Article Tags: POCUS

Brain Point of Care Ultrasound in Young Children Receiving Computed Tomography in the Emergency Department: A Proof of Concept Study

Stephanie R. Davenport; Nadya Ben Fadel; Jorge Davila; Nick Barrowman; Vid Bijelic; Allan E. Shefrin – Over the last 15 years, point of care ultrasound (POCUS) has emerged as one of the most important and most utilized tools in pediatric emergency medicine (PEM) [1,2]. What was initially used as a screening tool in the assessment of major traumas to help determine the requirements for further investigation or management is now used in over 40 clinical applications including the assessment of intra-abdominal hemorrhage, cardiac views to assess function and fluid, the identification of testicular torsion and the evaluation of skull fractures [1], to list a few.

Prevalence of Phantom Scanning in Cardiac Arrest and Trauma Resuscitations: The Scary Truth

Zachary Boivin; Curtis Xu; Donias Doko; Meghan Kelly Herbst; Trent She – The prevalence of phantom scanning, or point of care ultrasound (POCUS) performed without saving images, has not been well studied. Phantom scanning can negatively affect patient care, reduce billed revenue, and can increase medicolegal liability. We sought to quantify and compare the prevalence of phantom scanning among emergency department (ED) cardiac arrests and trauma resuscitations.

Venous Excess Ultrasound (VExUS) Grading to Assess Perioperative Fluid Status for Noncardiac Surgeries: a Prospective Observational Pilot Study

Justin C. Magin; Jacob R. Wrobel; Xinming An; Jacob Acton; Alexander Doyal; Shawn Jia; James C. Krakowski; Jay Schoenherr; Ricardo Serrano; David Flynn; Duncan McLean; Stuart A. Grant – Perioperative fluid administration impacts the rate of complications following surgery. VExUS grading system is a standardized point of care ultrasound (POCUS)-based, comprehensive method to assess volume status. VExUS could serve as a tool to guide fluid management, if validated perioperatively. The primary aim was to assess the success rate of obtaining required windows for VExUS grading , as well as the feasibility within a perioperative setting among noncardiac surgery. Further, this study describes the incidence of perioperative venous congestion and associations with 30-day postoperative complications.

Exploring the Applicability of Pre-Anesthetic Cardiac POCUS in Unexpected Conditions: Could it be Helpful?

Rodolfo C. Sabogal – Formal preoperative echocardiography has traditionally been recommended when there is substantial cardiovascular disease without recent follow up, unexplained dyspnea, a functional class less than 4 METS or a Duke Activity Status Index less than 34. However, it is important to note that certain patients may present with a variety of cardiac abnormalities due to their preexisting condition or multiple treatments, and these individuals warrant consideration. The objective of pre-anesthetic cardiac POCUS is to provide clinical information in a timely manner.

We Don’t Talk Enough About Overuse Injuries in Clinicians Using POCUS

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.

Recommendations for POCUS Curriculum in Canadian Undergraduate Medical Education: Consensus from the Inaugural Seguin Canadian POCUS Education Conference

Sacha Weill, Daniel Armand Picard, Daniel J. Kim MD, Michael Y. Woo MD – Point of care ultrasound (POCUS) in Canadian undergraduate medical education (UGME) is limited. To address this paucity, the inaugural Seguin Canadian POCUS Education Conference hosted 14 of the 17 Canadian medical schools to develop a list of recommendations for POCUS education in Canadian UGME.

Use Of POCUS for the Paediatric Patient with an Undifferentiated Upper Limb Injury

David J. McCreary, MBBS MRCPCH PgC US; Alex White, MBBS – A 2-year-old girl presented to the Paediatric Emergency Department following an unwitnessed injury to her left arm while playing at nursery limiting further examination. On assessment she was reluctant to use her left arm and further examination was difficult. In cases of unwitnessed and undifferentiated elbow injuries point of care ultrasound (POCUS) can be used to evaluate for elbow joint effusion, fracture, or radial head subluxation, also known as nursemaid’s elbow.

Delayed Iatrogenic Bladder Rupture Diagnosed by POCUS in the Emergency Department

Helen J. Lu, MD; Edward H. Lee, MD; Stephen Alerhand, MD – Bladder rupture is an uncommon injury that leads to significant morbidity and mortality. Though occurring mostly due to trauma, this life-threatening pathology may also occur spontaneously or after a procedure such as transurethral resection of bladder tumor (TURBT). Computed tomography (CT) cystography is the standard imaging modality for diagnosis. However, this test is unlikely to be ordered in a patient with undifferentiated abdominal pain unless there is specific suspicion for this diagnosis.

Missing Inferior Vena Cava on POCUS: A Case of Left-Sided IVC with Azygos Continuation

Ankit Mehta, MD, FACP, SFHM; Kreegan Reierson, MD; Benji Mathews, MD, MBA, SFHM – The merits of utilizing point of care ultrasound (POCUS) in acutely ill patients is leading to a widespread embrace. Assessment of IVC via POCUS as part of a comprehensive multi-organ approach can help guide volume tolerance. Anatomical/developmental variations of IVC can vary widely in prevalence.