Success of focused transthoracic echocardiography locations for cardiac visualization during cardiac arrest: A video-review analysis.

Objective: Our primary objective was to determine if there was a difference in success of cardiac visualization by focused transthoracic echocardiography (TTE) location (subxiphoid, parasternal, or apical) during chest compression interruptions among cardiac arrest patients. Secondarily, we sought to determine whether there were differences in chest compression interruption times with the focused TTE locations.

Methods: We conducted a retrospective cohort study of video-recorded, adult, cardiac arrest resuscitations in a quaternary care Emergency Department from 11/2018 to 11/2023.

Point-of-Care Ultrasound Findings in Occlusive Iliac Vein Thrombus During Pregnancy: A Case Report.

Introduction: Diagnosing deep venous thromboses and venous thromboemboli (DVT/VTE) in pregnant patients presents a unique challenge for emergency physicians. The risk of DVT/VTE increases during pregnancy, and the potential consequences of misdiagnoses are severe. Point-of-care ultrasonography (POCUS) is frequently a first-line diagnostic imaging modality.

Return of the Living Dead Gut - A Case Report of Ischemic Colitis Identified on Point of Care Ultrasound.

Ischemic colitis is the most common form of gastrointestinal ischemia 1. The diagnosis of ischemic colitis is made by clinical data and computed tomography (CT) imaging of the abdomen and pelvis 1. While colonoscopy is considered the gold standard for diagnosis, this is not performed in the emergency department (ED) 2.

Right Ventricular "Bubble Time" to Identify Patients With Right Ventricular Dysfunction.

Study Objective: We propose a novel method of evaluating right ventricular (RV) dysfunction in the emergency department (ED) using RV "bubble time"-the duration of time bubbles from a saline solution flush are visualized in the RV on echocardiography. The objective was to identify the optimal cutoff value for RV bubble time that differentiates patients with RV dysfunction and report on its diagnostic test characteristics.

Methods: This prospective diagnostic accuracy study enrolled a convenience sample of hemodynamically stable patients in the ED.

A Case Report of a LVAD Driveline Infection Diagnosed by Point-of-care Ultrasound.

Introduction: As the prevalence of patients with left ventricular assist devices (LVAD) presenting to the emergency department (ED) increases, clinicians must be aware of LVAD-associated infections.

Case Report: A well-appearing, 41-year-old male with history of heart failure status post prior-LVAD placement presented to the ED for swelling of his chest. What appeared initially as a superficial infection was further assessed with point-of-care ultrasound and found to represent a chest wall abscess involving the driveline, ultimately resulting in sternal osteomyelitis and bacteremia.

Pulmonary Congestion on Lung Ultrasound Predicts Increased Risk of 30-Day Readmission in Heart Failure Patients.

Objectives: Heart failure exacerbations are a common cause of hospitalizations with a high readmission rate. There are few validated predictors of readmission after treatment for acute decompensated heart failure (ADHF). Lung ultrasound (LUS) is sensitive and specific in the assessment of pulmonary congestion; however, it is not frequently utilized to assess for congestion before discharge.

Hip effusions or iliopsoas hematomas on ultrasound in identifying hip fractures in the emergency department.

Objective: We evaluated the sensitivity, specificity, predictive values, and likelihood ratios of hip effusion and/or iliopsoas hematoma on point-of-care ultrasound (POCUS) performed by ultrasound fellows and fellowship trained emergency providers to identify hip fractures in emergency department (ED) patients with a high suspicion of hip fracture.

Methods: This was a prospective observational study of a convenience sample of patients with high suspicion of hip fracture at two academic EDs between 2018 and 2021. Patients with negative x-rays who did not receive further imaging with magnetic resonance imaging (MRI) or computed tomography (CT) were excluded.

A consensus list of ultrasound competencies for graduating emergency medicine residents.

Objectives: Emergency ultrasound (EUS) is a critical component of emergency medicine (EM) resident education. Currently, there is no consensus list of competencies for EUS training, and graduating residents have varying levels of skill and comfort. The objective of this study was to define a widely accepted comprehensive list of EUS competencies for graduating EM residents through a modified Delphi method.

Using Ultrasound to Determine Optimal Location for Needle Decompression of Tension Pneumothorax: A Pilot Study.

Background: Chest injury can result in life-threatening complications like tension pneumothorax, in which rapid deterioration can occur without decompression. Traditionally, the second intercostal space (ICS) along the mid-clavicular line is taught as the site for decompression. However, this has been questioned due to high rates of treatment failure.

Uterine Sacculation on Point-of-care Ultrasound in a Pregnant Female Patient: A Case Report.

Introduction: Uterine rupture is a rare but potentially fatal complication of pregnancy. The incidence of uterine rupture is estimated to be between 0.3 and 11 per 10,000.

Ultrasound in the Emergency Department Identifies Ectopic Pregnancy Post Hysterectomy: A Case Report.

Introduction: Ruptured ectopic pregnancy is one of the leading causes of maternal death. Point-of-care ultrasound (POCUS) has been shown to be highly sensitive for excluding ectopic pregnancy. Ectopic pregnancy after a hysterectomy is a rare but life-threatening occurrence.

Femoral artery Doppler ultrasound is more accurate than manual palpation for pulse detection in cardiac arrest.

