Emergency ultrasound in the diagnosis of traumatic extrathoracic lung herniation Stacey Marlow, Tabitha Campbell, Ashley Davis, Hershel R. Patel
DOI: http://dx.doi.org/10.1016/j.ajem.2012.09.030
The American Journal of Emergency Medicine , Vol. 31 , Issue 3 ,
Published online: January 24 2013
x Traumatic extrathoracic lung herniation is an extremely rare and poorly described complication of blunt trauma. Diagnosis has been limited to computed tomographic imaging, which takes both time and requires the patient to leave the emergency department (ED). Focused assessment with sonography in trauma has become routine in the evaluation of blunt trauma in the ED before obtaining computed tomographic imaging. We report a case on use of the extended focused assessment with sonography in trauma examination in aiding the immediate diagnosis of traumatic extrathoracic lung herniation in blunt trauma.
Three-view bedside ultrasound to differentiate acute decompensated heart failure from chronic obstructive pulmonary disease Daniel Mantuani, Arun Nagdev
DOI: http://dx.doi.org/10.1016/j.ajem.2012.11.028
The American Journal of Emergency Medicine , Vol. 31 , Issue 4 ,
Published online: February 4 2013
x Identifying the cause of acute dyspnea in the emergency department is often challenging, even for the most experienced provider. Distinguishing chronic obstructive pulmonary disease from acute decompensated heart failure in the acutely dyspneic patient who presents in respiratory distress is often difficult. Patients are often unable to give a detailed history when in extremis, yet primary management needs to be initiated before further testing can be completed. Bedside diagnostic ultrasound has emerged as a tool for emergency physicians to rapidly evaluate the cardiopulmonary status in patients presenting with undifferentiated shortness of breath [1-3].
Ultrasound detection of the sliding lung sign by prehospital critical care providers Matthew Lyon, Perry Walton, Valori Bhalla, Stephen A. Shiver
DOI: http://dx.doi.org/10.1016/j.ajem.2011.01.009
The American Journal of Emergency Medicine , Vol. 30 , Issue 3 ,
Published online: February 21 2011
x The presence of the sonographic sliding lung sign (SLS) is a sensitive indicator for the absence of a pneumothorax.
Analysis of lawsuits filed against emergency physicians for point-of-care emergency ultrasound examination performance and interpretation over a 20-year period Michael Blaivas, Richard Pawl
DOI: http://dx.doi.org/10.1016/j.ajem.2010.12.016
The American Journal of Emergency Medicine , Vol. 30 , Issue 2 ,
Published online: January 31 2011
x The study aims to define extent of lawsuits filed against emergency physicians (EPs) over point-of-care emergency ultrasound (US) during the last 20 years.
The effect of bedside ultrasound on diagnosis and management of soft tissue infections in a pediatric ED Katrina Iverson, Demetris Haritos, Ronald Thomas, Nirupama Kannikeswaran
DOI: http://dx.doi.org/10.1016/j.ajem.2011.09.020
The American Journal of Emergency Medicine , Vol. 30 , Issue 8 ,
Published online: November 21 2011
x Presentation of skin and soft tissue infections (SSTIs) to the pediatric emergency department (PED) has increased. Physical examination alone can be inadequate in differentiating cellulitis from an abscess. The purposes of this study were to determine the effect of bedside ultrasound (US) in improving diagnostic accuracy for SSTIs in the PED and to evaluate its effect on the management of patients with SSTIs.
Pitfalls of the ultrasound diagnosis of pneumothorax Gaetano Rea, Maria D’Amato, Giorgia Ghittoni
DOI: http://dx.doi.org/10.1016/j.ajem.2014.03.053
The American Journal of Emergency Medicine , Vol. 32 , Issue 9 ,
Published online: June 11 2014
x The case presentation by Aspler et al [1] seems to be biased by the lack of correspondence of the shown image; more importantly, it appears to display the limitations of thoracic ultrasound in the diagnosis of pneumothorax more than its merits.
Acute heart failure diagnosis by ultrasound: new achievements and persisting limitations Daniela Catalano, Guglielmo M. Trovato, Marco Sperandeo
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.026
The American Journal of Emergency Medicine , Vol. 32 , Issue 4 ,
Published online: December 19 2013
x The article by Anderson et al [1] elegantly addresses the problem of misdiagnosis of acutely decompensated heart failure (ADHF). Their approach is very comprehensive and, in our opinion, is an important advancement of the current evidence in emergency medicine, beyond the existing severe limitations of previous studies using lung ultrasound (LUS). Nonetheless, we can agree only partially with the statements, which are the background of this and similar reports and by which the subsequent statistical analysis is severely biased.
