Combat Medic-Performed Auscultation Versus Thoracic Ultrasound Image Interpretation for Pneumothorax Detection: Look or Listen?

Background Pneumothorax (PTX) is a potentially life-threatening condition encountered by U.S. Army combat medics on the battlefield.

Accuracy of Needle Thoracostomy Site Selection among US Army Medics.

Background: Tension pneumothorax is a prominent cause of potentially survivable death on the battlefield. Field management for suspected tension pneumothorax is immediate needle thoracostomy (NT). Recent data noted higher NT success rates and ease of insertion at the fifth intercostal space, anterior axillary line (5th ICS AAL), leading to an amendment of the Committee on Tactical Combat Casualty Care recommendations on managing suspected tension pneumothorax to include the 5th ICS AAL as a viable alternative site for NT placement.

Impact of a Novel Biplane User Interface on Ultrasound-Guided Vascular Access Performance: A Prospective, Randomized, Crossover Study.

Background: Controversy exists regarding the optimal methods of employing ultrasound to enhance vascular access. A novel user interface which dynamically displays transverse (short) and longitudinal (long) planes simultaneously was developed to optimize ultrasound-guided vascular access. This study aimed to assess the impact of this novel biplane axis technology on central venous access performance.

PAs and point-of-care ultrasound: A scoping review.

Objective: Point-of-care ultrasound (POCUS) has rapidly emerged as a valuable tool in the bedside assessment of patients. This scoping review summarizes existing literature covering clinical use and educational integration of POCUS by physician assistants (PAs), with the overall goal of identifying gaps in POCUS research involving the PA profession.

Methods: Keyword searches of PubMed, EMBASE, Medline, and Google Scholar were conducted.

Combat Medic eFAST with Novel and Conventional Portable Ultrasound Devices: A Prospective, Randomized, Crossover Trial.

Background: Extended Focused Assessment with Ultrasonography in Trauma (eFAST) reliably identifies noncompressible torso hemorrhage (NCTH), a major cause of battlefield death. Increased portability of ultrasound enables eFAST far forward on the battlefield, and published data demonstrate combat medics can learn and reliably perform ultrasound exams. One medical company developed an ultrasound device with an intuitive graphical user interface (GUI) and novel, finger-worn transducer with built-in linear and phased arrays, referred to as the novel device.

Knowledge and Attitudes of Lifestyle Medicine-Based Care in a Military Community.

Introduction: The Department of Defense spends more than $3 billion annually on medical costs of lifestyle-related morbidity. Military service members and veterans engage in unhealthy behaviors at a higher rate than the civilian population. Lifestyle medicine may mitigate lifestyle-related chronic diseases and increase medical readiness in the U.

US Army Combat Medic Performance With Portable Ultrasound to Detect Sonographic Findings of Pneumothorax in a Cadaveric Model.

Background: Ultrasound, due to recent advances in portability and versatility, has become a valuable clinical adjunct in austere, resource-limited settings and is well demonstrated to be an accurate/efficient means to detect pneumothorax. The purpose of this study was to evaluate the impact of hands-on ultrasound training on ultrasound-naive US Army combat medics' ability to detect sonographic findings of pneumothorax with portable ultrasound in a cadaver model.

Methods: Ultrasound-naive US Army combat medics assigned to conventional military units were recruited from a single US Army installation and randomized to receive either didactic training only, or "blended" (didactic and hands-on) training on ultrasound detection of pneumothorax.

FAST Performance in a Stationary versus In-Motion Military Ambulance Utilizing Handheld Ultrasound: A Randomized Controlled Study.

Objective: On-scene prehospital conditions and patient instability may warrant a during-transport ultrasound (US) exam. The objective of this study was to assess the effect of ambulance turbulence on the performance of the Focused Assessment with Sonography in Trauma (FAST) with a handheld US device.

Methods: This was a randomized controlled trial in which participants were randomized to perform a FAST in either a stationary or an in-motion military ambulance.

Impact of Succinct Training on Open Cricothyrotomy Performance: A Randomized, Prospective, Observational Study of U.S. Army First Responders.

Introduction: Primary airway failure has become the second most common cause of potentially survivable battlefield fatality. Cricothyrotomy is taught to all U.S.

U.S. Army Combat Medic eFAST Performance with a Novel Versus Conventional Transducers: A Randomized, Crossover Trial.

Background: Point-of-injury extended focused assessment with sonography in trauma (eFAST) may identify life-threatening torso hemorrhage and expedite casualty evacuation. The purpose of this study was to compare combat medic eFAST performance between the novel and conventional ultrasound (US) transducers.

