Four cases of inadvertent arterial cannulation despite of ultrasound guidance Yushi U. Adachi, Shigehito Sato
DOI: http://dx.doi.org/10.1016/j.ajem.2010.03.029
The American Journal of Emergency Medicine , Vol. 28 , Issue 4 ,
Published in issue: May 2010
x We read with great interest the publication by Stone et al [1] in the recent issue of the journal about the ultrasound detection of guidewire position for avoiding arterial guidewire placement. They demonstrated that guidewire visualization within the jugular vein predicted venous catheter placement with a sensitivity and specificity of 100% and 100%, respectively, in all 20 adult patients. As the author discussed, the use of real-time ultrasound guidance decreases complication, especially arterial puncture [2].
Bedside ultrasound for verification of shoulder reduction with the lateral and anterior approaches Chi Kit Yuen, Ka Leung Mok, Pui Gay Kan, Yau Tak Wong
DOI: http://dx.doi.org/10.1016/j.ajem.2009.01.037
The American Journal of Emergency Medicine , Vol. 27 , Issue 4 ,
Published in issue: May 2009
x We read with interest the article “Bedside ultrasound for verification of shoulder reduction” by Halberg et al [1] and would like to raise a few comments. We feel curious that the authors could produce any ultrasound images of the shoulder of diagnostic quality by using ultrasound beam of 60 MHz as described by the authors. It is exceedingly rare to use diagnostic ultrasound of frequency as high as 60 MHz in the emergency room for assessing musculoskeletal problems. The penetrating power of ultrasound beam is inversely related to the frequency of the ultrasound; with a frequency of 60 MHz, most of the ultrasound will be attenuated by the soft tissue before being reflected by the bones in the shoulder, the imaging quality will certainly be very suboptimal.
Emergency bedside ultrasound for the diagnosis of rib fractures Stewart Siu-Wa Chan
DOI: http://dx.doi.org/10.1016/j.ajem.2008.04.013
The American Journal of Emergency Medicine , Vol. 27 , Issue 5 ,
Published in issue: June 2009
x The scope of clinical applications of emergency ultrasonography continues to expand. Bedside ultrasound has been typically described as an “extension of the palpating hand” and a “visual stethoscope” during physical examination. One of the relatively newer applications is its use in the detection of rib fractures. The author discusses the technique, applicability, limitations, and role of emergency ultrasound in the diagnosis of rib fractures.
Ultrasound-assisted ankle arthrocentesis Simon Roy, Andreas Dewitz, Ian Paul
DOI: http://dx.doi.org/10.1016/S0735-6757(99)90129-8
The American Journal of Emergency Medicine , Vol. 17 , Issue 3 ,
Published in issue: May 1999
x Difficulty is frequently encountered in performing ankle arthrocentesis. This report describes an ultrasound-assisted technique that can be readily learned by emergency physicians. It involves using the ultrasound beam to accurately locate the tibiotalar joint, thereby increasing the probability of obtaining joint fluid on aspiration.
Ultrasound-guided interscalene block: more than meets the eye Stephen M. Howell, Mario E. Serafini
DOI: http://dx.doi.org/10.1016/j.ajem.2008.02.007
The American Journal of Emergency Medicine , Vol. 26 , Issue 5 ,
Published in issue: June 2008
x We recently read the article “Ultrasound-Guided Interscalene Block for Shoulder Dislocation Reduction in the ED,” by Blaivas and Lyon [1], with great interest. The authors report 4 patients with shoulder dislocations that were successfully reduced after ultrasound-guided interscalene block. As the authors have pointed out, an interscalene block is an excellent technique for the management of patients with shoulder pain. Ultrasound guidance is one technique described in the anesthesiology literature for interscalene block needle placement.
Ultrasound-guided reduction of a Spigelian hernia in a difficult case: An unusual use of bedside emergency ultrasonography Michael Blaivas
DOI: http://dx.doi.org/10.1053/ajem.2002.29565
The American Journal of Emergency Medicine , Vol. 20 , Issue 1 ,
Published in issue: January 2002
x —Herniation through the abdominal wall is the most common wound complication after abdominal surgery.1 The rate of incisional herniation ranges from 2% to 11% with recurrent herniation in 20% to 46%.2 Another type of abdominal wall herniation is the Spigelian hernia. It is a hernia in an area of transition from muscle to aponeurosis in the transverses abdominis.3 Spigelian hernias account for 2% of abdominal wall hernias.4 It is often missed or misdiagnosed and presents emergently with incarceration or strangulation in up to 25% of cases.
