Prognostic Implications of a Point‐of‐Care Ultrasound Examination on Hospital Ward Admission

2019 ◽  
Vol 39 (2) ◽  
pp. 289-297
Author(s):  
Bruce J. Kimura ◽  
May M. Lou ◽  
Eric B. Dahms ◽  
Paul J. Han ◽  
Jill Waalen
Keyword(s):  
Ultrasound Examination ◽  
Point Of Care ◽  
Hospital Ward ◽  
Point Of Care Ultrasound ◽  
Prognostic Implications

scholarly journals Routine Point of Care Ultrasound (POCUS) Assessment of Gastric Antral Contents in Traumatic Emergency Surgical Patients for Prevention of Aspiration Pneumonitis: A Randomized Clinical Trial 

2020 ◽  
Author(s):  
Mohamed S. Shorbagy ◽  
Amr A. Kasem ◽  
Ahmed A. Gamal Eldin ◽  
Ramy Mahrose
Keyword(s):  
Aspiration Pneumonia ◽  
Nasogastric Tube ◽  
Emergency Surgery ◽  
Ultrasound Examination ◽  
Point Of Care ◽  
Stomach Contents ◽  
Gastric Antrum ◽  
Point Of Care Ultrasound ◽  
Anesthesia Technique ◽  
Polytrauma Patients

Abstract Background: Polytrauma patients are at a higher risk of delayed gastric emptying. To assess gastric volume, a reliable diagnostic tool is needed to prevent the occurrence of aspiration pneumonia, which remains a serious complication associated with anesthesia. Gastric antral ultrasound can provide reliable information about the size of the gastric antrum in traumatized patients undergoing emergency surgery.Methods: A prospective observational study of 45 polytrauma patients undergoing emergency surgery under general anesthesia. Prior to induction of anesthesia in the emergency department, gastric ultrasound was performed to allow qualitative and quantitative assessment of gastric antrum in a supine position and right lateral decubitus (RLD) position. Followed by routine placement of nasogastric tube to aspirate and calculate the volume of the stomach contents.Results: Forty-five polytrauma patients who underwent gastric ultrasound examination showed that the risk assessment of aspiration and anesthesia technique changed in 14 patients (31.1%) after the ultrasound examination.A very good relationship existed between the expected stomach volume at the RLD position and the suction volume in the nasogastric tube. In all cases, no aspirations were documented.Conclusion: Ultrasound examination of the stomach in polytrauma patients allows assessing the size and type of stomach contents. The data obtained can influence the choice of anesthesia technique while inducing anesthesia and reduce the risk of aspiration pneumonia.Trial registration: This trial was registered at ClinicalTrials.gov. Registry number: NCT04083677.

Governance in point-of-care ultrasound

2019 ◽  
pp. 273-278
Author(s):  
Peter Macnaughton ◽  
Marcus Peck
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Ultrasound Examination ◽  
Point Of Care ◽  
Good Practice ◽  
Point Of Care Ultrasound ◽  
Equipment Management ◽  
Image Storage ◽  
Ensure Patient Safety

The performance and interpretation of ultrasound examination are very user-dependent that require significant training and experience. This chapter details the processes that should be adopted within an intensive care unit using point-of-care ultrasound to ensure that practitioners are appropriately trained and are able to maintain and develop their skills. The chapter also outlines recommendations regarding good practice in reporting and image storage, together with guidance regarding equipment management, to ensure patient safety.

scholarly journals Using Point‐of‐Care Ultrasound on Home Visits: The Home‐Oriented Ultrasound Examination (HOUSE)

2019 ◽  
Vol 67 (12) ◽  
pp. 2662-2663 ◽  
Author(s):  
Alexander R. Bonnel ◽  
Cameron M. Baston ◽  
Paul Wallace ◽  
Nova Panebianco ◽  
Bruce Kinosian
Keyword(s):  
Ultrasound Examination ◽  
Point Of Care ◽  
Home Visits ◽  
Point Of Care Ultrasound

Impact of Point-of-Care Ultrasound Examination on Triage of Patients With Suspected Cardiac Disease

2016 ◽  
Vol 118 (10) ◽  
pp. 1583-1587 ◽  
Author(s):  
Sergio L. Kobal ◽  
Noah Liel-Cohen ◽  
Sarah Shimony ◽  
Yoram Neuman ◽  
Yuval Konstantino ◽  
...  
Keyword(s):  
Cardiac Disease ◽  
Ultrasound Examination ◽  
Point Of Care ◽  
Point Of Care Ultrasound

Auscultation versus Point-of-care Ultrasound to Determine Endotracheal versus Bronchial Intubation

2016 ◽  
Vol 124 (5) ◽  
pp. 1012-1020 ◽  
Author(s):  
Davinder Ramsingh ◽  
Ethan Frank ◽  
Robert Haughton ◽  
John Schilling ◽  
Kimberly M. Gimenez ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Predictive Value ◽  
Interobserver Agreement ◽  
Ultrasound Examination ◽  
Point Of Care ◽  
Main Bronchus ◽  
Randomized Study ◽  
Point Of Care Ultrasound ◽  
Bronchial Intubation ◽  
Double Blinded

