James Kirkpatrick ◽  
...  

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.


2020 ◽  
Vol 4 (4) ◽  
pp. 527-529
Author(s):  
Barry Knapp ◽  
Kean Feyzeau ◽  
Austin Smith ◽  
Donald Byars ◽  
Craig Goodmurphy ◽  
...  

Introduction: Point-of-care ultrasound (POCUS) education during medical school develops physicians who are properly prepared for the next generation of medicine. The authors present the case of a first-year medical student who self-diagnosed appendicitis using POCUS. Case Report: A 25-year-old, first-year medical student presented to the emergency department with lower abdominal pain. What seemed like a straightforward appendicitis presentation came with a twist; the student brought self-performed ultrasound imaging of his appendix. Conclusion: The student’s ultrasound skill set reflects favorably on the rapid evolution of ultrasound teaching in medical education.


Author(s):  
Helen L Ord ◽  
Michael J Griksaitis

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.


2021 ◽  
Vol 9 (E) ◽  
pp. 293-297
Author(s):  
Korakot Apiratwarakul ◽  
Kamonwon Ienghong ◽  
Nichaphat Tongthummachat ◽  
Takaaki Suzuki ◽  
Somsak Tiamkao ◽  
...  

BACKGROUND: Point-of-care ultrasound (POCUS) is the core competency in the Emergency Medicine (EM) residency training. However, there are many methods that can be used to evaluate this competency, and the best practices for teaching ultrasonography to residents have yet to be determined. AIM: The researchers aimed at evaluating the POCUS knowledge and skills of the EM residents after having participated in the POCUS training during their first ultrasound rotation in the Emergency Department. METHODS: A curriculum was developed in the form of a 2-week rotation in the EM residency program at the Department of EM at Khon Kaen University’s Srinagarind Hospital. It consisted of didactic lectures, bedside ultrasound trainings, the journal club, and the process of reviewing the images. Tools were developed, which included a knowledge exam. For each resident, the assessments were administered before and after the rotation. Furthermore, an ultrasound skills test was developed to be used at the end of the 1st year EM residency program. RESULTS: Nine EM residents completed their rotations and the tests. The average pre-training score and post-training scores were 5.25 ± 1.03 and 8.50 ± 1.20, respectively. The mean difference score between pre- and post-test was 3.25 ± 1.28. (95% CI −4.321, −2.178). In terms of the ultrasound skills test, the average total score was 26.13 out of 30 (87.1%). Moreover, the residents had higher scores in the aspects of image acquisition (87.5%) and image interpretation (87.5%). However, for the aspect of clinical decision-making, the average score was 75%. The survey questions indicated that with respect to all of the academic activities, the “Bedside ultrasound,” which had encouraged the residents to learn POCUS, was given the highest score (4.75 of 5). CONCLUSIONS: The 2-week ED ultrasound rotation had improved the residents’ EM ultrasound knowledge and skills.


Author(s):  
Paul Atkinson ◽  
Bob Jarman ◽  
Tim Harris ◽  
Rip Gangahar ◽  
David Lewis ◽  
...  

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.


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