Assessment of emergency physician–performed ultrasound in evaluating nonspecific abdominal pain Timothy Jang, Vijai Chauhan, Christopher Cundiff, Amy H. Kaji
DOI: http://dx.doi.org/10.1016/j.ajem.2014.01.004
The American Journal of Emergency Medicine , Vol. 32 , Issue 5 ,
Published online: January 21 2014
x The objective of this pilot study was to lay the groundwork for future studies assessing the impact of emergency physician–performed ultrasound (EPUS) on diagnostic testing and decision making in emergency department (ED) patients with nonspecific abdominal pain (NSAP).
Noninvasive detection of elevated intracranial pressure using a portable ultrasound system Bertrand Prunet, Yves Asencio, Guillaume Lacroix, Ambroise Montcriol, Arnaud Dagain, Jean Cotte, Pierre Esnault, Henry Boret, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.005
The American Journal of Emergency Medicine , Vol. 30 , Issue 6 ,
Published online: June 13 2011
x The aim of this study is to prospectively compare the accuracies of transcranial color-coded sonography (TCCS) and transcranial Doppler (TCD) in the diagnosis of elevated intracranial pressure.
Elongated left lobe of the liver mimicking a subcapsular hematoma of the spleen on the focused assessment with sonography for trauma exam Robert Jones, Matthew Tabbut, Diane Gramer
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.050
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: January 6 2014
x The focused assessment with sonography for trauma examination has assumed the role of initial screening examination for the presence or absence of hemoperitoneum in the patient with blunt abdominal trauma. Sonographic pitfalls associated with the examination have primarily been related to mistaking contained fluid collections with hemoperitoneum. We present a case in which an elongated left lobe of the liver was misdiagnosed as a splenic subcapsular hematoma. It is imperative that emergency physicians and trauma surgeons be familiar with this normal variant of the liver and its associated sonographic appearance on the perisplenic window in order to prevent nontherapeutic laparotomies or embolizations.
Physical examination combined with focused assessment with sonography for trauma examination to clear hemodynamically stable blunt abdominal trauma patients Donald Byars, Alicia Devine, Christopher Maples, Alexander Yeats, Krista Greene
DOI: http://dx.doi.org/10.1016/j.ajem.2013.06.042
The American Journal of Emergency Medicine , Vol. 31 , Issue 10 ,
Published online: September 3 2013
x The use of the focused assessment with sonography for trauma (FAST) examination has become standard practice over the past 10 years in the evaluation of patients with suspected abdominal trauma. It is generally accepted in trauma algorithms as an extension of the physical examination. Currently, it is used primarily to identify the need for an expedited emergency laparotomy in the hemodynamically unstable patient, unable to tolerate a computed tomographic (CT) scan. In hemodynamically stable patients, however, especially those with low-risk injury by history and physical examination, the role of the FAST examination to exclude further diagnostic testing is less studied.
Pitfalls in the ultrasound diagnosis of pneumothorax: the authors respond A. Aspler, M.B. Stone
DOI: http://dx.doi.org/10.1016/j.ajem.2014.03.044
The American Journal of Emergency Medicine , Vol. 32 , Issue 9 ,
Published online: April 4 2014
x The readers’ letter highlights accurately that the article by Aspler et al [1] raises challenges around the real-time diagnosis of pneumothorax with ultrasound.
The ultrasound-guided superficial cervical plexus block for anesthesia and analgesia in emergency care settings Andrew A. Herring, Michael B. Stone, Oron Frenkel, Annie Chipman, Arun D. Nagdev
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.023
The American Journal of Emergency Medicine , Vol. 30 , Issue 7 ,
Published online: October 26 2011
x The ultrasound-guided superficial cervical plexus (SCP) block may be useful for providers in emergency care settings who care for patients with injuries to the ear, neck, and clavicular region, including clavicle fractures and acromioclavicular dislocations. The SCP originates from the anterior rami of the C1-C4 spinal nerves and gives rise to 4 terminal branches—greater auricular, lesser occipital, transverse cervical, and suprascapular nerves—that provide sensory innervation to the skin and superficial structures of the anterolateral neck and sections of the ear and shoulder.
Comparison of bedside ultrasound and panorex radiography in the diagnosis of a dental abscess in the ED Srikar Adhikari, Michael Blaivas, Lina Lander
DOI: http://dx.doi.org/10.1016/j.ajem.2010.03.005
The American Journal of Emergency Medicine , Vol. 29 , Issue 7 ,
Published online: May 3 2010
x The purpose of the study was to compare bedside ultrasound (US) and panorex radiography in the diagnosis of a dental abscess in emergency department (ED).
