A Role for Clinical Anatomists in Ultrasound Education.

More educators are needed to deliver comprehensive ultrasound training across the medical education spectrum. Regardless of prior clinical experience level, all new ultrasound learners need to begin their education by gaining the same foundational ultrasound knowledge, skills, and abilities. Ultrasound-trained clinical anatomists are well positioned to teach basic image acquisition and fundamental skills and knowledge.

Clinical Ultrasound in Obstetrics and Gynecology.

Point-of-care ultrasound is a useful tool in the evaluation of women with pelvic complaints in the emergency department. Transabdominal and transvaginal approaches may be employed to assess a variety of obstetric or gynecologic pathologies.

Consensus-based ethical best practices for performing educational point-of-care ultrasonography in the emergency department.

Objectives: There is no standardized protocol for performing educational point-of-care ultrasonography (POCUS) that addresses patient-centered ethical issues such as obtaining informed consent. This study sought to define principles for ethical application of educational POCUS and develop consensus-based best practice guidance.

Methods: A questionnaire was developed by a trained ethicist after literature review with the help of a medical librarian.

The perceived work environment and well-being: A survey of emergency health care workers during the COVID-19 pandemic.

Background: During the COVID-19 pandemic, health care provider well-being was affected by various challenges in the work environment. The purpose of this study was to evaluate the relationship between the perceived work environment and mental well-being of a sample of emergency physicians (EPs), emergency medicine (EM) nurses, and emergency medical services (EMS) providers during the pandemic.

Methods: We surveyed attending EPs, resident EPs, EM nurses, and EMS providers from 10 academic sites across the United States.

Ultrasound-guided pediatric nerve blocks in the emergency department: an evidence-based update.

Analgesia in pediatric patients is critical for minimizing discomfort and maximizing satisfaction for both the patients and their caregivers. In the last decade, ultrasound has been shown to be effective in improving the safety and efficacy of regional anesthesia. This issue discusses materials, methods, and monitoring for pediatric patients undergoing nerve blocks in the emergency department, including both ultrasound-guided and landmark approaches.

In their own words: Experiences of emergency health care workers during the COVID-19 pandemic.

Background: During the COVID-19 pandemic, a substantial number of emergency health care workers (HCWs) have screened positive for anxiety, depression, risk of posttraumatic stress disorder, and burnout. The purpose of this qualitative study was to describe the impact of COVID-19 on emergency care providers' health and well-being using personal perspectives. We conducted in-depth interviews with emergency physicians, emergency medicine nurses, and emergency medical services providers at 10 collaborating sites across the United States between September 21, 2020, and October 26, 2020.

Making Artificial Intelligence Lemonade Out of Data Lemons: Adaptation of a Public Apical Echo Database for Creation of a Subxiphoid Visual Estimation Automatic Ejection Fraction Machine Learning Algorithm.

Objectives: A paucity of point-of-care ultrasound (POCUS) databases limits machine learning (ML). Assess feasibility of training ML algorithms to visually estimate left ventricular ejection fraction (EF) from a subxiphoid (SX) window using only apical 4-chamber (A4C) images.

Methods: Researchers used a long-short-term-memory algorithm for image analysis.

Artificial intelligence versus expert: a comparison of rapid visual inferior vena cava collapsibility assessment between POCUS experts and a deep learning algorithm.

Objectives: We sought to create a deep learning algorithm to determine the degree of inferior vena cava (IVC) collapsibility in critically ill patients to enable novice point-of-care ultrasound (POCUS) providers.

Methods: We used publicly available long short term memory (LSTM) deep learning basic architecture that can track temporal changes and relationships in real-time video, to create an algorithm for ultrasound video analysis. The algorithm was trained on public domain IVC ultrasound videos to improve its ability to recognize changes in varied ultrasound video.

Telehealth Solutions for In-hospital Communication with Patients Under Isolation During COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic is a public health crisis that has quickly overwhelmed our healthcare system. It has led to significant shortages in personal protective equipment (PPE), ventilators, and intensive care unit beds across the nation. As the initial entry point for patients with suspected COVID illness, emergency departments (ED) have had to adapt quickly to prioritize the safety of patients and providers while still delivering optimal, timely patient care.

Using ultrasound to teach living anatomy to non-medical graduate students.

Purpose: Ultrasound technology is used to supplement gross anatomy instruction in many medical sciences programs. However, this technology is not common practice for anatomy instruction in nonmedical graduate-level courses. Ultrasound sessions provide a clear view of local anatomy and could help graduate students transfer anatomical content from a didactic context onto a living, moving body.

Man With Bilateral Leg Swelling.

