scholarly journals Diagnostic accuracy of bedside ultrasonography in COVID-19 suspected patients admitted to the emergency department

2021 ◽  

Introduction: Due to the risk of cross contamination and radiation exposure of computed tomography (CT) and low sensitivity rate of X-Ray, point of care ultrasound (POCUS) lung can be used as a diagnostic tool of COVID-19 pneumonia. The current study aimed to evaluate the potential of POCUS for detection of lung pathologies caused by COVID-19. Methods: This prospective observational study was conducted with 84 patients admitted to the emergency department with suspected COVID-19. CT and POCUS lung were performed for all participants. CCT was taken as the reference diagnostic method and the presence of B-lines or consolidation or pleural irregularity-thickening (>3 mm) in the lung in POCUS lung, were evaluated in favor of COVID-19 pneumonia. Results: Of the 84 patients included, lesions of COVID-19 pneumonia were detected 53.5%. COVID-19 pneumonia findings were shown by POCUS lung in 51.2% of participants. The left lower lobe in 48.8% and the right lower lobe in 47.6% of the patients were the most commonly affected regions. In POCUS lung, COVID-19 pneumonia lesions located in 2nd area for 44.0%, in 7th area for 35.7%, in 8th area for 34.5%. Sensitivity of POCUS lung was found to be 88.9%, specificity pointed for 92.3%, positive predictive value was 93.0% and negative predictive value was 87.8%. Conclusion: POCUS lung, has a high sensitivity and specificity in the diagnosis of COVID-19 pneumonia, especially in severe lung involvement. Therefore, POCUS lung should be the method of choice as its practical use, bedside availability and avoidance of radiation exposure for COVID-19 associated lung lesions.

2019 ◽  
Vol 3 (3) ◽  
pp. 286-288
Author(s):  
Peter Patitsas ◽  
Richard Davis ◽  
Robert Strony

A 53-year-old male presented with pain in the right elbow that was sudden in onset and progressively worsening over approximately eight hours. The pain was exacerbated with any movement of the elbow. Of note, he had been recently admitted for robotic prostatectomy and had a prolonged hospital stay requiring a course of antibiotics. This case report details the emergency department evaluation of septic arthritis of the elbow with a focus on best practices for ultrasound- guided elbow arthrocentesis.


2019 ◽  
Vol 3 (4) ◽  
pp. 425-427
Author(s):  
Anthony Halupa ◽  
Robert Strony ◽  
David Bulbin ◽  
Chadd Kraus

A 71-year-old male presented to the emergency department (ED) for worsening right knee pain for the prior 3-4 weeks. Point-of-care ultrasound (POCUS) of the right knee showed a pseudo-double contour sign. Subsequent ultrasound-guided arthrocentesis of the knee joint was performed, and fluid studies showed the presence of calcium pyrophosphate crystals, which was consistent with pseudogout. Ultrasound for detection of calcium pyrophosphate crystals in pseudogout and chondrocalcinosis has sensitivity of 86.7% and specificity of 96.4% making POCUS a valuable tool for diagnosing crystalline-induced arthropathy in the ED.


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.


Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1043
Author(s):  
Tove Hoffman ◽  
Linda Kolstad ◽  
Bengt Rönnberg ◽  
Åke Lundkvist

The potential of rapid point-of-care (POC) tests has been subject of doubt due to an eventual risk of production errors. The aim was therefore to evaluate the two separate production lots of a commercial POC lateral flow test, intended for the detection of IgM and IgG against the SARS-CoV-2 spike protein (S1). Control samples consisted of serum from individuals with confirmed SARS-CoV-2 infection and pre-COVID-19 negative sera gathered from a biobank. The presence of anti-S1 IgM/IgG in the sera was verified by an in-house Luminex-based serological assay (COVID-19 SIA). One hundred samples were verified as positive for anti-S1 IgG and 74 for anti-S1 IgM. Two hundred samples were verified as negative for anti-S1 IgM/IgG. For the two lots of the POC-test, the sensitivities were 93.2% and 87.8% for IgM and 93.0% and 100% for IgG. The specificities were 100% for IgM and 99.5% for IgG. The positive predictive value was 100% for IgM and 98.9% and 99.0% for IgG. The negative predictive value was 97.6% and 95.7% for IgM, and 96.6% and 100% for IgG. The evaluated POC-test is suitable to assess anti-SARS-CoV-2 S1 IgM and IgG, as a measure of previous virus exposure on an individual level. The external validation of separate lots of rapid POC-tests is encouraged to ensure high sensitivity before market introduction.


Reports ◽  
2021 ◽  
Vol 4 (3) ◽  
pp. 21
Author(s):  
Bo-Ku Chen ◽  
Po-Wei Chiu ◽  
Chih-Hao Lin

Endarterectomy is an effective intervention to remove the atheromatous plaque in the inner lining of the artery, aiming to revascularize the occluded/stenosed vessel in patients with peripheral arterial occlusive disease (PAOD). The most common wound-related complication is postoperative bleeding, followed by infection, hematoma, and seroma. However, hematoma complications with air surrounded have rarely been reported in clinical cases. Case presentation: A 90-year-old female patient visited our emergency department because of a rapidly growing hematoma with pulsatile bleeding over her right groin area. She had received bilateral percutaneous transluminal angioplasty with endarterectomy for PAOD one month prior. A point-of-care ultrasound revealed a large hypoechoic mass, with a dirty shadow on the right groin area. Computed tomography angiography showed a hematoma over her right femoral region, with free air surrounding the right femoral artery. Angiography revealed an irregular shaped lesion on the right femoral artery without contrast extravasation. The patient was diagnosed with right-femoral post-endarterectomy infection with infected hematoma, with the inclusion of air. She underwent urgent excision and repair of the right femoral artery infectious lesion, debridement of the infectious hematoma and stenting of the right external iliac artery, common femoral artery and superficial femoral artery.


2020 ◽  
Vol 12 (1) ◽  
Author(s):  
T. J. Olgers ◽  
N. Azizi ◽  
H. R. Bouma ◽  
J. C. ter Maaten

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