POCUS Journal

Commentary

Inside the November 2024 Issue

Benjamin T. Galen - We are thrilled to bring you the second issue of the ninth volume of POCUS Journal. Published since 2016, POCUS Journal is the only multi-disciplinary, peer-reviewed, POCUS-focused journal that is free for authors and readers alike. 

Letter

Ultrasound-Guided Nerve Blocks Have the Potential to Reduce Racial and Ethnic Disparities in Emergency Department Pain Management

Kendall Lavin-Parsons, Zachary W. Binder - Injuries are a common presenting complaint in the emergency department [1]. Pain from injuries has traditionally been treated with opioids [2]. Extensive research exists describing the potential adverse effects of systemic opioids including bradypnea, hypotension, and central nervous system depression.

Innovations in POCUS Curriculum

Lung Point of Care Ultrasound (POCUS) in Cardiorespiratory Physiotherapy and Respiratory Therapy Practices: Current Status and Future Directions

George Ntoumenopoulos, Georgina A. Pizimolas, Sarine Mani, Simon Hayward, Jane Lockstone - Lung Point of Care Ultrasound (POCUS) strongly influences physiotherapy and respiratory therapy clinical decision-making in the intensive care unit (ICU). The uptake of Lung POCUS training by physiotherapists and respiratory therapists is low in some countries, often due to many barriers to its [...]

Case File

Ultrasound-Guided Nerve Blocks for Flexor Tenosynovitis

John M. Bowling, Erick Zoumberakis - Performing an ultrasound-guided nerve block (UGNB) is now common practice in many emergency departments (EDs) and is considered a core skill according to the American College of Emergency Physicians (ACEP). Nerve blocks are mostly utilized for fractures and laceration repairs, however, these blocks have many other applications. We present [...]

Case File

Diagnosis of a Stress Fracture Of a Metatarsal Bone with Point of Care Ultrasound (POCUS)

Alfred Doblinger - The early diagnosis of stress fractures is a challenge in daily primary care practice. Point of care ultrasound (POCUS) can be helpful in the diagnosis of early signs of an incipient stress fracture. A 52-year-old woman presented with a history of chronic overuse in the left forefoot.

Case File

A Cardiac Tumor and Liver Masses on Point of Care Ultrasound (POCUS): Implications in a Resource-Limited Setting

Waseem Sous, George Limwado, Enoch Ndarama, Michaela Sous - Malignant cardiac tumors are quite rare, but portend a poor prognosis [1,2]. Early identification and classification are essential given their aggressive nature, particularly when metastases are present [3,4]. Clinical presentations are varied, and detection relies primarily on echocardiography.

Case File

A Young Man with Chest Pain

Anderson Wang, Aalap Shah - A calculous cholecystitis is a life-threatening diagnosis that is more commonly associated with ill patients in the ICU. We present a case of acute acalculous cholecystitis (ACC) in an otherwise healthy 18-year-old man who presented to the Emergency Department (ED) with right-sided chest pain that was ultimately diagnosed with point [...]

Case File

A Rare Case of Hemoperitoneum Diagnosed with Point of Care Ultrasound (POCUS)

Jina Bai, Todd Cutler - A 68-year-old man presented with one week of vague abdominal symptoms and was found to have new ascites and pulmonary embolism for which a heparin drip was initiated. We report a case diagnosing hemoperitoneum with point of care ultrasound (POCUS).

Case File

Diagnosis and Treatment of a Morel-Lavallee Lesion via Point of Care Ultrasound (POCUS)

Djoser Mack, Joselyn Miller, Frank Yuan, Edison Lee, Trent She - Morel-Lavallee Lesion (MLL) is a rare diagnosis of a closed internal degloving injury that can occur with high energy trauma. The pain, soft tissue swelling, and ecchymosis that patients describe mimic many other emergent diagnoses to include compartment syndrome and fractures.

Case File

Visualizing the Real Time Reduction of Pulled Elbow Using Point of Care Ultrasound (POCUS)

David J McCreary - POCUS is a useful tool for correctly identifying pulled elbow. We believe that clinicians working in Pediatric Emergency Departments should be encouraged to embrace using it in cases which are less straightforward – either due to an atypical history or based on examination findings.

