scholarly journals Autonomous Robotic Point-of-Care Ultrasound Imaging for Monitoring of COVID-19–Induced Pulmonary Diseases

2021 ◽  
Vol 8 ◽  
Author(s):  
Lidia Al-Zogbi ◽  
Vivek Singh ◽  
Brian Teixeira ◽  
Avani Ahuja ◽  
Pooyan Sahbaee Bagherzadeh ◽  
...  
Keyword(s):  
Force Feedback ◽  
Close Contact ◽  
Point Of Care ◽  
Ct Scans ◽  
Surface Model ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
Ultrasound Probe ◽  
Optimal Position ◽  
Health Crisis

The COVID-19 pandemic has emerged as a serious global health crisis, with the predominant morbidity and mortality linked to pulmonary involvement. Point-of-Care ultrasound (POCUS) scanning, becoming one of the primary determinative methods for its diagnosis and staging, requires, however, close contact of healthcare workers with patients, therefore increasing the risk of infection. This work thus proposes an autonomous robotic solution that enables POCUS scanning of COVID-19 patients’ lungs for diagnosis and staging. An algorithm was developed for approximating the optimal position of an ultrasound probe on a patient from prior CT scans to reach predefined lung infiltrates. In the absence of prior CT scans, a deep learning method was developed for predicting 3D landmark positions of a human ribcage given a torso surface model. The landmarks, combined with the surface model, are subsequently used for estimating optimal ultrasound probe position on the patient for imaging infiltrates. These algorithms, combined with a force–displacement profile collection methodology, enabled the system to successfully image all points of interest in a simulated experimental setup with an average accuracy of 20.6 ± 14.7 mm using prior CT scans, and 19.8 ± 16.9 mm using only ribcage landmark estimation. A study on a full torso ultrasound phantom showed that autonomously acquired ultrasound images were 100% interpretable when using force feedback with prior CT and 88% with landmark estimation, compared to 75 and 58% without force feedback, respectively. This demonstrates the preliminary feasibility of the system, and its potential for offering a solution to help mitigate the spread of COVID-19 in vulnerable environments.

512 Bedside Transthoracic echography volume Assessment in the BICU

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S103-S103
Author(s):  
Michael G Chambers ◽  
Britton Garrett ◽  
Leopoldo C Cancio
Keyword(s):  
Point Of Care ◽  
Injured Patient ◽  
Bedside Ultrasound ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
Advanced Practice ◽  
Multidisciplinary Rounds ◽  
Volume Assessment ◽  
Us Findings ◽  
Image Repository

Abstract Introduction Point-of-Care Ultrasound (POCUS) has been shown to be a useful adjunct in assessment of various shock states and utilized to guide resuscitative and post-resuscitation de-escalation efforts. POCUS use for guiding resuscitation in burn injured patient has not be described. Objectives characterize the use of bedside ultrasound examinations performed by advance practice providers and treating physicians in a regional burn intensive care unit Methods Daily beside ultrasound examinations were performed utilizing a bedside ultrasound device by an advanced practice provider prior to rounds POCUS examinations consist of: Ultrasound images were archived to a centralized image repository and reviewed daily during multi-disciplinary rounds. Ultrasonographic volume assessment compared to clinical volume assessment made during daily multidisciplinary rounds. Results 100 examinations were performed of those 32 were within the initial 72 hour window: Conclusions Our results demonstrate that bedside ultrasound aides in guidance of both resuscitative and post-resuscitative efforts. We identified a cohort of patients who appeared hypervolemic clinically but US findings supported hypovolemia, we refer to as pseudohypervolemia US volume assessment provides information that changes management. We believe point of care ultrasound is a viable tool in preventing over-resuscitation as well as to guide post-resuscitative diuresis.

scholarly journals Thoracic Point-of-Care Ultrasound: A SARS-CoV-2 Data Repository for Future Artificial Intelligence and Machine Learning

2021 ◽  
pp. 155335062110186
Author(s):  
Abdel-Moneim Mohamed Ali ◽  
Emran El-Alali ◽  
Adam S. Weltz ◽  
Scott T. Rehrig
Keyword(s):  
Artificial Intelligence ◽  
Machine Learning ◽  
Point Of Care ◽  
Prognostic Indicators ◽  
Data Repository ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
Clinical Protocol ◽  
Improved Outcomes ◽  
Current Experience

