POCUS journal最新文献

Radiology Imaging Adds Time and Diagnostic Uncertainty when Point of Care Ultrasound Demonstrates Cholecystitis 就诊点超声波显示胆囊炎时，放射成像增加了时间和诊断的不确定性

POCUS journal Pub Date : 2024-04-22 DOI: 10.24908/pocus.v9i1.16596

David Cannata, Callista Love, Pascale Carrel, Trent She, Seth Lotterman, Felix Pacheco, M. Herbst

{"title":"Radiology Imaging Adds Time and Diagnostic Uncertainty when Point of Care Ultrasound Demonstrates Cholecystitis","authors":"David Cannata, Callista Love, Pascale Carrel, Trent She, Seth Lotterman, Felix Pacheco, M. Herbst","doi":"10.24908/pocus.v9i1.16596","DOIUrl":"https://doi.org/10.24908/pocus.v9i1.16596","url":null,"abstract":"Abstract Background: Point of care ultrasound (POCUS) is specific for acute cholecystitis (AC), but surgeons request radiology imaging (RI) prior to admitting patients with POCUS-diagnosed AC. Objectives: We sought to determine the test characteristics of POCUS for AC when performed and billed by credentialed emergency physicians (EPs), the accuracy rate of RI when performed after POCUS, and the time added when RI is requested after POCUS demonstrates AC. Methods: We performed a dual-site retrospective cohort study of admitted adult ED patients who had received biliary POCUS from November 1, 2020 to April 30, 2022. Patients with previously diagnosed AC, liver failure, ascites, hepatobiliary cancer, or cholecystectomy were excluded. Descriptive statistics and 95% confidence intervals for point estimates were calculated. Medians were compared using a Wilcoxon signed-rank test. Test characteristics of POCUS for AC were calculated using inpatient intervention for AC as the reference standard. Results: Of 473 screened patients, 143 were included for analysis: 80 (56%) had AC according to our reference standard. POCUS was positive for AC in 46 patients: 44 true positives and two false positives, yielding a positive likelihood ratio of 17.3 (95%CI 4.4-69.0) for AC. The accuracy rate of RI after positive POCUS for AC was 39.0%. Median time from ED arrival to POCUS and ED arrival to RI were 115 (IQR 64, 207) and 313.5 (IQR 224, 541) minutes, respectively; p < 0.01. Conclusion: RI after positive POCUS performed by credentialed EPs takes additional time and may increase diagnostic uncertainty.","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140674915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Resolution of Sonographic Appendicitis in Pediatrics: a Point of Care Ultrasound Case-Series 儿科声像图阑尾炎的缓解：护理点超声病例系列

POCUS journal Pub Date : 2024-04-22 DOI: 10.24908/pocus.v9i1.16860

E. Scheier, Benjamin Taragin

引用次数: 0

Pediatric Emergency Medicine Ultrasound Fellowship Programs 儿科急诊医学超声研究计划

POCUS journal Pub Date : 2024-04-22 DOI: 10.24908/pocus.v9i1.17372

Sigmund Kharasch, MD, Matthew Moake, MD, PhD, Antonio Riera MD

引用次数: 0

Best Practices for Point of Care Ultrasound: An Interdisciplinary Expert Consensus 医疗点超声最佳实践：跨学科专家共识

POCUS journal Pub Date : 2024-04-22 DOI: 10.24908/pocus.v9i1.17240

Brandon Oto, Robert Baeten, Leon Chen, Puja Dalal, Ria Dancel, Steven Fox, Carl William Lange, Cameron M. Baston, Paul Bornemann, Siddharth P. Dugar, Andrew Goldsmith, M. Herbst, James N. Kirkpatrick, Abhilash Koratala, Michael J Lanspa, Viveta Lobo, Jason Nomura, A. Pustavoitau, Mourad Senussi, Vincent L Sorrell, Frances Mae West, A. Sarwal