Objectives: Our primary objective was to assess the accuracy of Doppler ultrasound versus manual palpation in detecting any pulse with an arterial line waveform in cardiac arrest. Secondarily, we sought to determine whether peak systolic velocity (PSV) on Doppler ultrasound could detect a pulse with a systolic blood pressure (SBP) ≥ 60 mmHg.

Methods: We conducted a prospective, cross-sectional, diagnostic accuracy study on a convenience sample of adult, Emergency Department (ED) cardiac arrest patients.

Ultrasound Measurement of the Intervertebral Space in the Lateral Recumbent Versus Sitting Positions.

Background: Diagnostic lumbar puncture (LP) is an invasive procedure routinely performed within the emergency department (ED). LP is traditionally performed with the patient in either the lateral recumbent or sitting position. We investigated if the intervertebral space is larger in one of these positions.

Where There's Smoke, There's Fire: A Case Report of Turbulent Blood Flow in Lower Extremity Point-of-care Ultrasound in COVID-19.

Introduction: Coronavirus disease 2019 (COVID-19) may predispose patients to increased risk of venous thromboembolism (VTE) due to various pathophysiological mechanisms, including but not limited to endothelial injury, inflammation, cytokine-mediated microvascular damage, and reactive thrombocytosis. A high risk of vessel thrombosis correlates with disease severity, making early identification and treatment of prime consideration.Although identification of a deep venous thrombosis (DVT) or pulmonary embolism warrants immediate treatment with anticoagulation, trying to predict which COVID-19 patients may be at increased risk for developing these pathologies is challenging.

The use of point-of-care ultrasound to diagnose infective endocarditis causing an NSTEMI in a patient with chest pain.

Infective endocarditis is a severe condition that requires rapid identification and treatment. Early diagnosis is often difficult due to diverse and often vague presenting symptoms. One uncommon complication is acute coronary syndrome that can be secondary to dissemination of septic emboli.

A Prospective Evaluation of Point-of-Care Ultrasonographic Diagnosis of Diverticulitis in the Emergency Department.

Study Objective: We evaluate the sensitivity and specificity of point-of-care ultrasonography, performed by ultrasonographic fellowship-trained emergency physicians and physician assistants, compared with computed tomography (CT) scan in diagnosing acute diverticulitis in the emergency department (ED).

Methods: This was a prospective observational study of a convenience sample of patients with suspected diverticulitis who were treated at an academic ED between 2017 and 2020. Sonographers were blinded to clinical data, laboratory results, and CT scan findings.

Ultrasound Identification of Retrobulbar Hematomas by Emergency Physicians in a Cadaveric Model.

Introduction: Retrobulbar hemorrhage (RBH) is a rare complication of facial trauma that can lead to dangerous orbital compartment pressures and must be rapidly recognized to prevent permanent vision loss. Point-of-care ultrasound (POCUS) offers a rapid modality for evaluating a wide variety of ocular pathologies, and prior case reports demonstrate the ability of clinicians to recognize RBH using ultrasound. This study aimed to assess the ability of clinicians at various stages of training to identify a RBH using POCUS in a cadaveric model.

Use of Point-of-Care Ultrasound to Facilitate Guidance and Intrauterine Placement of a Foley Urinary Catheter to Tamponade Life-Threatening Postprocedure Hemorrhage Caused by Disseminated Intravascular Coagulation.

Background: Severe vaginal hemorrhage caused by disseminated intravascular coagulation (DIC) after dilation and evacuation is a rare but life-threatening situation that can be difficult to manage. Obtaining hemostasis in such a patient with heavy vaginal bleeding secondary to DIC can be difficult. One technique involves the use of a urinary bladder catheter inserted into the uterus that is inflated to apply pressure on the endometrium, allowing for tamponade of the bleeding.

Pyomyositis Diagnosed by Point-of-Care Ultrasound in the Emergency Department.

Background: Currently, the role of ultrasound in diagnosing superficial abscesses is well validated, however, its role for deep space infections and intramuscular pathology is limited. Distinguishing between simple cellulitis and abscess is critical for emergency physicians (EP), as the treatment is very different. Management of cellulitis relies on antibiotic therapy, whereas abscess treatment requires incision and drainage.

Point-of-care Ultrasound Aiding in the Diagnosis of Herlyn-Werner-Wunderlich Syndrome.

We present a case of a 12-year-old female with a history of congenital solitary kidney presenting to an academic pediatric emergency department (ED) in acute abdominal pain. Using ultrasound as the initial diagnostic modality, the patient was found to have Herlyn-Werner-Wunderlich syndrome (HWWS), an abnormal development of the Müllerian system during embryogenesis resulting in obstructed hemivagina with resulting hematometrocolpos. The patient presented with undifferentiated abdominopelvic pain, and in the course of the ED workup was diagnosed with a disorder infrequently encountered by emergency physicians.

Ultrasound-Guided Femoral Nerve Block to Facilitate the Closed Reduction of a Dislocated Hip Prosthesis.

Prosthetic hip dislocation is a common but unfortunate complication in patients who have undergone total hip arthroplasty. Successful closed reduction in the emergency department leads to a reduced length of stay and rate of hospitalization.1,2 The use of regional anesthesia by femoral nerve block represents a novel approach for controlling pain in patients with hip pathologies.