Letter to Editor: the effectiveness of bedside point-of-care ultrasonography in the diagnosis and management of metacarpal fractures: Contribution for management of metacarpal fractures Harun Yasin Tuzun, Selim Turkkan, Arsen Arsenishvili
DOI: http://dx.doi.org/10.1016/j.ajem.2016.01.008
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: January 8 2016
x We read the published article by Kozacı et al [1]titled “The effectiveness of bedside point-of-care ultrasonography in the diagnosis and management of metacarpal fractures” with great interest. The objective of the study is noteworthy, and we would like to add several points about metacarpal fracture management in orthopedic practice. Metacarpal fractures, which require surgery, must be diagnosed with radiography, and follow-up imaging of these fractures must be done with radiography. In our practice, when we perform metacarpal fracture surgery, we use either fluoroscopy or radiography to determine the plate, K-wire, or screw placement and fracture reduction.
Accuracy of emergency physicians using ultrasound measurement of crown-rump length to estimate gestational age in pregnant females Caitlin Bailey, Jennifer Carnell, Farnaz Vahidnia, Sachita Shah, Michael Stone, Mickeye Adams, Arun Nagdev
DOI: http://dx.doi.org/10.1016/j.ajem.2011.12.002
The American Journal of Emergency Medicine , Vol. 30 , Issue 8 ,
Published online: February 10 2012
x The objective of this study is to evaluate the accuracy of emergency providers (EPs) of various levels of training in determination of gestational age (GA) in pregnant patients using bedside ultrasound measurement of crown-rump length (CRL).
Acute, simultaneous, bilateral rhegmatogenous retinal detachment diagnosed with bedside emergency ultrasound James Palma, Eric Schott
DOI: http://dx.doi.org/10.1016/j.ajem.2012.08.042
The American Journal of Emergency Medicine , Vol. 31 , Issue 2 ,
Published in issue: February 2013
x Retinal detachment is an acute vision-threatening condition that occurs when the neurosensory layer of the retina separates from the underlying retinal pigment epithelium. While uncommon in the general population, the diagnosis should be considered in any patient with acute visual changes such as flashes, floaters, or decreased visual acuity. The prompt diagnosis, referral, and treatment of retinal detachment are essential for the patient's best chance for restoration of vision. We present an extremely unusual case of simultaneous, nontraumatic, bilateral rhegmatogenous retinal detachment in which the diagnosis was confirmed using bedside ocular ultrasound upon presentation to the emergency department (ED).
Ultrasound assessment of optic disc edema in patients with headache Siri Daulaire, Lauren Fine, Margaret Salmon, Catherine Cummings, Otto Liebmann, Sachita Shah, Nathan Teismann
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.030
The American Journal of Emergency Medicine , Vol. 30 , Issue 8 ,
Published online: October 26 2011
x Point-of-care ocular ultrasonography is emerging as a powerful tool to evaluate emergency department (ED) patients at risk for ophthalmologic and intracranial pathology. We present cases of 3 patients in whom optic disc swelling was identified using ocular ultrasound. Causes for optic disc swelling in our patients included idiopathic intracranial hypertension, secondary syphilis, and malignant hypertension with associated hypertensive retinopathy. Because direct visualization of the optic disc may be challenging in an ED setting, ultrasound examination of the optic disc may represent an important adjunct to fundoscopy when assessing patients with headache or visual complaints.
Ultrasound to reduce cognitive errors in the ED Fabrizio Elia, Francesco Panero, Paola Molino, Giovanni Ferrari, Franco Aprà
DOI: http://dx.doi.org/10.1016/j.ajem.2012.04.008
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: July 16 2012
x Emergency medicine setting is intrinsically prone to a greater risk of medical errors than other specialties. Cognitive errors are particularly frequent when the clinical decision-making process heavily relies on heuristics. These could be defined as “mental shortcuts,” which enable physicians to rapidly overcome both time and efforts required by the normative reasoning. Our article demonstrates how emergency physicians' thinking may be affected by failed heuristics, through the description of 3 real clinical cases.
An atypical misplacement of a temporary pacing catheter diagnosed and resolved by ultrasound Pablo Blanco, Jason T. Nomura
DOI: http://dx.doi.org/10.1016/j.ajem.2014.03.013
The American Journal of Emergency Medicine , Vol. 32 , Issue 10 ,
Published online: March 20 2014
x Temporary transvenous pacing catheter placement is an important and critical procedure for emergency physicians. Ultrasound can be used to guide placement and to diagnosis correct or incorrect catheter placement. This case report discusses a patient with an acute ST elevation myocardial infarction leading to unstable arrhythmias requiring emergent transvenous cardiac pacing. The pacemaker was inserted using electrocardiographic monitoring through the bipolar pacing catheter. There was some difficulty placing the catheter, but successful capture with a left bundle-branch block pattern was obtained.