{"title":"Best Practices for Point of Care Ultrasound: An Interdisciplinary Expert Consensus","authors":"Brandon Oto, Robert Baeten, Leon Chen, Puja Dalal, Ria Dancel, Steven Fox, Carl William Lange, Cameron M. Baston, Paul Bornemann, Siddharth P. Dugar, Andrew Goldsmith, M. Herbst, James N. Kirkpatrick, Abhilash Koratala, Michael J Lanspa, Viveta Lobo, Jason Nomura, A. Pustavoitau, Mourad Senussi, Vincent L Sorrell, Frances Mae West, A. Sarwal","doi":"10.24908/pocus.v9i1.17240","DOIUrl":"https://doi.org/10.24908/pocus.v9i1.17240","url":null,"abstract":"Abstract Despite the growing use of point of care ultrasound (POCUS) in contemporary medical practice and the existence of clinical guidelines addressing its specific applications, there remains a lack of standardization and agreement on optimal practices for several areas of POCUS use. The Society of Point of Care Ultrasound (SPOCUS) formed a working group in 2022 to establish a set of recommended best practices for POCUS, applicable to clinicians regardless of their training, specialty, resource setting, or scope of practice. Using a three-round modified Delphi process, a multi-disciplinary panel of 22 POCUS experts based in the United States reached consensus on 57 statements in domains including: (1) The definition and clinical role of POCUS; (2) Training pathways; (3) Credentialing; (4) Cleaning and maintenance of POCUS devices; (5) Consent and education; (6) Security, storage, and sharing of POCUS studies; (7) Uploading, archiving, and reviewing POCUS studies; and (8) Documenting POCUS studies. The consensus statements are provided here. While not intended to establish a standard of care or supersede more targeted guidelines, this document may serve as a useful baseline to guide clinicians, leaders, and systems considering initiation or enhancement of POCUS programs.","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140673247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Point of Care Ultrasound Used to Diagnose Nontyphoidal Endocarditis 用于诊断非类风湿性心内膜炎的护理点超声检查

POCUS journal Pub Date : 2024-04-22 DOI: 10.24908/pocus.v9i1.16937

Zahraa Yousef Alqallaf, O. Maadarani, M. Elhabibi, Mohamad AbdelFatah, Z. Bitar

引用次数: 0

Vaginal Bleeding in a Peri-Menopausal Woman 围绝经期妇女的阴道出血问题

POCUS journal Pub Date : 2024-04-22 DOI: 10.24908/pocus.v9i1.16621

Ambika Shivarajpur, Brian Kohen

引用次数: 0

Point of Care Ultrasound Identification and Aspiration of a Neck Lymph Node 颈部淋巴结的定点超声波识别和抽吸

POCUS journal Pub Date : 2024-04-22 DOI: 10.24908/pocus.v9i1.16761

Andrew W. Moore, Ali Mrad, Leonard Riley, Sonia Castillo

引用次数: 0

The Application of Point of Care Ultrasound to Screen for Pulmonary Hypertension: A Narrative Review 应用护理点超声波筛查肺动脉高压：叙述性综述