Current experience suggests that artificial intelligence (AI) and machine learning (ML) may be useful in the management of hospitalized patients, including those with COVID-19. In light of the challenges faced with diagnostic and prognostic indicators in SARS-CoV-2 infection, our center has developed an international clinical protocol to collect standardized thoracic point of care ultrasound data in these patients for later AI/ML modeling. We surmise that in the future AI/ML may assist in the management of SARS-CoV-2 patients potentially leading to improved outcomes, and to that end, a corpus of curated ultrasound images and linked patient clinical metadata is an invaluable research resource.

scholarly journals Clinical measurements obtained from point-of-care ultrasound images to assess acquisition skills

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Brian P. Lucas ◽  
Antonietta D’Addio ◽  
Clay Block ◽  
Harold L. Manning ◽  
Brian Remillard ◽  
...  
Keyword(s):  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
Clinical Measurements

scholarly journals Rural point-of-care ultrasound of the kidney and bladder: quality and effect on patient management

2018 ◽  
Vol 10 (4) ◽  
pp. 324 ◽  
Author(s):  
Garry Nixon ◽  
Katharina Blattner ◽  
Jill Muirhead ◽  
Ngaire Kerse
Keyword(s):  
Patient Care ◽  
Urinary Retention ◽  
Point Of Care ◽  
Renal Stones ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
Positive Contribution ◽  
Diagnostic Certainty ◽  
Negative Effect ◽  
Clinical Records

ABSTRACT INTRODUCTION Point-of-care ultrasound (POCUS) of the kidney and bladder are among the most commonly performed POCUS scans in rural New Zealand (NZ). AIM To determine the quality, safety and effect on patient care of POCUS of the kidney and bladder in rural NZ. METHODS Overall, 28 doctors in six NZ rural hospitals completed a questionnaire both before and after undertaking a POCUS scan over a 9-month period. The clinical records and saved ultrasound images were reviewed by a specialist panel. RESULTS The 28 participating doctors undertook 138 kidney and 60 bladder scans during the study. POCUS of the bladder as a test for urinary retention had a sensitivity of 100% (95% CI 88–100) and specificity of 100% (95% CI 93–100). POCUS of the kidney as a test for hydronephrosis had a sensitivity 90% (95% CI 74–96) and specificity of 96% (95% CI 89–98). The accuracy of other findings such as renal stones and bladder clot was lower. POCUS of the bladder appeared to have made a positive contribution to patient care in 92% of cases without evidence of harm. POCUS of the kidney benefited 93% of cases, although in three cases (2%), it may have had a negative effect on patient care. DISCUSSION POCUS as a test for urinary retention and hydronephrosis in the hands of rural doctors was technically straightforward, improved diagnostic certainty, increased discharges and overall had a positive effect on patient care.

Lung Ultrasound as a New Technique for Diagnosis of Neonatal Respiratory Diseases

2018 ◽  
Vol 37 (4) ◽  
pp. 224-232 ◽  
Author(s):  
Yasser N. Elsayed
Keyword(s):  
Lung Disease ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
X Ray ◽  
The Past ◽  
Neonatal Lung ◽  
Chest X Ray ◽  
A New Technique

Point-of-care ultrasound in the NICU is becoming more commonplace and is now used for a number of indications. Over the past ten years, the use of ultrasound as an alternative to a chest x-ray for the diagnosis of neonatal lung disease has been explored, and protocols were developed to refine the interpretation of ultrasound images in neonatal lung disease. The purpose of this column is to briefly explain the physics of ultrasound and describe the application of ultrasound to neonatal lung assessment.

scholarly journals P83 Online Multidisciplinary Review of Point of Care Ultrasound Images During the COVID-19 Pandemic

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
B A Shuker ◽  
J Perry ◽  
Benjamin Shuker
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multidisciplinary Team ◽  
Point Of Care ◽  
Anticoagulation Therapy ◽  
Vena Cava ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
Thoracic Imaging ◽  
Online Platform

