Author Affiliation Jeremy Montez, BS, PA-C Keck School of Medicine, University of Southern California Sean Henderson, MD Keck School of Medicine, University of Southern California We would like to thank the contributing authors Manson et al1 for their article “Identification of Sonographic B-Lines with Linear Transducer Predicts Elevated B-Type Natriuretic Peptide Level.” By attempting to […]
This study sought to correlate the presence of pleural-based B-lines seen by emergency department ultrasound performed with the linear transducer with B-type natriuretic peptide (BNP) level in patients with suspected congestive heart failure.
This report highlights the importance of using bedside ultrasound in the emergency department to confirm guide-wire placement when performing central venous catheter placement prior to dilating and cannulating the vessel.
Use of bedside emergency department (ED) ultrasound has become increasingly important for the clinical practice of emergency medicine (EM). We sought to evaluate differences in the availability of immediate bedside ultrasound based on basic ED characteristics and physician staffing.
An adult male presented to the emergency department complaining of two days of exertional shortness of breath and progressive chest pain. He was afebrile with a blood pressure of 135/88 mmHg, heart rate of 105 beats/minute, respiratory rate of 22 breaths/minute, and a SaO2 of 94% on room air.
Ultrasound images of a patient presenting to the emergency department with expressive aphasia who was found to have carotid dissection. The first image is a standard two dimensional image that depicts the internal carotid with a visible flap within the lumen. The second image is a color Doppler image showing turbulent flow within the true lumen and visible flow within the false lumen. The case and the patient’s outcome are summarized along with some teaching points about carotid dissection. Also, there is some background and research on using ultrasound to help identify dissection.
A 79-year-old female presented to the emergency department complaining of two weeks of dyspnea on exertion and heart palpitations. A computed tomography (CT) pulmonary angiogram was obtained to rule out pulmonary embolism, which was negative.
Bedside ultrasound interrogation of the thorax can aide the clinician in determining the cause of the respiratory dysfunction. Often plain radiographs are not sufficient to differentiate pathology. We present a case in which bedside ultrasound defined the pathology without the need for further imaging.
The U.S. Department of Health and Human Services Office of the Inspector General has issued a report concerning “high use” and “questionable use” ultrasound. Findings include those geographic areas where occurrences are most frequent, as well as the most common elements that characterize questionable use. While not its primary focus, emergency physician performed bedside ultrasound is within the scope of the report. Implications for emergency ultrasound are discussed and practice recommendations made for minimizing regulatory exposure for emergency physicians and departments.
Education in emergency ultrasound (EUS) has become an essential part of emergency medicine (EM) resident training. In 2009, comprehensive residency training guidelines were published to ensure proficiency in ultrasound education. The American College of Emergency Physicians (ACEP) recommends that 150 ultrasound exams be performed for physician competency. Our goal is to evaluate the current ultrasound practices among EM residency programs and assess the need for further formalization of EUS training.
Femur fractures typically affect elderly patients with multiple co-morbidities. Pain control can be difficult, requiring intensive nursing and physician care as elderly patients may manifest cardiovascular and respiratory complications from opiate administration. Ultrasound (US)-guided three-in-one (3-in-1) femoral nerve block (FNB) is an option for pain management in patients with femur fractures, as it provides regional anesthesia to the femoral, obturator and lateral cutaneous nerves. Our goal is to provide medical education regarding the use of US-guided 3-in-1FNB as a rapid and easy procedure that may provide optimal patient care in patients with femur fractures.
Simultaneous bilateral quadriceps tendon rupture is a rare injury. We report the case of bilateral quadriceps tendon rupture sustained with minimal force while refereeing a football game. The injury was suspected to be associated with statin use as the patient had no other identifiable risk factors. The diagnosis was confirmed using bedside ultrasound.
We assessed the acoustic transmission, image quality, and vessel integrity of the Blue Phantom™ 2 Vessel Original Ultrasound Training Model with repeated use.
A 15-year-old Hispanic primigravid female at 12 weeks gestation presented to the Emergency Department (ED) complaining of vaginal bleeding for two days. The patient denied any abdominal pain, nausea, vomiting, or fever.
A 33-year-old man presented to the emergency department with two days of right-sided facial and submandibular swelling. He denied fevers, shortness of breath, difficulty swallowing or recent dental problems.
The following case describes a 26-year-old female who presented to the emergency department with a nontrauamtic retrobulbar hematoma associated with warfarin toxicity. The application and limitations of focused bedside ocular sonography for this condition are discussed.
The focused assessment with sonography for trauma (FAST) exam is a routine diagnostic adjunct in the initial assessment of blunt trauma victims but lacks the ability to reliably predict which patients require laparotomy. Physiologic data play a major role in decision making regarding the need for emergent laparotomy versus further diagnostic testing or observation. The need for laparotomy often influences the decision to transfer the patient to a trauma center. We set out to derive a simple scoring system using both ultrasound findings and immediately available physiologic data that would predict which patients require laparotomy.
To determine whether a medical student emergency ultrasound clerkship has an effect on the number of patients undergoing ultrasonography and the number of total scans in the emergency department.
A 45-year-old male with a history of poorly controlled hypertension arrived to the emergency department complaining of ripping chest pain radiating to his back and abdomen.
Recent case reports have shown that ultrasonography can be used to diagnose ocular pathology in an emergency setting. Ultrasound may be especially useful when periorbital edema and pain interfere with the examination of the post-traumatic eye.
This case report describes a 54-year-old male on warfarin for atrial fibrillation who presented to the emergency department (ED) following a syncopal episode with persistent hypotension. The patient’s International Normalized Ratio (INR) returned elevated at 6.0, and a rapid bedside cardiac ultrasound revealed a large pericardial effusion consistent with cardiac tamponade. The anticoagulation was reversed and the patient underwent successful pericardiocentesis with removal of 1,100 mL of blood.
A 42-year-old male presented to the emergency department with pain and swelling of his distal right wrist. Bedside ultrasound placed over the swelling revealed a pseudoaneurysm of the radial artery. The patient received percutaneous thrombin injection of the aneurysm sac followed by direct ultrasound compression therapy of the pseudoaneurysm neck, resulting in thrombosis of the sac. The use of bedside ultrasound by the emergency physician led to appropriate care and proper disposition for definitive management.
To estimate the sensitivity and specificity of emergency department (ED) ultrasound for the detection of solid organ injury following blunt abdominal trauma.
