scholarly journals Adjunctive Use of Point of Care Ultrasound to Diagnose Compartment Syndrome of the Thigh

POCUS Journal ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 64-66
Author(s):  
Neil Long ◽  
Justin S. Ahn ◽  
Daniel J. Kim
Keyword(s):  
Compartment Syndrome ◽  
Operating Room ◽  
Orthopedic Surgery ◽  
Point Of Care ◽  
The Other ◽  
Medical Emergency ◽  
Point Of Care Ultrasound ◽  
Limb Pain ◽  
Anterior Compartment ◽  
Course Of Illness

Compartment syndrome is a medical emergency and must be considered in patients who present with severe limb pain. Compartment syndrome is a clinical diagnosis, classically described as presenting with the 5 ‘P’s (pain, pulselessness, pallor, paraesthesia, and paralysis). Apart from pain, the other findings signify acute arterial obstruction and would be late findings. We present a case of a 31-year-old male in which point of care ultrasound (POCUS) expedited this diagnosis by demonstrating a large thigh hematoma in the anterior compartment. This prompted emergent orthopedic surgery consultation, and the diagnosis of compartment syndrome was confirmed both at the bedside and in the operating room. Compartment syndrome can be a challenging diagnosis, especially early in the course of illness. While POCUS should not be used in isolation in the assessment of possible compartment syndrome, it can be used as an adjunct in the workup, especially if it identifies an underlying cause.

scholarly journals A point-of-care thoracic ultrasound protocol for hospital medical emergency teams (METUS) improves diagnostic accuracy

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Blans M.J ◽  
Bousie E ◽  
Hoeven van der J.G ◽  
Bosch F.H
Keyword(s):  
Point Of Care ◽  
Correct Diagnosis ◽  
Medical Emergency Team ◽  
Final Diagnosis ◽  
Medical Emergency ◽  
Point Of Care Ultrasound ◽  
Emergency Team ◽  
Medical Emergency Teams ◽  
The Us ◽  
Few Data

Abstract Background Point-of-care ultrasound (POCUS) has proven itself in many clinical situations. Few data on the use of POCUS during Medical Emergency Team (MET) calls exist. In this study, we hypothesized that the use of POCUS would increase the number of correct diagnosis made by the MET and increase MET’s certainty. Methods Single-center prospective observational study on adult patients in need for MET assistance. Patients were included in blocks (weeks). During even weeks, the MET physician performed a clinical assessment and registered an initial diagnosis. Subsequently, the POCUS protocol was performed and a second diagnosis was registered (US+). During uneven weeks, no POCUS was performed (US−). A blinded expert reviewed the charts for a final diagnosis. The number of correct diagnoses was compared to the final diagnosis between both groups. Physician’s certainty, mortality and possible differences in first treatment were also evaluated. Results We included 100 patients: 52 in the US + and 48 in the US−  group. There were significantly more correct diagnoses in the US+ group compared to the US− group: 78 vs 51% (P  = 0.006). Certainty improved significantly with POCUS (P  <  0.001). No differences in 28-day mortality and first treatment were found. Conclusions The use of thoracic POCUS during MET calls leads to better diagnosis and increases certainty. Trial registration. ClinicalTrials.gov. Registered 12 July 2017, NCT03214809 https://www.clinicaltrials.gov/ct2/show/NCT03214809?term=metus&cntry=NL&draw=2&rank=1

scholarly journals Ultrasound versus manipulation to determine an intercostal space for single-port thoracoscopy surgery: A Diagnostic Accuracy Study

2019 ◽  
Author(s):  
chenxi li ◽  
Jianjun Wang ◽  
Zeheng Ma ◽  
Bing Li ◽  
Kang Kang ◽  
...  
Keyword(s):  
Operating Room ◽  
Standard Method ◽  
Single Port ◽  
Point Of Care ◽  
Lateral Position ◽  
Intercostal Space ◽  
Point Of Care Ultrasound ◽  
Correct Position ◽  
Thoracic Surgeon ◽  
Accuracy Study

Abstract Background:Malposition of the intercostal space used for single-port thoracoscopy surgery can lead to severe problems for patients under general anesthesia. The focus of this study was to assess the accuracy of point-of-care ultrasound in verifying the correct position of the intercostal space used for single-port thoracoscopy surgery. Methods: A total of 200 patientsaged18 to 65 years and classified as ASA status I-Ⅲ who underwent selective single-port thoracoscopic lobectomy were enrolled. After the induction of anesthesia, the patients were placed in a lateral position. An independent thoracic team left the operating room after confirming the incision position. First, the intercostal space was located by a young resident thoracic surgeon (working experience less than 1 year),andthe young thoracic surgeon left the operating room after he or she determined the location. Second, the intercostal space was located by a highly experienced thoracic surgeon (working experience more than 20 years) by manipulation; afterwards, the highly experienced thoracic surgeon left the operating room.Finally, the operation was started by a fixed independent thoracic team. After the chest cavity was opened, the final investigator verified the location of the intercostal space under direct vision through thoracoscopy.The timerequired by ultrasound and manipulation were also recorded. Results: There wereno differences between the manipulation and ultrasound methods in terms of accuracy, which was 87.2%(95% CI0.871-0.873) and 85.6%(95% CI0.854-0.857),respectively (p> 0.05). The inter-relationships between ultrasound and the standard method and between manipulation and the standard method were consistent (p<0.05). Manipulation positioning showed a sensitivity of 90.6% (95% CI0.862-0.950) and specificity of 30%(95% CI0.016-0.584), while ultrasound positioning showed a sensitivity of 87.1%(95% CI0.820-0.921) and specificity of 60%(95% CI0.296-0.904).Compared with that of manipulation positioning, the specificity of ultrasound positioning was higher (p<0.05).No differences inPPV and NPV were found between manipulation and ultrasound positioning (p> 0.05). The timerequired by ultrasound (30.37±17.01s) was significantly shorter than that required by manipulation (41.31±35.42 s)(p<0.05). Conclusions: Compared with the manipulation method, the ultrasound-guided methodcould accurately locate the intercostal space for single-port thoracoscopy surgery.Ultrasound requires less time than manipulation. Trial registration:ISRCTN10722758. Registered 04 June 2019 Keywords：Intercostal space; Positioning; Ultrasound; Manipulation;

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

POCUS Journal ◽  
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.

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 ◽  
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.

Sign in / Sign up

Export Citation Format

Share Document