Improving patient safety with ultrasonography guidance during internal jugular central venous catheter placement by novice practitioners.

Introduction: This study compared ultrasonography-guided (USG) placement with anatomic placement during internal jugular (IJ) central venous catheter (CVC) insertion by novice practitioners using a simulation model.

Methods: A prospective, randomized, crossover study of 28 fourth year medical students was conducted with institutional review board approval. Participants viewed an instructional material before participation, and supervision was standardized.

The diagnosis of aortic dissection by emergency medicine ultrasound.

A series of five cases of aortic dissection are presented that were diagnosed by emergency physicians using ultrasound to search the abdominal and thoracic aorta for pathology. Aortic dissection is a vascular emergency with a high morbidity and mortality, yet its presentation can be varied and subtle. This article reports the use of Emergency ultrasound in a series of five aortic dissections discovered with a limited, yet timely viewing of the aorta and heart by emergency physicians.

Ultrasonography-guided peripheral intravenous access versus traditional approaches in patients with difficult intravenous access.

Study Objective: We assess the success rate of emergency physicians in placing peripheral intravenous catheters in difficult-access patients who were unsuccessfully cannulated by emergency nurses. A technique using real-time ultrasonographic guidance by 2 physicians was compared with traditional approaches using palpation and landmark guidance.

Methods: This was a prospective, systematically allocated study of all patients requiring intravenous access who presented to 2 university hospitals between October 2003 and March 2004.