A 52-year-old man without known medical history presented with painful, progressive, bilateral lower extremity edema over a two-week period. An abdominal exam noted a firm left upper quadrant mass. Emergency department (ED) point-of-care ultrasound (POCUS) revealed a hyperechoic, heterogeneous structure in the inferior vena cava that was determined to represent a tumor thrombus extending from a primary renal cell carcinoma.

Establishing the Key Outcomes for Pediatric Emergency Medical Services Research.

The evidence supporting best practices when treating children in the prehospital setting or even the effect emergency medical services (EMS) has on patient outcomes is limited. Standardizing the critical outcomes for EMS research will allow for focused and comparable effort among the small but growing group of pediatric EMS investigators on specific topics. Standardized outcomes will also provide the opportunity to collectively advance the science of EMS for children and demonstrate the effect of EMS on patient outcomes.

Man with leg rash.

Clinical Introduction: A 51-year-old male presented to the ED with a rash to his left thigh (figure 1) with erythema, swelling and pain. He endorsed paraesthesias, pruritus, fevers, vomiting and diarrhoea. Initial vitals were unremarkable.

Bedside Ultrasound Reduces Diagnostic Uncertainty and Guides Resuscitation in Patients With Undifferentiated Hypotension.

Objectives: Utilization of ultrasound in the evaluation of patients with undifferentiated hypotension has been proposed in several protocols. We sought to assess the impact of an ultrasound hypotension protocol on physicians' diagnostic certainty, diagnostic ability, and treatment and resource utilization.

Design: Prospective observational study.

Trauma-Induced Bilateral Ectopia Lentis Diagnosed with Point-of-Care Ultrasound.

Background: Ocular trauma and acute loss of vision are high-yield patient presentations that may benefit from the use of bedside ultrasound to aid in the diagnosis of a variety of vision-threatening problems.

Case Report: We present a case of bilateral lens dislocation in which the diagnosis of lens dislocation was missed on initial computed tomography of the orbits but detected on bedside ultrasound. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Point-of-care ultrasound can rapidly identify ocular pathology and expedite specialist consultation, and if necessary, transfer to a specialty center for further management.

Ultrasound credentialing in North American emergency department systems with ultrasound fellowships: a cross-sectional survey.

Objective: To describe the credentialing systems of North American emergency department systems (EDS) with emergency ultrasound (EUS) fellowship programmes.

Methods: This is a prospective, cross-sectional, survey-based study of North American EUS fellowships using a 62-item, pilot-tested, web-based survey instrument assessing credentialing and training systems. The American College of Emergency Physicians (ACEP) distributed the surveys using SNAP survey (Snap Surveys Ltd, Portsmouth, New Hampshire, USA).

SonoGames: an innovative approach to emergency medicine resident ultrasound education.

SonoGames was created by the Academy of Emergency Ultrasound for the 2012 annual meeting of the Society for Academic Emergency Medicine. The assessment of resident knowledge and of the performance of point-of-care ultrasound examinations is an integral component of ultrasound education and is required in emergency medicine residency training. With that in mind, game organizers sought to assess and improve emergency medicine residents' point-of-care ultrasound knowledge, hands-on skills, and integration of knowledge into clinical decision making.

The state of ultrasound education in U.S. medical schools: results of a national survey.

Purpose: To determine the state of ultrasound education in U.S. medical schools and assess curricular administrators' opinions on its integration in undergraduate medical education (UME).

Can anatomists teach living anatomy using ultrasound as a teaching tool?

The utilization of bedside ultrasound by an increasing number of medical specialties has created the need for more ultrasound exposure and teaching in medical school. Although there is a widespread support for more vertical integration of ultrasound teaching throughout the undergraduate curriculum, little is known about whether the quality of ultrasound teaching differs if performed by anatomists or clinicians. The purpose of this study is to compare medical students' evaluation of ultrasound anatomy teaching by clinicians and anatomists.

Ultrasound-guided arthrocentesis of the elbow: a posterior approach.

Background: Identification of fluid in the elbow joint by physical examination alone can be challenging. Ultrasound can assist in the diagnosis of elbow effusion, and guide aspiration of the effusion.

Objectives: We illustrate the anatomy and ultrasound guidance technique of a posterior approach to elbow arthrocentesis using examples of normal and pathologic elbow joint ultrasound images.

Ultrasound-guided peripheral venous access: a systematic review of randomized-controlled trials.

Objective: To systematically review the current literature on the effect of using ultrasound (US) guidance for the placement of peripheral intravenous (PIV) catheters in patients with difficult access.

Materials And Methods: A systematic search was performed for the keywords ultrasonography, catheterization, and peripheral vein. A systematic review was performed on randomized-controlled studies comparing the use of dynamic US guidance with the conventional landmark technique.