Implication of bedside cardiopulmonary ultrasound on health care cost – An additional advantage: Author reply Emeric Gallard, Jean-Eudes Bourcier, Jean-Philippe Redonnet, Didier Garnier
DOI: http://dx.doi.org/10.1016/j.ajem.2015.01.042
The American Journal of Emergency Medicine , Vol. 33 , Issue 3 ,
Published online: January 31 2015
x We thank you for your interest in our study and agree with you on the importance of thinking about the costs resulting from patient care in the emergency department (ED). Although our study did not focus on this issue, we have demonstrated that, in comparison with the usual procedure, cardiopulmonary ultrasound in the hands of the ED physician succeeds in giving an exact diagnosis for more patients. This allows us nowadays to avoid realizing costly examinations such as N-terminal pro-brain natriuretic peptide or chest x-ray.
Bedside ultrasonography as a diagnostic tool for the fifth metatarsal fractures: methodological concern in reliability analysis Siamak Sabour
DOI: http://dx.doi.org/10.1016/j.ajem.2014.01.012
The American Journal of Emergency Medicine , Vol. 32 , Issue 5 ,
Published online: January 30 2014
x I was interested to read the article by Yesilaras and colleagues [1] published in November 2013 issue of The American Journal of Emergency Medicine . The authors aimed to determine the reliability of ultrasonography for the diagnosis of fractures of the fifth metatarsal [1].
Short- vs long-axis approach to ultrasound-guided peripheral intravenous access: a prospective randomized study Simon A. Mahler, Hao Wang, Chadwick Lester, Janice Skinner, Thomas C. Arnold, Steven A. Conrad
DOI: http://dx.doi.org/10.1016/j.ajem.2010.07.015
The American Journal of Emergency Medicine , Vol. 29 , Issue 9 ,
Published online: October 18 2010
x The objective of the study was to determine if the short-axis approach and long-axis approach to ultrasound-guided peripheral intravenous access (USGPIV) differ in success rate, catheter insertion time, and number of needle sticks.
Diagnostic performance of a pocket-sized ultrasound device for quick-look cardiac imaging Bruce J. Kimura, Glynn W. Gilcrease III, Brian K. Showalter, James N. Phan, Tanya Wolfson
DOI: http://dx.doi.org/10.1016/j.ajem.2010.07.024
The American Journal of Emergency Medicine , Vol. 30 , Issue 1 ,
Published online: November 1 2010
x Although pocket-sized, simplified ultrasound devices have emerged to enable subjective point-of-care assessment, few data on their cardiac application exist. We sought to examine the image quality and the accuracy of subjective diagnosis of video loops obtained from a pocket-sized ultrasound device for 2 significant cardiac abnormalities, left ventricular systolic dysfunction and left atrial enlargement, obtained from a single, quick-look view.
Esophageal rupture diagnosed with bedside ultrasound Charlotte Derr, Jessica Maloney Drake
DOI: http://dx.doi.org/10.1016/j.ajem.2011.12.036
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: March 2 2012
x A 69-year-old man presented to the emergency department with hematemesis, hypotension, tachycardia, and hypothermia. The emergency physician performed a bedside ultrasound of the chest, heart, and abdomen. The heart was unable to be visualized in the parasternal, apical, or subxiphoid windows, and free fluid and particulate matter were visualized in the chest and abdomen. The inability to visualize the heart in the normal cardiac windows suggested a diagnosis of pneumopericardium. Based upon the patient's presenting symptoms and ultrasound findings, an esophageal perforation was suspected.
Bacterial growth on ED ultrasound machines Gibrham Rodriguez, Dan Quan
DOI: http://dx.doi.org/10.1016/j.ajem.2011.03.009
The American Journal of Emergency Medicine , Vol. 29 , Issue 7 ,
Published online: June 15 2011
x Emergency department (ED) patients are often treated for soft-tissue infections and now demonstrate a high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) [1]. It has been well documented that this pathogen can be transmitted by direct contact from an infected source such as a human or an inanimate object. Spread of MRSA and many other bacterial pathogens in the ED has become an infection control issue for many hospitals because of ED overcrowding, lack of adequate hand washing, and lack of universal precautions by health care providers [3].
