Bedside ultrasound for verification of shoulder reduction Michael J. Halberg, Timothy W. Sweeney, William B. Owens
DOI: http://dx.doi.org/10.1016/j.ajem.2008.05.023
The American Journal of Emergency Medicine , Vol. 27 , Issue 1 ,
Published in issue: January 2009
x Shoulder dislocations are a common complaint in the emergency department. The management of these injuries is well described and often involves procedural sedation. Unfortunately, patients often recover from this sedation before radiographs can verify successful reduction. We describe 2 patients with glenohumeral dislocations and subsequent reduction immediately verified by bedside ultrasound before the patients' recovery from procedural sedation. Our experience suggests that ultrasound may reduce the need for repeated sedation, expedite care, and reduce costs.
Ultrasound-assisted localization for lumbar puncture in the ED Ming-Yuan Huang, Aven P. Lin, Wen-Han Chang
DOI: http://dx.doi.org/10.1016/j.ajem.2008.03.007
The American Journal of Emergency Medicine , Vol. 26 , Issue 8 ,
Published in issue: October 2008
x We read with great interest the article by Ferre et al [1] regarding the use of ultrasound by emergency physicians for identifying the anatomical landmarks of lumbar puncture. In this study, 76 patients enrolled were more obese with a mean body mass index of 31.4 (95% confidence interval, 29.1-33.6). Despite nearly half (47%) of the subjects having difficult- or impossible-to-palpate landmarks, ultrasound is very sensitive in identifying the spinous process (100%, 76/76 subjects) and ligamentum flavum (97.4%, 74/76) by using curved array from midline approach.
Lung ultrasound associated to capnography to verify correct endotracheal tube positioning in prehospital Pierre-Marie Brun, Jacques Bessereau, Nicolas Cazes, Emgan Querellou, Hichem Chenaitia
DOI: http://dx.doi.org/10.1016/j.ajem.2011.10.023
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: December 28 2011
x Endotracheal intubation is the “gold standard” of the control of airway patency but is associated with nonnegligible morbidity rates. A rapid detection of esophageal intubation is essential. Capnography is considered the reference technique for correct endotracheal tube (ETT) positioning confirmation. However, capnography can provide false-positive and false-negative results in some situations. Recently, the ultrasound assessment has been studied for confirming ETT placement. Despite of few trials, the ultrasound procedure may enhance physician confidence and decision making in airway management.
Real-time B-mode ultrasound in the ED saves time in the diagnosis of deep vein thrombosis (DVT) Daniel Theodoro, Michael Blaivas, Sandeep Duggal, Graham Snyder, Michael Lucas
DOI: http://dx.doi.org/10.1016/j.ajem.2004.02.007
The American Journal of Emergency Medicine , Vol. 22 , Issue 3 ,
Published in issue: May 2004
x We hypothesize that EPs can decrease the time to disposition when performing examinations for deep venous thrombosis (DVT) compared with disposition times using imaging specialists (IS). We performed a prospective, single-blind observational study at an academic ED over the course of 1 year. Patients were enrolled based on study physician availability. EPs ordered the corroborative ultrasound, then performed their own examination. EPs recorded patient triage time, ED results, and disposition times for both EP and IS departments.
Ultrasound guided reduction of pediatric forearm fractures in the ED William Durston, Richard Swartzentruber
DOI: http://dx.doi.org/10.1016/S0735-6757(00)90054-8
The American Journal of Emergency Medicine , Vol. 18 , Issue 1 ,
Published in issue: January 2000
x Reducing badly displaced or angulated pediatric forearm fractures in the emergency department can be difficult. Multiple attempts at reduction may be required, with repeated trips to the radiology department, before an adequate reduction is achieved. We have recently found that bedside ultrasound by emergency physicians is very helpful in guiding the reduction of difficult forearm fractures, allowing the physician to assess the adequacy of the reduction at the patient's bedside. In this report, we describe the technique we have developed for ultrasound-guided fracture reduction and present three case histories showing the usefulness of this technique.
Physical examination in determining the outcomes of ultrasound for DVT Lisa Chan, Kevin M Reilly
DOI: http://dx.doi.org/10.1016/S0735-6757(00)90136-0
The American Journal of Emergency Medicine , Vol. 18 , Issue 3 ,
Published in issue: May 2000
Accuracy of emergency physicians using ultrasound to determine gestational age in pregnant women Sachita Shah, Nathan Teismann, Brita Zaia, Farnaz Vahidnia, Gerin River, Dan Price, Arun Nagdev
DOI: http://dx.doi.org/10.1016/j.ajem.2009.07.024
The American Journal of Emergency Medicine , Vol. 28 , Issue 7 ,
Published online: March 29 2010
x Rapid and accurate determination of gestational age may be vital to the appropriate care of the critically ill pregnant patient. Before the use of emergency ultrasound, physical examination of fundal height (FH) in the nonverbal patient was considered the quickest method to estimate gestational age. We conducted a prospective, observational study of the performance of bedside sonography to determine gestational age.
