Integrated Multi-Organ Ultrasound.

Integrated multi-organ ultrasound is increasingly used across various medical specialties. It should be performed in conjunction with history, physical examination, and other investigations in the diagnostic process to enhance the detection of conditions in the lung, heart, and abdomen. Multi-organ ultrasound has been shown to improve diagnostic accuracy in a sizeable portion of patients, potentially altering treatment plans.

Effect of a Point-of-Care Ultrasound-Driven vs Standard Diagnostic Pathway on 24-Hour Hospital Stay in Emergency Department Patients with Dyspnea-Protocol for A Randomized Controlled Trial.

Purpose: Point-of-care ultrasound (POCUS) helps emergency department (ED) physicians make prompt and appropriate decisions, but the optimal diagnostic integration and potential clinical benefits remain unclear. We describe the protocol and statistical analysis plan for a randomized controlled trial. The objective is to determine the effect of a POCUS-driven diagnostic pathway in adult dyspneic ED patients on the proportion of patients having a hospital stay of less than 24 hours when compared to the standard diagnostic pathway.

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A focused point-of-care abdominal ultrasound is an examination performed at the patient's location and interpreted within the clinical context. This review gives an overview of this examination modality. The objective is to rapidly address predefined dichotomised questions about the presence of an abdominal aortic aneurysm, gallstones, cholecystitis, hydronephrosis, urinary retention, free intraperitoneal fluid, and small bowel obstruction.

Point-of-Care Lung Ultrasound in Emergency Medicine: A Scoping Review With an Interactive Database.

Background: This scoping review was conducted to provide an overview of the evidence of point-of-care lung ultrasound (LUS) in emergency medicine. By emphasizing clinical topics, time trends, study designs, and the scope of the primary outcomes, a map is provided for physicians and researchers to guide their future initiatives.

Research Question: Which study designs and primary outcomes are reported in published studies of LUS in emergency medicine?

Study Design And Methods: We performed a systematic search in the PubMed/MEDLINE, Embase, Web of Science, Scopus, and Cochrane Library databases for LUS studies published prior to May 13, 2023.

Management of medical emergency patients in Danish emergency departments.

Introduction: In many emergency departments (ED), specialised teams are activated to take care of medical emergency patients (MEP). The aim of this study was to describe the organisation of the management of adult MEPs in Danish EDs. The study examined trigger team activation criteria, training and composition of trigger teams.

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Focused cardiac ultrasound (FoCUS) is a point-of-care cardiac examination performed and interpreted by the emergency physician in the clinical context. This review summarises the current knowledge of FoCUS. The objective is to answer four predefined clinical questions: Are there any signs of pericardial effusion? Are there any signs of right ventricular dilatation? Are there any signs of reduced or hyperdynamic left ventricular function? Are there any signs of abnormal inferior vena cava? FoCUS is not a replacement for echocardiography but a useful tool in detecting cardiopulmonary pathology and haemodynamic abnormalities in the emergency setting.

Lack of Thoracentesis Competencies and Training in Danish Emergency Departments: A Danish Nationwide Study.

Background: Dyspnea caused by pleural effusion is a common reason for admission to the emergency department (ED). In such cases, thoracentesis performed in the ED may allow for swift symptom relief, diagnostics, and early patient discharge. However, the competence level of thoracentesis and training in the ED are currently unclear.

Focused lung ultrasound to predict respiratory failure in patients with symptoms of COVID-19: a multicentre prospective cohort study.

Background: In this study we aimed to assess if a focused lung ultrasound examination predicts the need for mechanical ventilation, admission to an intensive care unit, high-flow oxygen treatment, death from COVID-19 within 30 days and 30-day all-cause mortality in patients with clinical suspicion of COVID-19 or PCR-verified SARS-CoV-2 infection.

Methods: A multicentre prospective cohort trial was performed. Film clips from focused lung ultrasound examinations were recorded and rated by blinded observers using different scoring systems.

The Framing of machine learning risk prediction models illustrated by evaluation of sepsis in general wards.

Problem framing is critical to developing risk prediction models because all subsequent development work and evaluation takes place within the context of how a problem has been framed and explicit documentation of framing choices makes it easier to compare evaluation metrics between published studies. In this work, we introduce the basic concepts of framing, including prediction windows, observation windows, window shifts and event-triggers for a prediction that strongly affects the risk of clinician fatigue caused by false positives. Building on this, we apply four different framing structures to the same generic dataset, using a sepsis risk prediction model as an example, and evaluate how framing affects model performance and learning.

[Point-of-care ultrasound in emergency departments in Denmark].

Point-of-are ultrasound (PoCUS) has become an integrated part of initial diagnostics and procedural guidance after establishing emergency departments and a speciality in emergency medicine in Denmark. Focused PoCUS is a fast examination, which is done and interpreted bedside to answer clinical, predefined dichotomous questions. Emergency physicians have an obligate course in PoCUS as part of their training and must be certified to get speciality recognition.

Simulation-based team training in time-critical clinical presentations in emergency medicine and critical care: a review of the literature.

Background: The use of simulation-based team training has increased over the past decades. Simulation-based team training within emergency medicine and critical care contexts is best known for its use by trauma teams and teams involved in cardiac arrest. In the domain of emergency medicine, simulation-based team training is also used for other typical time-critical clinical presentations.