Needle and guidewire visualization in ultrasound-guided internal jugular vein cannulation James H. Moak, Michael S. Lyons, Stewart W. Wright, Christopher J. Lindsell
DOI: http://dx.doi.org/10.1016/j.ajem.2010.01.004
The American Journal of Emergency Medicine , Vol. 29 , Issue 4 ,
Published online: April 14 2010
x Reimbursement for ultrasound-guided central lines requires documenting the needle entering the vessel lumen. We hypothesized that physicians often successfully perform ultrasound-guided internal jugular (IJ) cannulation without visualizing the needle in the lumen and that guidewire visualization occurs more frequently.
About ultrasound in pneumothorax Andrew Verniquet, Rafid Kakel
DOI: http://dx.doi.org/10.1016/j.ajem.2011.04.015
The American Journal of Emergency Medicine , Vol. 29 , Issue 7 ,
Published online: June 6 2011
x The interesting case report “the double lung point: an unusual sonographic sign of juvenile spontaneous pneumothorax” by Volpicelli and Audino [1] raises several questions.
Subcutaneous emphysema: an immediate call for chest computed tomographic scan or ultrasonography Hesham R. Omar
DOI: http://dx.doi.org/10.1016/j.ajem.2011.10.029
The American Journal of Emergency Medicine , Vol. 30 , Issue 3 ,
Published online: December 28 2011
x I have read the interesting article by Amrein et al [1] in a recent issue of the journal regarding posttraumatic occult pneumothorax, which is now increasingly recognized due to the widespread availability of computed tomographic (CT) scans and the advent of the extended focused assessment with sonography for trauma (eFAST) in most centers. The case not only exemplified the phenomenon of occult pneumothorax but also the predictability of occult pneumothorax. The presence of subcutaneous emphysema in the neck or thoracic wall whether clinically or on chest x-ray should be an immediate trigger for obtaining a chest CT scan or ultrasonography to rule out pneumothorax for 3 reasons.
A new technique for evaluating jugular venous distension in congestive heart failure using ultrasound Michael D. Zwank, Catherine G. Carlson, Christopher P. Anderson
DOI: http://dx.doi.org/10.1016/j.ajem.2012.05.017
The American Journal of Emergency Medicine , Vol. 30 , Issue 8 ,
Published online: August 6 2012
x Dyspnea is a common chief complaint among patients presenting to the emergency department (ED). Distinguishing between the various causes of dyspnea can often be challenging for the ED physician who must arrive at the diagnosis with limited information. Past studies have suggested that ultrasound examination of internal jugular venous distension in patients with congestive heart failure (CHF) exacerbation (eCHF) can be a helpful diagnostic tool [1-3]. We describe a new technique of examining the internal jugular vein (IJV) with ultrasound that we applied to a group of patients with eCHF and a group of healthy controls.
Comment on “Noninvasive detection of elevated intracranial pressure using a portable ultrasound system” Juan Antonio Llompart-Pou, Josep Maria Abadal, Luis Rayo, Jon Pérez-Bárcena
DOI: http://dx.doi.org/10.1016/j.ajem.2011.07.021
The American Journal of Emergency Medicine , Vol. 30 , Issue 1 ,
Published in issue: January 2012
x We read with interest the recently published article by Prunet et al regarding the role of transcranial Doppler (TCD) and a portable transcranial color coded sonography (TCCS) in the evaluation of pulsatility index (PI) and its correlation with intracranial pressure [1].
Nail bed injury detected by ultrasonography Secgin Soyuncu, Firat Bektas
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.026
The American Journal of Emergency Medicine , Vol. 30 , Issue 7 ,
Published online: August 22 2011
x A 46-year-old man presented to the emergency department after being injured with a press machine from his left hand 30 minutes before admission. Subungual hematoma was diagnosed in his index finger, although the nail plate was intact. Emergency physicians could identify nail bed injury with bedside ultrasonography examination. This noninvasive, inexpensive, and repeatable diagnostic modality could preserve patients from a complex, invasive nail removal procedure.