Performance comparison of lung ultrasound and chest x-ray for the diagnosis of pneumonia in the ED Jean-Eudes Bourcier, Julie Paquet, Mickael Seinger, Emeric Gallard, Jean-Philippe Redonnet, Fouad Cheddadi, Didier Garnier, Jean-Marie Bourgeois, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.003
The American Journal of Emergency Medicine , Vol. 32 , Issue 2 ,
Published online: November 4 2013
x The aim of our study was to assess the potential of bedside lung ultrasound examination by the attending emergency physician in the diagnosis of acute pneumonia.
Bedside renal ultrasound in the evaluation of suspected ureterolithiasis James H. Moak, Michael S. Lyons, Christopher J. Lindsell
DOI: http://dx.doi.org/10.1016/j.ajem.2010.11.024
The American Journal of Emergency Medicine , Vol. 30 , Issue 1 ,
Published online: December 27 2010
x To determine whether ultrasound changes emergency physicians' estimated likelihood of acute ureterolithiasis in patients with flank pain.
Ultrasound identification of traumatic pneumobilia Jennifer Huang, Michael B. Stone
DOI: http://dx.doi.org/10.1016/j.ajem.2009.05.007
The American Journal of Emergency Medicine , Vol. 28 , Issue 2 ,
Published in issue: February 2010
x A 65-year-old woman presented to the emergency department with low back pain after being hit by a truck at low speed. Although her abdominal examination showed benign results, an extended Focused Assessment With Sonography in Trauma ultrasound examination was performed and incidentally demonstrated evidence of pneumobilia. There were no additional intra-abdominal injuries noted. Subsequent computed tomography and magnetic resonance cholangiopancreatography confirmed these findings. The etiology of traumatic pneumobilia is discussed with a brief review of the literature on the subject.
Point-of-care ultrasound diagnosis and treatment of posterior shoulder dislocation Sierra Beck, Mikaela Chilstrom
DOI: http://dx.doi.org/10.1016/j.ajem.2012.06.017
The American Journal of Emergency Medicine , Vol. 31 , Issue 2 ,
Published online: September 3 2012
x Acute traumatic posterior shoulder dislocations are rare. The diagnosis is often missed or delayed, as radiologic abnormalities can be subtle. We report a case of a 37-year-old man who presented to the emergency department with severe right shoulder pain and inability to move his arm after a motor vehicle collision. Based on examination, he was initially thought to have an anterior dislocation; however, point-of-care (POC) ultrasound clearly demonstrated a posterior shoulder dislocation. Real-time ultrasound-guided intra-articular local anesthetic injection facilitated closed reduction in the emergency department without procedural sedation, and POC ultrasound confirmed successful reduction at the bedside after the procedure.
Ultrasound-guided reduction of distal radius fractures Shiang-Hu Ang, Shu-Woan Lee, Kai-Yet Lam
DOI: http://dx.doi.org/10.1016/j.ajem.2009.05.022
The American Journal of Emergency Medicine , Vol. 28 , Issue 9 ,
Published online: March 29 2010
x In our local emergency departments (EDs), manipulation and reduction (M&R) of distal radius fractures are performed by emergency doctors, with blind manual palpation, using postreduction x-rays to assess adequacy. We sought to study the effectiveness of ultrasound guidance in the reduction of distal radius fractures in adult patients presenting to a regional ED.
Emergency ultrasound in nontraumatic cardiac arrest—2 practical remarks: Letter regarding Giovanni Volpicelli's recent article “Usefulness of emergency ultrasound in nontraumatic cardiac arrest” Rainer Gatz
DOI: http://dx.doi.org/10.1016/j.ajem.2010.03.001
The American Journal of Emergency Medicine , Vol. 28 , Issue 4 ,
Published in issue: May 2010
x The recent article by Volpicell [1], as indeed others published by him earlier, are of great interest and practical utility to all who practice bedside echography on their emergency and intensive care patients, like I have been doing for some 15 years now. Do allow me to add just 2 practical suggestions to Volpicelli's article, with which I otherwise fully agree.