Implication of bedside cardiopulmonary ultrasound on health care cost: an additional advantage Lovely Chhabra, Vinod K. Chaubey
DOI: http://dx.doi.org/10.1016/j.ajem.2015.01.041
The American Journal of Emergency Medicine , Vol. 33 , Issue 3 ,
Published online: January 31 2015
x We read with great interest the work by Gallard et al [1]. Authors’ work is commendable in triaging and diagnosing patients with acute dyspnea with the use of bedside cardiopulmonary ultrasound. Indeed, the point-of-care (POC) cardiopulmonary ultrasound is not only an important diagnostic modality but also serves as an immensely useful guide during emergent cardiac procedures (such as pericardiocentesis) and resuscitation of critically ill patients [2]. This is especially true with the newest high-quality and easy-to-use handheld cardiac ultrasound devices.
Pocket mobile smartphone system for the point-of-care submandibular ultrasonography Jacek Wojtczak, Peter Bonadonna
DOI: http://dx.doi.org/10.1016/j.ajem.2012.09.013
The American Journal of Emergency Medicine , Vol. 31 , Issue 3 ,
Published online: November 19 2012
x Focused ultrasonography of the airway may be useful in the prediction of difficult intubation. The wider use of sonography in quantitative airway assessment may depend on the availability of highly portable, inexpensive, and accurate ultrasound systems. Pocket-sized ultrasound devices are emerging as a useful tool for point-of-care ultrasonography. The aim of this study was to evaluate the suprahyoid airway of healthy volunteers using a smartphone-based ultrasound imaging system in comparison with a platform-based machine.
ETCO2 and ultrasound fail to directly confirm the depth of ETT placement Hooman Hossein-nejad
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.052
The American Journal of Emergency Medicine , Vol. 32 , Issue 3 ,
Published online: November 6 2013
x We are pleased to respond to the reader's comments. As a matter of fact, esophageal intubation cannot be detected by chest x-ray (CXR), yet there are other possibilities of endotracheal tube (ETT) misplacement, such as inappropriate depth of the tube or bronchial intubation. End tidal CO2 (ETCO2 ) or ultrasonography is used to distinguish between esophageal and tracheal intubation. Nevertheless, they have not been useful for the direct confirmation of the appropriate tracheal depth of ETT [1,2]. References, including American Heart Association and American College of Emergency Physician guidelines , do not consider these methods alternatives to CXR to confirm the appropriate depth of the tube.
Another use of the ultrasound-guided transversus abdominis plane block in the ED Christian Landy, David Plancade, Ingrid Millot, Nicolas Gagnon, Julien Nadaud, Jean-Christophe Favier
DOI: http://dx.doi.org/10.1016/j.ajem.2011.12.012
The American Journal of Emergency Medicine , Vol. 30 , Issue 4 ,
Published online: February 10 2012
x We read with interest the article published by Herring et al [1], describing the interest of the transversus abdominis plane (TAP) block for analgesia in emergency situations.
Point-of-care ultrasound diagnosis of acute Achilles tendon rupture in the ED Srikar Adhikari, Jared Marx, Todd Crum
DOI: http://dx.doi.org/10.1016/j.ajem.2011.01.029
The American Journal of Emergency Medicine , Vol. 30 , Issue 4 ,
Published online: March 16 2011
x Patients with acute Achilles tendon injuries from sport-related activities are frequently seen in the emergency department (ED). Missed or delayed diagnosis of an Achilles tendon rupture can result in significant patient morbidity. However, the diagnosis of an Achilles tendon rupture is not always clear clinically. Physical examination maneuvers to assess for a tendon injury can be limited by pain and soft tissue swelling. Ultrasound has been shown to be very sensitive in detecting an Achilles tendon rupture.
Ultrasound-guided peripheral intravenous placement with standard-length catheters and long catheters Fu-Shan Xue, Rui-Ping Li, Yi Cheng, Xu Liao
DOI: http://dx.doi.org/10.1016/j.ajem.2012.08.012
The American Journal of Emergency Medicine , Vol. 31 , Issue 1 ,
Published online: September 12 2012
x In a prospective, randomized controlled trial comparing performance of standard-length catheters and long catheters for ultrasound (US)–guided peripheral intravenous cannulation (PIC) in acute hospitalized patients with difficult venous access, Elia et al [1] showed that compared with standard-length catheter US-guided PIC, long catheter US-guided PIC required a higher time but was associated with a lower risk of catheter failure. Their findings have potential implications for use of long catheters as a solution to low survival of US-guided peripheral catheters.