The use of ultrasound in ocular diseases Cem Ozgonul, Murat Kucukevcilioglu, Gokcen Gokce
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.047
The American Journal of Emergency Medicine , Vol. 34 , Issue 1 ,
Published online: October 25 2015
x We read with great interest the recent published article by Budhram et al [1] in which authors aimed to determine the prevalence of monocular and binocular mobile vitreous opacities in the vitreous chamber in an asymptomatic population at normal and high gain levels. In conclusion, the authors stated that mobile vitreous opacity in the vitreous chamber was uncommon at normal gain levels but relatively common at high gain settings and found both unilaterally and bilaterally. Although it is a well-designed and straightforward study, there is a point that we would like to add for a proper understanding of the issue, to avoid giving a wrong message to readers.
Ultrasound-guided interscalene block for shoulder dislocation reduction in the ED David Graf
DOI: http://dx.doi.org/10.1016/j.ajem.2008.07.005
The American Journal of Emergency Medicine , Vol. 26 , Issue 9 ,
Published in issue: November 2008
x I am an anesthesiologist who is one of the first 300 US physicians to become certified in emergency medicine (1980).
A novel in-plane technique for ultrasound-guided pericardiocentesis Arun Nagdev, Daniel Mantuani
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.021
The American Journal of Emergency Medicine , Vol. 31 , Issue 9 ,
Published online: June 27 2013
x Ultrasound-guided procedures are becoming very common in emergency medicine and critical care. Ultrasound guidance for pericardiocentesis has been shown to reduce errors as compared with the landmark-based technique. A simplified in-plane ultrasound-guided pericardiocentesis allows the clinician an opportunity to visualize the needle and the guide wire during the procedure. In addition, post procedure ultrasound of the pericardial effusion, right ventricle and inferior vena cava allow the clinician confirmation of improvement of physiologic parameters that can lead to cardiovascular collapse from impending pericardial tamponade.
The Society of Clinical Ultrasound Fellowships: An Innovation in the Point of Care Ultrasound Fellowship Application Process Resa E. Lewiss, Srikar Adhikari, Kristin Carmody, J. Matthew Fields, Patrick Hunt, Andrew S. Liteplo, Arun Nagdev, Christopher Raio, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.070
Publication stage: In Press Accepted Manuscript
The American Journal of Emergency Medicine
Published online: April 8 2016
x To the Editor, (See Figs. 1 and 2.)
Bedside ultrasound identification of a duplicated inferior vena cava Geoffrey E. Hayden, Carrie Klotz
DOI: http://dx.doi.org/10.1016/j.ajem.2010.03.014
The American Journal of Emergency Medicine , Vol. 29 , Issue 2 ,
Published online: July 14 2010
x A 47-year-old man presented to the emergency department with upper abdominal pain radiating to his back. Other than mild, reproducible abdominal pain, he had a normal physical examination. A bedside ultrasound examination of his aorta was performed and demonstrated a third vascular structure on axial (short-axis) imaging of the abdomen. Computed tomography of his abdomen and pelvis confirmed a duplicated inferior vena cava. This anomaly is discussed in terms of its relevance to the emergency sonographer, with a brief review of the literature on the subject.
Comet tail artifacts in emergency chest ultrasound Stewart Siu-Wa Chan
DOI: http://dx.doi.org/10.1016/j.ajem.2006.11.041
The American Journal of Emergency Medicine , Vol. 25 , Issue 6 ,
Published in issue: July 2007
x I read with interest the excellent work of Volpicelli et al [1] (October 2006), which assessed the potential of bedside lung ultrasound to diagnose alveolar-interstitial syndrome (AIS) in the emergency setting. The authors' use of “comet tail artifacts” in their diagnostic criteria is indeed a novel advance in the clinical application of emergency ultrasound. However the use of the term comet tail artifact may be confusing for the novice and the general readership.
Ultrasound as a diagnostic tool Edward P. Krenzelok, Michael B. Heller
DOI: http://dx.doi.org/10.1016/0735-6757(92)90034-U
The American Journal of Emergency Medicine , Vol. 10 , Issue 4 ,
Published in issue: July 1992
Ultrasound-assisted internal jugular vein catheterization in the ED Paul Hrics, Scott Wilber, Michelle P Blanda, Ugo Gallo
DOI: http://dx.doi.org/10.1016/S0735-6757(98)90140-1
The American Journal of Emergency Medicine , Vol. 16 , Issue 4 ,
Published in issue: July 1998
x A prospective, descriptive study is reported on the use and success of ultrasound-assisted internal jugular central vein catheterization (CVC) in the emergency department (ED). In patients not in cardiac arrest who had an indication for internal jugular CVC, lines were placed by trained ED staff using ultrasound. Data were collected prospectively on age, sex, body habitus, indication, vein visibility, number of punctures and needle passes, and success. There were 40 attempts at internal jugular CVC in 34 patients and ultrasound was used in 32 of the 40 (80%) attempts.
