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.
Sigmund Kharasch, MD; Matthew Moake, MD PhD; Antonio Riera, MD – Point of care ultrasound (POCUS) has undergone important growth in the field of Pediatric Emergency Medicine (PEM) in the last 14 years and is recognized as a critical diagnostic tool in the care of ill and injured children. The first PEM POCUS fellowship was established in 2010. Now, there are currently 30 ultrasound fellowships that offer training to PEM physicians. In 2014, 46 PEM POCUS leaders established the P2 (PEM POCUS) Network (www.P2network.org). This serves as a platform for sharing expertise, building research collaborations, and offering mentorship in the use of POCUS in PEM.
Jeremy J. Webb; Chad Mosby; John Stadnyk; Michael Jones – In recent years, the development of hand-held devices have intrigued POCUS enthusiasts due to improved affordability, portability, and ease of use. They also provide extra functionality for image storage and transmission for remote provider-to-provider communication and review. Due to these capabilities, portable ultrasound has found its use expanded to pre-hospital, wilderness, and austere settings, where cart-based machines and other imaging modalities are not an option.
Alexis Salerno; Resa E. Lewiss – The transvaginal pelvic point of care ultrasound (POCUS) examination remains a patient-centered and relevant examination. Since 2008, emergency medicine physicians are required to learn, perform, and interpret POCUS examinations to deliver safe and patient-centered diagnostic and procedural care. Pelvic POCUS is one of these core applications in the emergency physician scope of practice. A pelvic POCUS examination seeks to answer the focused question, “Is there an intrauterine pregnancy (IUP)” and risk stratifies the patient when ectopic pregnancy is a clinical concern.
Traci Fox, EdD, RT(R), RDMS, RVT; Kaylah Maloney, MD; Arthur Au, MD; Resa E Lewiss, MD – The hospital is full of clinicians working with poor ergonomic form. In the emergency department, for example, this includes and is not limited to clinicians bending over to place IVs and intubating patients. When it comes to ultrasound, some clinicians might think, “I’m only scanning a few patients a day,” and the examinations are typically quick and focused. Enter the term “repetitive” stress injury” (RSI). To date, the literature pertaining to RSI and point of care ultrasound (POCUS) clinicians is very limited. We think it’s time for this to change.
Jason T. Nomura, MD; Matthew Flannigan, DO; Rachel B. Liu, MD; Daniel L. Theodoro, MD MSCI – Point of Care Ultrasound (POCUS) use by emergency physicians has grown in both breadth and depth of clinical use [1-3]. POCUS workflow is different from a traditional imaging-based specialist workflow because a single clinician orders, obtains images, interprets, and reports the exam results.
Lianne J. McLean, MB BCh BAO, MHI; Resa E. Lewiss, MD – Point-of-care Ultrasound (POCUS) skills are required competencies for emergency medicine and paediatric emergency medicine training [1,2,3,4]. Over time, more specialties will require these skills of their graduates. Experienced physicians who completed their training before POCUS requirements may ask: How can I gain POCUS skills training and competency?
Alanna O’Connell, DO; Al’ai Alvarez, MD; Peter Tomaselli, MD; Arthur Au, MD; Dimitrios Papanagnou, MD MPH; Resa E. Lewiss, MD – A Medical Education (MedEd) fellowship provides emergency medicine (EM) residency graduates the structured and rigorous training to develop skills as educators. Although not accredited by the Accreditation Council for Graduate Medical Education (ACGME), MedEd fellowships have established minimum curriculum standards [1].
Nathaniel Reisinger, MD; Abhilash Koratala, MD – We know what you’re thinking. we’ve heard it a thousand times: “Oh, you’re a kidney doctor who dinks around with ultrasound? What do you look for? Hydronephrosis?” You may be asking, “Is this issue just going to be a bunch of pictures of hydronephrosis and distended bladders?” And yes, for the thousandth time, in acute kidney injury it’s almost never wrong to get a kidney and bladder ultrasound as part of the initial workup.
Ann Young, MD PhD; Benoit Imbeault, MD; Alberto Goffi, MD; Alireza Zahirieh, MD; Claire Kennedy, MD; Daniel Blum, MDCM; Ron Wald, MDCM MPH; William Beaubien-Souligny, MD PhD – In nephrology, point of care ultrasound (POCUS) has multiple applications including the rapid evaluation of acute kidney injury, enhancing the initial evaluation of chronic kidney disease, direct evaluation of vascular access, and improved fluid balance management in acute and chronic settings. Recently, the role of POCUS has been formally acknowledged by the American College of Physicians and curricula specific to nephrology have been proposed.