Subject Index
DOI: http://dx.doi.org/10.1016/S0735-6757(12)00518-9
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published in issue: November 2012
BRIPPED scan for evaluation of ED patients with shortness of breath Virginia M. Stewart, Hjalti M. Bjornsson, Michelle Clinton, Donald V. Byars
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.006
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: November 5 2015
x The BRIPPED scan is an ultrasound evaluation of pulmonary B-lines, right ventricle size, inferior vena cava collapsibility, pleural and pericardial effusion, pneumothorax, left ventricle ejection fraction, and lower extremity deep venous thrombosis. The primary goal was to evaluate the effect of the BRIPPED scan on the physician's list of differential diagnoses for patients presenting with shortness of breath.
Imaging during low back pain ED visits: a claims-based descriptive analysis Erin Schlemmer, James C. Mitchiner, Michael Brown, Elizabeth Wasilevich
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.060
The American Journal of Emergency Medicine , Vol. 33 , Issue 3 ,
Published online: December 30 2014
x Low back pain (LBP) is a common reason for emergency department (ED) visits. This study aimed to determine the frequency and type of nonindicated imaging during LBP ED visits and to describe demographic and prior health care use characteristics among the nonindicated population.
Evaluation of the pulmonary embolism rule-out criteria in a retrospective cohort at an urban academic hospital Andrew L. Bozarth, Navin Bajaj, Margaret R. Wessling, Dustin Keffer, Shais Jallu, Gary A. Salzman
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.010
The American Journal of Emergency Medicine , Vol. 33 , Issue 4 ,
Published online: March 4 2015
x The pulmonary embolism rule-out criteria (PERC) is an 8-variable clinical decision rule that identifies patients at low risk for pulmonary embolism (PE) to prevent unnecessary diagnostic testing in the evaluation of suspected PE in the emergency department (ED). The objective of this study was to determine PERC's safety and diagnostic use in our institution's ED population.
Contrast-enhanced ultrasonography to diagnose gallbladder perforation ShaoShan Tang, Yao Wang, YiJiao Wang
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.034
The American Journal of Emergency Medicine , Vol. 31 , Issue 8 ,
Published online: June 26 2013
x The purpose of this study was to evaluate contrast-enhanced ultrasonography (CEUS) as a modality for diagnosing perforation of the gallbladder (GB) and pericholecystic hepatic abscess.
Emergency physician focused cardiac ultrasound improves diagnosis of ascending aortic dissection Joseph R. Pare, Rachel Liu, Christopher L. Moore, Tyler Sherban, Michael S. Kelleher Jr., Sheeja Thomas, R. Andrew Taylor
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.005
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 12 2015
x Ascending aortic dissection (AAD) is an uncommon, time-sensitive, and deadly diagnosis with a nonspecific presentation. Ascending aortic dissection is associated with aortic dilation, which can be determined by emergency physician focused cardiac ultrasound (EP FOCUS). We seek to determine if patients who receive EP FOCUS have reduced time to diagnosis for AAD.
The diagnostic accuracy of an abdominal radiograph with signs and symptoms of intussusception Donna Mendez, A. Chantal Caviness, Long Ma, Charles C. Macias
DOI: http://dx.doi.org/10.1016/j.ajem.2011.01.010
The American Journal of Emergency Medicine , Vol. 30 , Issue 3 ,
Published online: March 30 2011
x The objective of this study was to compare the diagnostic accuracy of an abdominal ultrasound to that of a highly suggestive abdominal radiograph combined with signs and symptoms of intussusception.
Diagnosing heart failure among acutely dyspneic patients with cardiac, inferior vena cava, and lung ultrasonography Kenton L. Anderson, Katherine Y. Jenq, J. Matthew Fields, Nova L. Panebianco, Anthony J. Dean
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.007
The American Journal of Emergency Medicine , Vol. 31 , Issue 8 ,
Published online: June 14 2013
x Rapid diagnosis (dx) of acutely decompensated heart failure (ADHF) may be challenging in the emergency department (ED). Point-of-care ultrasonography (US) allows rapid determination of cardiac function, intravascular volume status, and presence of pulmonary edema. We test the diagnostic test characteristics of these 3 parameters in making the dx of ADHF among acutely dyspneic patients in the ED.