Bedside ultrasound for the detection of diabetic myonecrosis Arun Nagdev, Michael Murphy, Craig Sisson
DOI: http://dx.doi.org/10.1016/j.ajem.2008.02.017
The American Journal of Emergency Medicine , Vol. 26 , Issue 8 ,
Published in issue: October 2008
x Diabetic myonecrosis is an uncommon complication of diabetes mellitus. There are fewer than 50 cases reported in the general medical literature. Patients classically complain of the abrupt onset of diffuse anterior thigh pain with no signs of overlying infection or signs of systemic toxicity. Because of the difficulty in diagnosis, most patients endure multiple medical visits until appropriate imaging modalities are obtained. Currently, magnetic resonance imaging (MRI) or tissue biopsy is considered the gold standard for diagnosis.
Ultrasonography in Japanese emergency departments Robert A. Shapiro, Masakazo Nakamoto
DOI: http://dx.doi.org/10.1016/0735-6757(90)90235-R
The American Journal of Emergency Medicine , Vol. 8 , Issue 5 ,
Published in issue: September 1990
x This is a review of 50 consecutive cases where ultrasound was performed in the emergency department of a general hospital demonstrating the efficacy of its usage by “nonspecialists”. This study demonstrates that in the Japanese model of emergency care delivery, abdominal ultrasound has been shown to be used in the emergency department with accuracy and safety.
ED point-of-care ultrasound in the diagnosis of ankle fractures in children Ian Taggart, Nika Voskoboynik, Sachita Shah, Otto Liebmann
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.037
The American Journal of Emergency Medicine , Vol. 30 , Issue 7 ,
Published online: August 22 2011
x In pediatric ankle injury, radiography is the current standard used to differentiate fracture from ligamentous injury; however, the associated cost, increased time, and radiation exposure pose a significant downside to this imaging modality. Point-of-care ultrasound may be an attractive alternative in this setting, as illustrated by this patient case. A 14-year-old boy presented to the emergency department with a left ankle inversion injury sustained while playing soccer. An emergency physician performed ultrasound examination that revealed findings consistent with a nondisplaced Salter-Harris I fracture of the distal fibula.
Real-time ultrasound guided internal jugular vein catheterization in the emergency department Peter A Hudson, John S Rose
DOI: http://dx.doi.org/10.1016/S0735-6757(97)90056-5
The American Journal of Emergency Medicine , Vol. 15 , Issue 1 ,
Published in issue: January 1997
x Establishing central intravenous access in the emergency department (ED) is often both crucial and difficult. In patients with nonexistant or ambiguous external anatomic landmarks, a real-time ultrasound guided approach to internal jugular vein cannulation is useful. In addition, the use of ultrasound guidance in internal jugular vein cannulation is supported by reports that have documented reductions in number of cannulation attempts, time required to establish central access, and rate of complications.
Visualization of ingested medications in the stomach by ultrasound Yona Amital, Bruce Silver, Jerrold B. Leikin, Henri Frischer
DOI: http://dx.doi.org/10.1016/0735-6757(92)90118-H
The American Journal of Emergency Medicine , Vol. 10 , Issue 1 ,
Published in issue: January 1992
x The authors describe a potential application of ultrasound in detection of pills in the stomach, and report the first case of its use in a patient. Thirty pills were studied in vitro by ultrasound. All were clearly detected, with better imaging compared with plain radiography. Four pills with slow disintegration (sustained release or enteric coated) and two with fast disintegration (immediate release) were further studied by ultrasound, following their ingestion by human volunteers. All four pills with slow disintegration were clearly visualized in the stomach, while detection of the other two pills was inconsistent.
Author's Reply: Pelvic examination is unnecessary in pregnant patients with normal bedside ultrasound Amanda Seymour, Alfred Sacchetti
DOI: http://dx.doi.org/10.1016/j.ajem.2010.03.026
The American Journal of Emergency Medicine , Vol. 28 , Issue 4 ,
Published in issue: May 2010
x We would like to thank Drs Hsu and Hsiao for their comments on our recent report on the use of ultrasound in pregnant patients. We certainly agree that identifying a nonobstetric source of any complaint in a pregnant patient can be difficult if not impossible. However, in the context of the emergency department (ED), it may not be necessary to identify the exact cause of a problem such as vaginal spotting. If the patient is not bleeding heavily and a viable intrauterine pregnancy is visualized on bedside ultrasound, then any of the other etiologies for minor vaginal bleeding such as a cervical polyp may be safely left to the patient's primary obstetric provider for diagnosis.
