scholarly journals Images in Primary Care Medicine: Point-of-Care Ultrasound in Gout

Cureus ◽  
2021 ◽  
Author(s):  
Dennis Espejo ◽  
Elizabeth Dearing ◽  
Kathleen Y Ogle ◽  
Maria Portela ◽  
Keith S Boniface
Keyword(s):  
Primary Care ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Primary Care Medicine

scholarly journals Environmental and Patient Impact of Applying a Point-of-Care Ultrasound Model in Primary Care: Rural vs. Urban Centres

2020 ◽  
Vol 17 (9) ◽  
pp. 3333
Author(s):  
Francesc X Marín-Gomez ◽  
Jacobo Mendioroz Peña ◽  
Vicenç Canal Casals ◽  
Marcos Romero Mendez ◽  
Ana Darnés Surroca ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Primary Care ◽  
Air Pollution ◽  
Air Pollutants ◽  
Point Of Care ◽  
Motor Vehicles ◽  
Point Of Care Ultrasound ◽  
Major Contributor ◽  
Specialized Service ◽  
The Impact

Motor vehicles are a major contributor to air pollution, and the exposure to this human-caused air pollution can lead to harmful health effects. This study evaluates the impact of the provision of point-of-care ultrasounds (POCUS) by primary care (PC) to avoid the patient’s need to travel to a specialized service. The study estimates the costs and air pollution avoided during 2019. The results confirm that performing this ultrasound at the point of care reduces the emission of 61.4 gr of carbon monoxide, 14.8 gr of nitric oxide and 2.7 gr of sulfur dioxide on each trip. During the study, an average of 17.8 km, 21.4 min per trip and almost 2000 L of fuel consumed in a year were avoided. Performing POCUS from PC reduces fuel consumption and the emission of air pollutants and also saves time and money. Furthermore, only 0.3% of the scans had to be repeated by radiologists. However, more studies with more participants need to be done to calculate the exact impact that these pollution reductions will have on human health.

scholarly journals Adoptability and Accuracy of Point-of-Care Ultrasound in Screening for Valvular Heart Disease in the Primary Care setting

2021 ◽  
Author(s):  
Yashasvi Chugh ◽  
Opema Lohese ◽  
Paul Sorajja ◽  
Ross Garberich ◽  
Lariss Stanberry ◽  
...  
Keyword(s):  
Primary Care ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Care Setting ◽  
Primary Care Setting ◽  
Point Of Care ◽  
Primary Care Providers ◽  
Left Ventricular ◽  
Point Of Care Ultrasound ◽  
Care Providers

Background: Despite continued efforts, the majority of patients with valvular heart disease (VHD) remain undiagnosed and untreated. This study aimed to assess the adoptability and accuracy of point-of-care handheld echocardiographic assessments (POCE) in the primary care setting. Methods: Eleven previously untrained primary care providers were trained to use the Vscan Extend (GE, WI) POCE to assess VHD, left ventricular function (LVEF), and major extra-cardiac findings. Their assessments were compared to those of 3 blinded expert readers. A total of 180 assessments were evaluated using Kappa statistics (κ) together with their estimated standard error, p-value, and 95% CI bounds. Results: Identical or nearly identical agreement between previously untrained primary providers and expert readers was evident for the diagnosis of tricuspid regurgitation, mitral regurgitation, pericardial effusion, volume status. These agreements were strongest in apical long axis (κ =1, p<0.001) and parasternal long and short axis views (k>=0.82 p<0.001), though agreement remained robust in apical 4-chamber views (k>=0.76). The agreements in LVEF assessment were identical in the apical long axis view (κ =1, p<0.001) and robust in the remaining 3 views (κ>=0.66, p<0.001). The assessments of aortic stenosis (parasternal/long, κ =0.42, and parasternal/short, κ =0.47, both p<0.001) were weak in their agreement. Conclusion: Compared to expert echocardiography readers, the untrained providers’ use of POCE for VHD shows high user adoptability and diagnostic accuracies in the primary care setting.

scholarly journals ADOPTABILITY AND ACCURACY OF POINT-OF-CARE ULTRASOUND IN SCREENING FOR VALVULAR HEART DISEASE IN THE PRIMARY CARE SETTING

2021 ◽  
Vol 77 (18) ◽  
pp. 1711
Author(s):  
Opema Lohese ◽  
Ross Garberich ◽  
Larissa Stanberry ◽  
Paul Sorajja ◽  
Joao Cavalcante ◽  
...  
Keyword(s):  
Primary Care ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Care Setting ◽  
Primary Care Setting ◽  
Point Of Care ◽  
Point Of Care Ultrasound

scholarly journals Elastofibroma Dorsi: Case Report with Point of Care Ultrasound Primary Care Applications