Point-of-care ultrasound induced changes in management of unselected patients in the emergency department - a prospective single-blinded observational trial.

Background: Point-of-Care ultrasound (POCUS) changes the management in specific groups of patients in the Emergency Department (ED). It seems intuitive that POCUS holds an unexploited potential on a wide variety of patients. However, little is known about the effect of ultrasound on the broad spectrum of unselected patients in the ED.

Point-of-care ultrasound findings in unselected patients in an emergency department -results from a prospective observational trial.

Background: Point-of-care ultrasound (POCUS) can improve patient management in the emergency department (ED). However, previous studies have focused only on selected groups of patients, such as trauma, shock, dyspnea, or critically ill patients, or patients with an already known diagnosis. Most patients seen in the ED do not match these criteria.

Remote Real-Time Ultrasound Supervision via Commercially Available and Low-Cost Tele-Ultrasound: a Mixed Methods Study of the Practical Feasibility and Users' Acceptability in an Emergency Department.

Minor emergency departments (ED) struggle to access sufficient expertise to supervise learners of lung and cardiac point-of-care ultrasound (POCUS). Using tele-ultrasound (tele-US) for remote supervision may remedy this situation. We aimed to evaluate the feasibility of real-time supervision via tele-US when applied to an everyday ED clinic.

Childhood trampoline injuries.

Introduction: With the increasing use of recreational trampolines, more injuries are seen in emergency depart-ments (ED). Little is known about the relationship between adherence to safety precautions and injuries. This retro-spective study aims to describe the types of injuries and the precautions taken when using trampolines, and to investigate the relationship between injuries and safety precautions.

Remote real-time supervision via tele-ultrasound in focused cardiac ultrasound: A single-blinded cluster randomized controlled trial.

Background: Supervision via tele-ultrasound presents a remedy for lacking on-site supervision in focused cardiac ultrasound, but knowledge of its impact is largely absent. We aimed to investigate tele-supervised physicians' cine-loop quality compared to that of non-supervised physicians and compared to that of experts.

Methods: We conducted a single-blinded cluster randomized controlled trial in an emergency department in western Denmark.

Is point-of-care ultrasound disruptive innovation? Formulating why POCUS is different from conventional comprehensive ultrasound.

Background: Point-of-care ultrasound (PoCUS) is spreading throughout Emergency Medicine, Critical Care and Pre-hospital Care. However, there is an underlying inherited conflict with the established specialties performing comprehensive examinations. It has been stated that PoCUS is disruptive innovation.

Trauma facilities in Denmark - a nationwide cross-sectional benchmark study of facilities and trauma care organisation.

Background: Trauma is a leading cause of death among adults aged < 44 years, and optimal care is a challenge. Evidence supports the centralization of trauma facilities and the use multidisciplinary trauma teams. Because knowledge is sparse on the existing distribution of trauma facilities and the organisation of trauma care in Denmark, the aim of this study was to identify all Danish facilities that care for traumatized patients and to investigate the diversity in organization of trauma management.

Validation of the Peripheral Ultrasound-guided Vascular Access Rating Scale.

Evidence-based standards in proficiency are needed for ultrasound-guided peripheral intravenous access. In this study, we explored the validity of the Peripheral Ultrasound-Guided Vascular Access (P-UGVA) Rating Scale.We recruited 3 groups of physicians (5 novices, 5 intermediates, and 5 experts) of increasing proficiency in peripheral ultrasound-guided intravenous access.

Ultrasonography in trauma: a nation-wide cross-sectional investigation.

Background: The Focused Assessment with Sonography in Trauma (FAST) protocol is considered beneficial in emergent evaluation of trauma patients with blunt or penetrating injury and has become integrated into the Advanced Trauma Life Support (ATLS) protocol. No guidelines exist as to the use of ultrasonography in trauma in Denmark. We aimed to determine the current use of ultrasonography for assessing trauma patients in Denmark.

Rating scale for the assessment of competence in ultrasound-guided peripheral vascular access - a Delphi Consensus Study.

Introduction: Peripheral vascular access is vital for treatment and diagnostics of hospitalized patients. Ultrasound-guided vascular access (UGVA) is superior to the landmark technique. To ensure competence-based education, an assessment tool of UGVA competence is needed.

Developing an emergency ultrasound app - a collaborative project between clinicians from different universities.

Focused emergency ultrasound is rapidly evolving as a clinical skill for bedside examination by physicians at all levels of education. Ultrasound is highly operator-dependent and relevant training is essential to ensure appropriate use. When supplementing hands-on focused ultrasound courses, e-learning can increase the learning effect.

[Adder bites].

Correct treatment of adder bites can reduce morbidity. We aim at creating an evidence-based guideline on pre- and in-hospital treatment of bites by the European adder (Vipera berus). Pre-hospital treatment consists of reassurance, immobilisation, elevation and paracetamol for pain.

A framework for implementation, education, research and clinical use of ultrasound in emergency departments by the Danish Society for Emergency Medicine.

The first Danish Society for Emergency Medicine (DASEM) recommendations for the use of clinical ultrasound in emergency departments has been made. The recommendations describes what DASEM believes as being current best practice for training, certification, maintenance of acquired competencies, quality assurance, collaboration and research in the field of clinical US used in an ED.