Abstract Background Unrecognized malposition of the endotracheal tube (ETT) can lead to severe complications in patients under general anesthesia. The focus of this double-blinded randomized study was to assess the accuracy of point-of-care ultrasound in verifying the correct position of the ETT and to compare it with the accuracy of auscultation. Methods Forty-two adult patients requiring general anesthesia with ETT were consented. Patients were randomized to right main bronchus, left main bronchus, or tracheal intubation. After randomization, the ETT was placed via fiber-optic visualization. Next, the location of the ETT was assessed using auscultation by a separate blinded anesthesiologist, followed by an ultrasound performed by a third blinded anesthesiologist. Ultrasound examination included assessment of tracheal dilation via cuff inflation with air and evaluation of pleural lung sliding. Statistical analysis included sensitivity, specificity, positive predictive value, negative predictive value, and interobserver agreement for the ultrasound examination (95% CI). Results In differentiating tracheal versus bronchial intubations, auscultation showed a sensitivity of 66% (0.39 to 0.87) and a specificity of 59% (0.39 to 0.77), whereas ultrasound showed a sensitivity of 93% (0.66 to 0.99) and specificity of 96% (0.79 to 1). Identification of tracheal versus bronchial intubation was 62% (26 of 42) in the auscultation group and 95% (40 of 42) in the ultrasound group (P = 0.0005) (CI for difference, 0.15 to 0.52), and the McNemar comparison showed statistically significant improvement with ultrasound (P < 0.0001). Interobserver agreement of ultrasound findings was 100%. Conclusion Assessment of trachea and pleura via point-of-care ultrasound is superior to auscultation in determining the location of ETT.

scholarly journals Feasibility and accuracy of point-of-care ultrasound examination performed by medical students

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P2934-P2934 ◽  
Author(s):  
G. N. Andersen ◽  
A. T. Viset ◽  
O. C. Mjolstad ◽  
O. Salvesen ◽  
H. Dalen ◽  
...  
Keyword(s):  
Medical Students ◽  
Ultrasound Examination ◽  
Point Of Care ◽  
Point Of Care Ultrasound

scholarly journals Use of a Smartphone-Based Augmented Reality Video Conference App to Remotely Guide a Point of Care Ultrasound Examination

Diagnostics ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 159 ◽  
Author(s):  
Davinder Ramsingh ◽  
Cori Van Gorkom ◽  
Matthew Holsclaw ◽  
Scott Nelson ◽  
Martin De La Huerta ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Ultrasound Examination ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Video Conference ◽  
Resource Limited Settings ◽  
Resource Limited

Reports on the use of various smartphone-based video conference applications to guide point-of-care ultrasound (POCUS) examinations in resource-limited settings have been described. However, the use of an augmented reality-enabled smartphone video conference application in this same manner has not been described. Presented is a case in which such as application was used to remotely guide a point of care ultrasound examination.

scholarly journals Diagnostic point-of-care ultrasound in medical inpatients at Queen Elizabeth Central Hospital, Malawi: an observational study of practice and evaluation of implementation

2020 ◽  
Author(s):  
Fumbani Limani ◽  
Dingase Dula ◽  
Alexander J Keeley ◽  
Elizabeth Joekes ◽  
Tamara Phiri ◽  
...  
Keyword(s):  
Patient Management ◽  
Ultrasound Examination ◽  
Point Of Care ◽  
Training Programme ◽  
Radiology Department ◽  
Point Of Care Ultrasound ◽  
Central Hospital ◽  
Medical Inpatients ◽  
Record Review ◽  
Queen Elizabeth Central Hospital

Abstract Background In less well-resourced settings, where access to radiology services is limited, point-of-care ultrasound (POCUS) can be used to assess patients and guide clinical management. The aim of this study was to describe ultrasound practice in the assessment of medical inpatients at Queen Elizabeth Central Hospital, Blantyre, Malawi, and evaluate uptake and impact of POCUS following the introduction of a training programme at the college of Medicine, Blantyre, Malawi. Methods : A weekly prospective record review of sequential adult medical inpatients who had received an ultrasound examination was conducted. Results Of 835 patients screened, 250 patients were included; 267 ultrasound examinations were performed, of which 133 (50%) were POCUS (defined as performed by a clinician at the bedside). The time from request to performance of examination was shorter for POCUS examinations than radiology department ultrasound (RDUS) (median 0 [IQR 0–2, range 0–11] vs 2 [IQR 1–4, range 0–15] d, p=0.002); 104/133 (78.2%) POCUS and 90/133 (67.7%) RDUS examinations were deemed to have an impact on management. Conclusion Following the introduction of a training programme in POCUS, half of all ultrasound examinations were delivered as POCUS. POCUS was performed rapidly and impacted on patient management. POCUS may relieve the burden on radiology services in less well-resourced settings.

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