Methods: We conducted a randomized crossover trial.

Impact of a 4-hour Introductory eFAST Training Intervention Among Ultrasound-Naïve U.S. Military Medics.

Introduction: Advances in the portability of ultrasound have allowed it to be increasingly employed at the point of care in austere settings. Battlefield constraints often limit the availability of medical officers throughout the operational environment, leading to increased interest in whether highly portable ultrasound devices can be employed by military medics to enhance their provision of combat casualty care. Data evaluating optimal training for effective medic employment of ultrasound is limited however.

Inspiring the Future of Physician Assistant Ultrasound Education: Lessons Learned From the Inaugural Yes, iScan Event.

Purpose: Point-of-care ultrasound (POCUS), despite its rapid integration into undergraduate medical education curriculum, remains underutilized among physician assistant (PA) programs, with a resultant training gap between PAs and their physician collaborators. Herein, we present the Yes, iScan Ultrasound event, piloted at the 2018 American Academy of PAs (AAPA) conference, as a means to generate PA student interest in, and introductory engagement with, the emerging clinical adjunct of POCUS.

Methods: Physician assistant students and instructors were recruited to voluntarily participate.

Evaluation of Glucomannan Powder as an Ultrasound Transmission Gel Alternative for Resource-Constrained Environments: A Prospective, Comparative Study.

Introduction: Resource and logistical constraints may limit the availability of commercial ultrasound (US) transmission gel (USTG) in austere environments. Glucomannan powder, a dietary fiber supplement, can be mixed with tap water to form a gel that may be a field-expedient substitute for USTG. We compared glucomannan gel with a commercial USTG for US image adequacy and quality.

Ultrasound Evaluation of Soft-Tissue Foreign Bodies by US Army Medics.

Objective: The study's primary objective was to determine army medics' accuracy performing bedside ultrasound (US) to detect radiolucent foreign bodies (FBs) in a soft-tissue hand model. Secondary objectives included the assessment of US stand-off pad effects on soft-tissue FB detection rates and assess established FB detectable lower limit size of 2 mm.

Methods: Prospective, single blinded, observational study of US-naïve Army medics' abilities utilizing bedside US to detect wooden FBs in a chicken thigh model with or without an US stand-off pad.

Military Medic Performance with Employment of a Commercial Intraosseous Infusion Device: A Randomized, Crossover Study.

Background: Obtaining intraosseous (IO) access remains an invaluable skill in the management and resuscitation of patients on the battlefield. The U.S.

A Novel Ultrasound Transmission Gel for Resource-Constrained Environments.

Ultrasound represents an ideal diagnostic adjunct for medical personnel operating in austere environments, because of its increasing portability and expanding number of point-of-care applications. However, these machines cannot be used without a transmission medium that allows for propagation of ultrasound waves from transducer to patient. This article describes a novel ultrasound gel alternative that may be better suited for resource-constrained environments than standard ultrasound gel, without compromising image quality.

Revolution or Evolution? A Proposal for the Integration of Point-of-Care Ultrasound Into Physician Assistant Clinical Practice.

Advances in technology and increased affordability of machines have allowed ultrasound to become ubiquitous across the spectrum of medical care. Increasing portability has brought ultrasound to the point of care in multiple medical specialties. Formal ultrasound training is rapidly being incorporated into multispecialty residency programs and undergraduate medical education curricula, yet little formal training exists for physician assistants (PAs) on this emerging clinical adjunct.

A rare cause of abdominal pain and hypotension in pregnancy.

Splenic artery aneurysm rupture is rare. Pregnancy is a significant risk factor and the mortality for mother and fetus is very high if the rupture is undiagnosed or diagnosis is delayed. Patients typically present with abdominal pain and hemodynamic instability.

Ultrasound detection of pneumothorax with minimally trained sonographers: a preliminary study.

Background: Prompt recognition and treatment of a tension pneumothorax is critical to reducing mortality in both military and civilian settings. Physician assistants, Special Operations Forces (SOF) and conventional force Medics are often the first medical providers to care for combat trauma patients with penetrating chest trauma and frequently have limited diagnostic capabilities available to them due to mission constraints. The purpose of this study is to examine the potential for non-physician providers to determine the absence or presence of a pneumothorax in a porcine model, with the use of a portable ultrasound machine, after receiving minimal training.

Severe stress in an elderly woman causes a temporary "broken" heart.

This novel cardiac syndrome has clinical features that mimic those of acute myocardial infarction. The typical patient is a postmenopausal woman.