POCUS Journal ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 60-63
Author(s):  
Trent Mazer ◽  
Karam Nabeel Gagi ◽  
Michael Bishop
Keyword(s):  
Primary Care ◽  
Soft Tissue Tumor ◽  
Point Of Care ◽  
Treatment Options ◽  
Care Physician ◽  
Point Of Care Ultrasound ◽  
Elastofibroma Dorsi ◽  
Unclear Etiology ◽  
Slow Growing ◽  
Review Current

Elastofibroma dorsi (ED) is an uncommon, benign, slow-growing soft tissue tumor with an unclear etiology. The growth often presents as a local deformity with mild pain or discomfort in the subscapular region of geriatric populations. The following paper discusses a 73 year old female with mildly painful ED who presented to her primary care physician. We further review current literature on epidemiology, utilization of point of care ultrasound (POCUS) and treatment options.

scholarly journals Utility of Point of Care Ultrasound in Humanitarian Assistance Missions

2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 789-794
Author(s):  
John F Sullivan ◽  
Marinha do Brasil ◽  
John W Roman ◽  
Edmund A Milder ◽  
E Carter ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Patient Management ◽  
Point Of Care ◽  
Humanitarian Assistance ◽  
Point Of Care Ultrasound ◽  
Diagnostic Modality ◽  
Madeira River ◽  
The Usa ◽  
Relief Efforts

ABSTRACT Introduction Point of care ultrasound (POCUS) is increasingly used in primary care in the USA and has been shown to provide significant benefit to care in deployed military settings and during disaster relief efforts. It is less studied as a tool during humanitarian assistance missions. We sought to determine the utility of POCUS in a humanitarian assistance setting during the February 2019 joint U.S.–Brazilian hospital assistance mission aboard the Hospitalar Assistance Ship Carlos Chagas along the Madeira River in the Brazilian Amazon. Materials and Methods Point of care ultrasound was offered as a diagnostic modality to primary care physicians during the course of a month-long mission. A handheld IVIZ ultrasound machine was loaned for use during this mission by Sonosite. A P21v phased array (5-1 MHz) or an L38v linear (10-5 MHz) transducer was used for scanning. Requests for POCUS examinations, their findings, and changes in patient management were recorded. Results Point of care ultrasound examinations were requested and performed in 24 of 814 (3%) outpatient primary care visits. Ten of these studies (42% of POCUS examinations, 1.2% of all patient visits) directed patient management decisions, in each case preventing unnecessary referral. Conclusions In this austere setting, POCUS proved to be an inexpensive, effective tool at preventing unnecessary referrals. Future medical humanitarian assistance missions may likewise find POCUS to be a primary care force-multiplier.

scholarly journals Moving the needle towards the democratization of echocardiography: a case report

2019 ◽  
Author(s):  
Jonathan dos Santos ◽  
Patrícia Borges Fernandes ◽  
Francisco Rocha Gonçalves ◽  
Alexandra Gonçalves
Keyword(s):  
Primary Care ◽  
Physical Examination ◽  
Primary Care Physician ◽  
Primary Care Physicians ◽  
Point Of Care ◽  
Family Doctor ◽  
Vena Cava ◽  
Left Ventricular ◽  
Care Physician ◽  
Point Of Care Ultrasound

Abstract Background Echocardiography has been traditionally performed in echo labs and the potential benefits of its use by primary care physicians (PCPs) are still unexplored. We present a case where POCUS (point-of-care ultrasound) was used as a complement of physical examination by a family doctor, allowing a prompt clinical decision in a heart failure (HF) patient. Case summary An 85-year-old woman, living independently, asks her family doctor for a home consultation due to increasing dyspnoea. On examination, severe dyspnoea and bilateral ankle oedema was noted and a point-of-care echocardiogram was performed by the primary care physician, who observed: severely compromised left ventricular systolic function, moderate mitral and tricuspid regurgitation, and severe dilation of the inferior vena cava. As a result, the diagnosis of HF with decreased ejection fraction was formed supporting the therapeutic decision. Discussion This case represents an elderly patient with dyspnoea, without previous HF diagnosis. The primary care physician, used portable ultrasound as a complement of physical examination, which confirmed a HF diagnosis, allowing a prompt decision-making on therapy. POCUS, can be a powerful tool to expedite treatment in different settings, including the home consultations by PCPs.

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