Bedside ultrasound of acute adrenal hemorrhage Marie Knorr, David Evans
DOI: http://dx.doi.org/10.1016/j.ajem.2011.12.025
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: March 2 2012
x Most complications from traumatic isolated adrenal hemorrhage are thought to be minor and do not require specific treatment. However, there are often additional intra-abdominal organ injuries, such as liver and ipsilateral kidney, associated with adrenal injury. It is, therefore, important to identify these injuries as early as possible, preferably on initial assessment. We describe a case of a 43-year-old man who presented to the emergency department after sustaining blunt force trauma to the flank during a soccer match and was subsequently diagnosed with acute adrenal injury by use of bedside ultrasonography.
Volumetric bladder ultrasound performed by trained nurses increases catheterization success in pediatric patients Brigitte M. Baumann, Kathryn McCans, Sarah A. Stahmer, Mary B. Leonard, Justine Shults, William C. Holmes
DOI: http://dx.doi.org/10.1016/j.ajem.2007.03.020
The American Journal of Emergency Medicine , Vol. 26 , Issue 1 ,
Published in issue: January 2008
x The objective of the study was to determine whether the use of volumetric ultrasound by trained pediatric emergency department (ED) nurses improves first-attempt urine collection success rates.
Diagnosis of periorbital gas on ocular ultrasound after facial trauma S. Timothy McIlrath, Michael Blaivas, Matthew Lyon
DOI: http://dx.doi.org/10.1016/j.ajem.2004.10.001
The American Journal of Emergency Medicine , Vol. 23 , Issue 4 ,
Published in issue: July 2005
x Ocular trauma can occur from isolated facial trauma or in major blunt trauma such as motor vehicle accidents or falls. Despite the etiology of the injury, a thorough evaluation is important but may often be difficult if severe swelling is present. Recently, emergency ultrasound has seen the use of ocular ultrasound to evaluate visual changes and trauma. Literature suggests that unsuspected and difficult to diagnose pathology may be easily detected on ultrasound of the orbit. We present 3 cases of isolated facial trauma in which routine evaluation with ocular ultrasound led to the discovery of periorbital air with one patient having air insufflating the upper lid of the affected side.
Ultrasound detection of guidewire position during central venous catheterization Michael B. Stone, Arun Nagdev, Michael C. Murphy, Craig A. Sisson
DOI: http://dx.doi.org/10.1016/j.ajem.2008.09.019
The American Journal of Emergency Medicine , Vol. 28 , Issue 1 ,
Published online: October 26 2009
x Ultrasound guidance decreases complications of central venous catheter (CVC) placement, but risks of arterial puncture and inadvertent arterial catheter placement exist. Ultrasound-assisted detection of guidewire position in the internal jugular vein could predict correct catheter position before dilation and catheter placement.
Survey of staff opinions on ultrasound by emergency physicians Michael L Carl, William E Durston, Wayne F Guerra
DOI: http://dx.doi.org/10.1016/S0735-6757(00)90135-9
The American Journal of Emergency Medicine , Vol. 18 , Issue 3 ,
Published in issue: May 2000
Comment on “novel technique in ED: Supracondylar ultrasound-guided nerve block for reduction of distal radius fractures” Daniele Coraci, Marina A. Bellavia, Valter Santilli, Luca Padua
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.045
Publication stage: In Press Corrected Proof
The American Journal of Emergency Medicine
Published online: March 19 2016
x We have read with great attention the work “Novel technique in ED: supracondylar ultrasound-guided nerve block for reduction of distal radius fractures”, by Aydin and colleagues [1]. The authors presented four patients with distal radius fracture and given a radial nerve anesthetic block in order to perform painless bone reduction. The block was performed by the help of ultrasound (US). This paper is informative and it may represent a possible guide for physicians in emergency conditions. The authors, in fact, show the high usefulness of this block technique, which represents a possible approach for the treatment of distal radius fracture.
Clinician-based ultrasound facilitates the evaluation of lateral neck mass in the ED Nathan Charlton, Thomas Cook
DOI: http://dx.doi.org/10.1016/j.ajem.2007.07.028
The American Journal of Emergency Medicine , Vol. 26 , Issue 3 ,
Published in issue: March 2008
x The presentation of new-onset neck mass in the emergency department can represent serious pathology, and its evaluation often uses expensive and time-consuming imaging technologies such as computed tomography and magnetic resonance imaging. Clinician-based ultrasound allows physicians to quickly evaluate these masses in a cost-effective manner. We present the case of a young girl with progressive abdominal pain and a 1-day history of lateral neck mass evaluated by clinician-based ultrasound.