The role of emergency ultrasound for evaluating acute pyelonephritis in the ED Kuo-Chih Chen, Shih-Wen Hung, Vei-Ken Seow, Chee-Fah Chong, Tzong-Luen Wang, Yu-Chuan Li, Hang Chang
DOI: http://dx.doi.org/10.1016/j.ajem.2010.01.047
The American Journal of Emergency Medicine , Vol. 29 , Issue 7 ,
Published online: May 3 2010
x Controversy remains over the imaging method of choice for evaluating acute pyelonephritis (APN) in the emergency department (ED).
ED visits and spending by unauthorized immigrants compared with legal immigrants and US natives Jim P. Stimpson, Fernando A. Wilson, Leah Zallman
DOI: http://dx.doi.org/10.1016/j.ajem.2014.03.018
The American Journal of Emergency Medicine , Vol. 32 , Issue 6 ,
Published online: March 20 2014
x In light of the ongoing debate about immigration reform, a recent study found that contributions by immigrants to the Medicare Trust Fund outweigh their expenditures [1]. Another 2013 study found that health expenditures are lower for unauthorized immigrants and legal residents than US natives and naturalized citizens [2]. However, evidence for the emergency department (ED) setting is limited, where much of the debate on health service utilization of unauthorized immigrants is concentrated. The most recent study of ED utilization found that noncitizen immigrants used significantly less ED services compared with citizens [3].
Three-view bedside ultrasound for the differentiation of acute respiratory distress syndrome from cardiogenic pulmonary edema Daniel Mantuani, Arun Nagdev, Michael Stone
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.028
The American Journal of Emergency Medicine , Vol. 30 , Issue 7 ,
Published online: August 26 2011
x Bedside ultrasound is being increasingly used by emergency physicians (EPs) for the differentiation of acute dyspnea in critically ill patients [1]. Lung ultrasound is emerging as a highly sensitive tool in diagnosing alveolar interstitial edema with the presence of diffuse “B-lines” arising from the pleural line [2]. However, when used independently, lung ultrasound is unable to differentiate between cardiogenic and noncardiogenic causes of pulmonary edema [3]. This case report describes a rapid 3-view or “triple scan” sonographic examination to differentiate acute respiratory distress syndrome (ARDS) from cardiogenic pulmonary edema.
Anatomical distribution of traumatic pneumothoraces on chest computed tomography: implications for ultrasound screening in the ED Maria Mennicke, Kavita Gulati, Isabel Oliva, Katja Goldflam, Hicham Skali, Stephen Ledbetter, Elke Platz
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.020
The American Journal of Emergency Medicine , Vol. 30 , Issue 7 ,
Published online: September 12 2011
x We sought to assess the anatomical distribution of traumatic pneumothoraces (PTXs) on chest computed tomography (CT) to develop an optimized protocol for PTX screening with ultrasound in the emergency department (ED).
An alternate technique for assessing optic nerve in papilledema by ultrasound B scan Jyoti Matalia, Sheetal Shirke, Minal Kekatpure
DOI: http://dx.doi.org/10.1016/j.ajem.2015.03.027
The American Journal of Emergency Medicine , Vol. 33 , Issue 7 ,
Published online: March 17 2015
x We read with great interest the article entitled “Real-time optic nerve sheath diameter reduction measured with bedside ultrasound after therapeutic lumbar puncture in a patient with idiopathic intracranial hypertension” by Singleton et al [1]. They have described the use of ocular ultrasound in a case of idiopathic intracranial hypertension and demonstrated real-time change in the size of the optic nerve sheath diameter after a lumbar puncture.
Anterior chamber depth measurement using ultrasound to assess elevated ıntraocular pressure Ümit Yolcu, Abdullah Ilhan, Fatih Ç. Gundogan
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.046
The American Journal of Emergency Medicine , Vol. 33 , Issue 4 ,
Published online: December 30 2014
x We have read the article entitled “Anterior chamber depth measurement using ultrasound to assess elevated intraocular pressure” with great interest
[1]. The authors reported 2 cases with glaucoma and a case of trauma. They measured the anterior chamber depth (ACD) of patients and compared the results with the intraocular pressure (IOP) measurements using a tonometer.
Sonographic evaluation of a paralyzed hemidiaphragm from ultrasound-guided interscalene brachial plexus nerve block Daniel Mantuani, Arun Nagdev
DOI: http://dx.doi.org/10.1016/j.ajem.2012.02.004
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: March 30 2012
x The ultrasound-guided interscalene brachial plexus is becoming increasingly popular for anesthesia in the management of upper-extremity injuries by emergency physicians. Traditional high-volume injections of local anesthesia will also affect the phrenic nerve, leading to temporary paralysis of the ipsilateral hemidiaphragm. With direct ultrasound guidance, more precise needle placement allows for lower-volume injections that reduce inadvertent spread of local anesthetic to the phrenic nerve without decreasing the efficacy of onset of time and quality of the block.