Novel use of ultrasound in the ED: ultrasound-guided hematoma block of a proximal humeral fracture Ümit Kaldırım, Ümit Yolcu, Şükrü Ardic, Serkan Bilgic
DOI: http://dx.doi.org/10.1016/j.ajem.2014.08.061
The American Journal of Emergency Medicine , Vol. 32 , Issue 11 ,
Published online: August 26 2014
x We have read your article entitled, “Novel use of ultrasound in the emergency department: ultrasound-guided hematoma block of a proximal humeral fracture” with great interest [1]. We think that this article reports a frequently seen case in emergency departments, and it consists valuable information. We would like to make a contribution to the article.
Diagnosis of metacarpal fracture with equivocal x-ray by point-of-care ultrasound: a case report Jennifer Ruskis, Tobias Kummer
DOI: http://dx.doi.org/10.1016/j.ajem.2014.01.018
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: January 23 2014
x Metacarpal fractures represent a very common injury among patients presenting to the emergency department. Diagnosis is of utmost importance given the high morbidity associated with lack of full hand function. We report a case of a 37-year-old man who sustained extremity trauma after a mechanical fall. He presented with an examination that revealed diffuse tenderness over the wrist and hand. X-ray of the hand was equivocal for a metacarpal fracture; however, point-of-care ultrasound revealed disruption of the bony cortex confirming the diagnosis.
A simplified ultrasound-based edema score to assess lung injury and clinical severity in septic patients Thiago M. Santos, Daniel Franci, Carolina M.G. Coutinho, Diego L. Ribeiro, Marcelo Schweller, José R. Matos-Souza, Marco A. Carvalho-Filho
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.053
The American Journal of Emergency Medicine , Vol. 31 , Issue 12 ,
Published online: October 11 2013
x Lung ultrasound (US) is an excellent tool to assess lung edema in a myriad of different clinical situations. We hypothesized that lung US might also be a good prognostic and management instrument in septic patients, regardless of disease severity.
Ultrasound-guided catheter-over-needle internal jugular vein catheterization Michael D. Zwank
DOI: http://dx.doi.org/10.1016/j.ajem.2011.08.013
The American Journal of Emergency Medicine , Vol. 30 , Issue 2 ,
Published online: October 28 2011
x I describe here a novel technique of inserting a 2.5-inch catheter into the internal jugular vein with ultrasound guidance using sterile technique but no barrier precautions.
Ultrasound detection of obstructive pyelonephritis due to urolithiasis in the ED Jennifer Carnell, Jason Fischer, Arun Nagdev
DOI: http://dx.doi.org/10.1016/j.ajem.2010.07.006
The American Journal of Emergency Medicine , Vol. 29 , Issue 7 ,
Published online: October 11 2010
x Identifying acute pyelonephritis (APN) with early obstructive uropathy is clinically important in the emergency department (ED) because obstructive urolithiasis is an independent risk factor for inpatient death, prolonged hospitalization, and failure of outpatient APN therapy. Furthermore, diagnosis of an early obstructive uropathy can be difficult when based solely on clinical findings. Clinicians may assume the cause of the patient's symptoms to be APN alone, without considering the concurrent presence of an obstructing stone.
Usefulness of guidewire visualization during ultrasound-guided internal jugular vein cannulation Pawel Andruszkiewicz, Dorota Sobczyk
DOI: http://dx.doi.org/10.1016/j.ajem.2014.08.037
The American Journal of Emergency Medicine , Vol. 32 , Issue 11 ,
Published online: August 20 2014
x Cannulation of the internal jugular vein (IVC) can result in rare but serious complications [1].
ED ultrasound diagnosis of a type B aortic dissection using the suprasternal view Hans Rosenberg, Khaled Al-Rajhi
DOI: http://dx.doi.org/10.1016/j.ajem.2011.11.012
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: January 13 2012
x Aortic dissection (AD) is one of the most challenging diagnoses in emergency medicine. This is due, in part, to its variable presentation, ranging from abrupt tearing chest pain in a hemodynamically unstable patient to back pain in a stable patient, as well as its high mortality rates. (1) With the expanding role of ultrasound (U/S) performed by emergency physicians, it is possible to make the diagnosis of AD at the bedside before any other imaging modality has been accessed. (2) In this case report, we describe the use of emergency department (ED) bedside U/S and specifically highlight the use of the suprasternal view in the diagnosis of AD.