Case Report

Rare Cause of Pediatric Abdominal Pain Diagnosed on Point of Care Ultrasound (POCUS)

Courtney Owens, Lindsey Chaudoin - An 11-year-old postmenarchal female presented to the pediatric emergency department (ED) with 2 days of periumbilical and right lower abdominal pain. Radiology-performed ultrasound (RADUS) did not visualize the appendix, and there was a plan for surgical consultation to decide between serial abdominal exams versus computed tomography (CT) scan.

Case Report

Evaluating a Lung Abscess in a Pediatric Patient using Point of Care Ultrasound (POCUS)

Alisha Ching, Charles William Kropf - Application of ultrasound to evaluate pediatric respiratory disease in the emergency department setting is rapidly growing, particularly as we often weigh the risks of exposure to radiation with other readily available imaging modalities in the acute care setting.

Case Report

Perioperative Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RA) and Gastric Point Of Care Ultrasound (POCUS)

Sivasenthil Arumugam, Hari Kalagara - Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are frequently used for diabetes and weight loss management. The GLP-1 RA   drugs delay gastric emptying and are a concern for increased risk of aspiration in the perioperative period. Current recommendations to hold these medications before surgery are consensus based.

Case Report

Dengue Cardiomyopathy Treatment Strategy Optimisation by Integrating Point of Care Ultrasound (POCUS) with VExUS

Wei Ven Chin, Mae Jane Khaw - Dengue fever is an arthropod-borne viral disease that is widespread throughout the world. We report a case of dengue cardiomyopathy that was detected and treated to best effect using point of care ultrasound (POCUS) and the VExUS score.

Case Report

Lung Point in a Case of Bronchoscopy Lung Volume Reduction: Consider Its Mimics Before Inserting the Tube

Mohannad Wazirali, Paul M. Shaniuk - Point of Care Ultrasound (POCUS) is used to evaluate many clinical scenarios. Chest POCUS has been integrated as a part of a clinical protocol to assess patients with lung pathology [1].

Research

Survey on Cardiologists’ Perspectives on Cardiac Point of Care Ultrasound (POCUS)

Linda Liu, Christine Chow, Cooper Kersey, Brandon Wiley, Jonathan R. Lindner, Andrew M. Pattock, Carlos L. Alviar, Sula Mazimbag, Yoonsik Cho, Kavita Khaira, James N. Kirkpatrick, Younghoon Kwon - Cardiac point of care ultrasound (POCUS) has been used with increasing frequency. As a result of this trend, this study sought to characterize cardiologists’ perspectives on [...]

Research

Pleural Effusion Identified by Point of Care Ultrasound (POCUS) in Septic Shock: Impact on Clinical Outcomes

Erick Joel Rendón-Ramírez, Andrés Mauricio Morales-García, Adrián Rendón-Pérez, Homero Nañez-Terreros, Ricardo Cesar Solis, Alexandra Daniela Magaña-García, Samantha Medrano-Juárez, Jose Francisco Caloca-Estrada, Roberto Mercado-Longoria, Jorge Eduardo Leija-Herrera, José M. Porcel - To analyze the association between pleural effusion detected by chest point of care ultrasound (POCUS) and clinical outcomes in patients with septic shock admitted to [...]

Research

Implementation and Assessment of a Curriculum for Renal Point of Care Ultrasound (POCUS) Training

Yoshiko Ishisaka, Hong Yu Wang, Hayato Mitaka, Elliot  Charen, Paru Patrawalla - Renal ultrasound is a non-invasive method to assess for obstructive acute kidney injury (AKI). Point of care ultrasound (POCUS) has been shown to be a good screening tool for obstructive AKI, and with formal training, has high sensitivity and specificity. We aimed to [...]

Research

Correlation of Point of Care Ultrasound (POCUS) Guided Pupillary Assessment Parameter with Glasgow Coma Scale in Patients with Altered Mental Status– A Cross Sectional Study

Priyanka Modi, Sanjeev Bhoi - Earlier studies have proved deteriorating Glasgow Coma Scale (GCS) as a marker of raised intracranial pressure (ICP). Low GCS is associated with abnormal pupillary parameters. Currently, many studies have proved that ultrasound provides a feasible and objective assessment of pupillary light reflex. However, literature is lacking to evaluate objective pupillary [...]