Abstract   Point-of-care-ultrasound (POCUS) is a valuable diagnostic tool in intensive care. Evaluation of POCUS images acquired in our intensive care unit (ICU) prior to the COVID-19 pandemic had typically been performed solely at the point of care. Where further evaluation was required, cross-sectional thoracic imaging or departmental echocardiography would be requested. Clinicians also had access to ICU ultrasound machines for review of images, or to repeat studies for clarification of findings. However, the nature of the pandemic limited access to ICU to minimise contact with COVID-19. Objectives We aimed to develop an online solution for review of POCUS images by the multidisciplinary team (MDT). Methods Microsoft Teams was utilised to create a dedicated channel for the MDT to review POCUS images. Images were exported from ultrasound machines used inside our ICU to portable USB drives in standard formats (DICOM or WMV). The portable USB drives were decontaminated prior to transfer outside of the ICU. Anonymised images were uploaded with relevant clinical details to the Teams platform for MDT review. Results The online platform provided rapid access to images for review by the MDT. POCUS images from ICU patients with and without COVID-19 were reviewed. MDT review frequently led to a change in patient management. Significant examples included identification of a missed inferior vena cava thrombus leading to initiation of anticoagulation therapy, and rapid expert input for a case of cardiac tamponade. Conclusion The use of an online platform allowed our intensive care unit to establish a reliable method for images acquired from point-of-care-ultrasound to be remotely reviewed by an expert multidisciplinary team, consequently improving patient care.

SONO case series: 35-year-old male patient with flank pain

2020 ◽  
Vol 37 (9) ◽  
pp. 582-584 ◽  
Author(s):  
William Shyy ◽  
Roneesha Knight
Keyword(s):  
Renal Colic ◽  
Point Of Care ◽  
Case Series ◽  
Current Evidence ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
Emergency Physicians ◽  
Case Presentation ◽  
The Past ◽  
Questions And Answers

The diagnosis and management of obstructing nephrolithiasis by emergency physicians has undergone great advancements in the past few years. No longer do all patients with suspected renal colic need a CT scan and an immediate urology consult. In this case presentation, we present a classic case of obstructing nephrolithiasis along with the associated point-of-care ultrasound images. We will walk with the reader through a series of questions and answers discussing the patient’s diagnosis based on the most current evidence-based recommendations.

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

2015 ◽  
Vol 7 (3) ◽  
pp. 454-457 ◽  
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.

scholarly journals LO69: A retrospective cohort study on the impact of point-of-care ultrasound on radiologic imaging in patients presenting to the emergency department with suspected uncomplicated renal colic

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S32-S33
Author(s):  
J. Alain ◽  
R. Huard ◽  
A. Mokhtari ◽  
M. Parent ◽  
D. Simonyan ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Renal Colic ◽  
Point Of Care ◽  
Ct Scans ◽  
Point Of Care Ultrasound ◽  
Kappa Score ◽  
Radiologic Imaging

Introduction: The number of CT scans prescribed in the Emergency department (ED) for suspected renal colic has increased over recent years without an associated improvement in patient-centred outcomes. We assessed whether Point-of-Care Ultrasound (PoCUS) decreases the use of formal radiologic imaging. Methods: We completed a retrospective cohort study on consecutive patients 18 years of age and older presenting to the ED with suspected uncomplicated renal colic in a tertiary care centre in Québec in 2016. Exclusion criteria included: previous urologic intervention, solitary kidney, dialysis, fever, pyuria, acute kidney injury, pregnancy, suspicion of a serious alternative diagnosis or persistent symptoms despite analgesia. We compared the proportion (95%CI) of formal radiologic imaging performed (Ultrasound or CT) in patients who had PoCUS in the ED vs. those who did not. Two-tailed Fisher exact test (α = 0.05) and odds ratios (95%CI) calculated from multivariate logistic regression models adjusted for age, gender, Charlson Index and previous renal colic were used to compare the two groups. The reliability of data collection was evaluated with a kappa score (95%CI). Results: 169 patients with uncomplicated renal colic were included. There was no difference between the groups in terms of age, gender, Charlson Index, or previous renal colic. The PoCUS level of training and the doctor's education level was significantly higher in the PoCUS group. There was a non-significant trend towards less formal imaging in patients of the PoCUS group 65/88 (73.9% [63.4-82.7%]) vs. the non-PoCUS group 69/81 (85.2% [75.6-92.1%]), p = 0.087. After adjustment for confounders, the patients not evaluated with PoCUS were more likely to have formal imaging with a significant odds ratio of 2.41 [1.05-5.56]). Among patients who underwent a CT, incidentalomas were found in 16.5% and only 2.0% demonstrated significant findings leading to changes in ED management, such as an alternative diagnosis, need for admission, or an urgent urological intervention. Inter-observer agreement was excellent between assessers with a kappa score of 0.88 [0.66-1.00]. Conclusion: ED patients with uncomplicated renal colic who are investigated with PoCUS tend to have fewer formal imaging test. When CT scans were performed, incidentalomas were found in 16.5% and ED management changed only 2.0% of the time. PoCUS appears to be a useful tool for decreasing CT utilisation in this low-risk ED population.

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