Research

Team-Based Learning & Point of Care Ultrasound (POCUS) to Augment a Preclinical Cardiovascular Physiology Course

Mark Danila, Cynthia Zheng, Ryan J. Salvatore, Rachel Cary, Sara Youssef, Grace Pinhal-Enfield, Catherine Chen - There has been increasing interest in point of care ultrasound (POCUS) as a learning tool in preclinical medical anatomy and physiology courses. Few interventions have used team-based learning (TBL) to teach cardiac POCUS.

Research

Sonographic Detection of Iatrogenic Carotid Artery Guidewires During Internal Jugular Vein Catheterization

James  H. Moak, Kristen C. Swann, Matthew M. Kongkatong, Jakob E. Ottenhoff, Christopher D. Thom - Visualization of the guidewire during internal jugular (IJ) vein catheterization by point of care ultrasound (POCUS) has been recommended for avoiding inadvertent carotid artery dilation. The purpose of this study was to determine the accuracy of POCUS for identifying [...]

Research

Just In Time! Assessment of Internal Medicine Resident Point of Care Ultrasound (POCUS) Attitudes and Behaviors After Spaced Intervention at Two Residency Programs

Kevin M. Piro, Patricia A. Carney, Christopher J. Smith - Point of care ultrasound (POCUS) is a complex psychomotor skill that requires scaffolded support for skill acquisition. However, the effect of spaced curricular elements on learner POCUS behaviors are not clearly understood.

Research

Piloting a Diagnostic Foot and Ankle Fracture Sonographic Algorithm with Rural and Adolescent Patients

Tomas Alamin, Margaret Lin-Martore, Aaron E. Kornblith, Aidan O’Donnell, Sally Gragalia - Foot and ankle injuries are a common presenting complaint to the Emergency Department (ED) and are often assessed with plain radiography. Rural environments may not have access to radiography mandating the referral or transfer patients to regional centers for definitive diagnosis.

Research

Knowledge and Confidence Among Five Cohorts of Faculty Learners in a Point of Care Ultrasound (POCUS) Program: Factors Defining Learner Success

Michael Janjigian, Anne Dembitzer, Isaac Holmes, Caroline Srisarajivakul-Klein, Khemraj Hardowar, Harald Sauthoff - The availability of faculty proficient in point of care ultrasound (POCUS) has emerged as a barrier to the ongoing expansion of POCUS across the field of internal medicine. We sought to examine the faculty graduates of our institutional POCUS program to identify [...]

Research

Association Between Standard Gait Measures and Anterior Quadriceps Muscle Thickness as Measured by Point of Care Ultrasound (POCUS)

Uyanga Ganbat, Boris Feldman, Shane Arishenkoff, Graydon S. Meneilly, Kenneth M. Madden - Gait parameters and sarcopenia both predict falls risk among older adults. Our objective was to evaluate whether fast, easy-to-obtain measures of anterior thigh muscle by point of care ultrasound (POCUS) are significantly associated with standard gait measures.

Research

Subclinical Congestion Evaluated by Point of Care Ultrasound (POCUS) at Discharge Predicts Readmission in Patients with Acute Heart Failure: Prognostic Cohort Study

Sergio Velasco Malagón, Estivalis Acosta-Gutiérrez, José Atilio Nuñez-Ramos, Sebastián Salinas, Guillermo Mora Pabón - Heart failure (HF) is a complex entity that increases the risk of adverse outcomes. Point of care ultrasound (POCUS) allows easy lung and systemic venous congestion identification. Using ultrasound to detect sub-clinical congestion at discharge may help predict readmissions and mortality.

Research

Delphi Consensus Recommendations for the Development of the Emergency Medicine Point of Care Ultrasound (POCUS) Curriculum in Nepal

Anmol P. Shrestha, Wolfgang Blank, Ursula H. Blank, Rudolf Horn, Susane Morf, Sanu K. Shrestha, Shailesh P. Shrestha, Samjhana Basnet, Anjana Dongol, Raj Kumar DangalRoshana Shrestha - Emergency Medicine Point of Care Ultrasound (EM-POCUS) is a diagnostic bedside tool for quick and accurate clinical decision-making. Comprehensive training in POCUS is a mandatory part of EM [...]

Commentary

Acknowledgments

Dear  Readers, We extend our deepest gratitude to Bill and June Gladwish for their recent philanthropic support of point-of-care ultrasound research. Having benefited from the specialized care at Kingston Health Science Center over the years, their passion for advancing healthcare is evident in their generous contribution. This issue was partially supported by their contribution to [...]