POCUS journal Pub Date : 2024-04-22 DOI: 10.24908/pocus.v9i1.17494

Danny Yu Jia Ke, Melissa Tso, Amer Johri

{"title":"The Application of Point of Care Ultrasound to Screen for Pulmonary Hypertension: A Narrative Review","authors":"Danny Yu Jia Ke, Melissa Tso, Amer Johri","doi":"10.24908/pocus.v9i1.17494","DOIUrl":"https://doi.org/10.24908/pocus.v9i1.17494","url":null,"abstract":"Abstract Background: Pulmonary Hypertension (PH) is a condition with several cardiopulmonary etiologies that has the potential of progressing to right heart failure without proper intervention. After a history, physical exam, and investigations, cases of suspected PH typically undergo imaging via a transthoracic echocardiogram (TTE). This is a resource-intensive procedure that is less accessible in remote communities. However, point of care ultrasound (POCUS), a portable ultrasound administered at the bedside, has potential to aid in the diagnostic process of PH. Methods: The MEDLINE, Embase, and CENTRAL databases were searched to screen the intersection of POCUS and PH. Studies involved adult patients, and only English articles were accepted. Reviews, case reports, unfinished research, and conference abstracts were excluded. Our aim was to identify primary studies that correlated POCUS scan results and additional clinical findings related to PH. Results: Nine studies were included after our search. In these studies, POCUS was effective in identifying dilatation of inferior vena cava (IVC); internal jugular vein (IJV); and hepatic, portal, and intrarenal veins in patients with PH. The presence of pericardial effusion, pleural effusion, or b-lines on POCUS are also associated with PH. Conclusions: This review suggests important potential for the use of POCUS in the initial screening of PH. IVC and basic cardiopulmonary POCUS exams are key for PH screening in patients with dyspnea. Right-heart dilatation can be visualized, and peripheral veins may be scanned based on clinical suspicion. POCUS offers screening as an extension of a physical exam, with direct visualization of cardiac morphology. However, more studies are required to develop a statistically validated POCUS exam for PH diagnosis. More studies should also be conducted at the primary-care level to evaluate the value of screening using POCUS for PH in less-differentiated patients.","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140672176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effectiveness of a Brief Point of Care Ultrasound Course at a National Nephrology Conference 在全国肾脏病学会议上举办简短的护理点超声课程的效果

POCUS journal Pub Date : 2024-04-22 DOI: 10.24908/pocus.v9i1.16858

Abhilash Koratala, Nilam J Soni, Rupal Mehta, Nathaniel C Reisinger

{"title":"Effectiveness of a Brief Point of Care Ultrasound Course at a National Nephrology Conference","authors":"Abhilash Koratala, Nilam J Soni, Rupal Mehta, Nathaniel C Reisinger","doi":"10.24908/pocus.v9i1.16858","DOIUrl":"https://doi.org/10.24908/pocus.v9i1.16858","url":null,"abstract":"Abstract The rising demand for point of care ultrasound (POCUS) instruction during nephrology fellowship has been limited due to a shortage of trained faculty and courses designed specifically for nephrologists. A hands-on POCUS pre-course was organized during the April 2023 National Kidney Foundation (NKF) Spring Clinical Meeting to address this challenge. The course consisted of pre-recorded lectures and a 4-hour hands-on workshop guided by multidisciplinary POCUS experts. The anonymous post-course survey received responses from 25 out of 39 participants, yielding a 64.1% response rate. On a scale of 0-10, confidence levels for acquiring kidney images rose from 2.6 + 2.3 (mean + SD) pre-workshop to 7.8 + 1.5 post-workshop (p<0.001). Similarly, a remarkable improvement in confidence for acquiring lung and cardiac images was seen as scores increased from 1.8 + 2.4 to 7.7 + 1.5 (p<0.001) and from 1.5 + 2.2 to 7.2 + 1.3 (p<0.001), respectively. Additionally, respondents reported a substantial improvement in their confidence to interpret kidney, lung, and cardiac POCUS images, with scores increasing from 4.5 + 2.2 to 7.7 + 1.1 (p<0.001), 2.3 + 2.4 to 7.6 + 1.5 (p<0.001), and 2 + 2 to 7.3 + 1.5 (p<0.001), respectively. Barriers to implementing POCUS use at institutions included a perceived lack of trained faculty, limited protected time for faculty, and insufficient support from division leadership. The NKF POCUS pre-course successfully improved participants’ confidence in acquiring and interpreting basic POCUS images.","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140676098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gas Forming Pyogenic Liver Abscess Diagnosed by Point of Care Ultrasound 通过医疗点超声诊断出气体形成的化脓性肝脓肿

POCUS journal Pub Date : 2024-04-22 DOI: 10.24908/pocus.v9i1.16854

Wei Ven Chin, Mae Jane Khaw

引用次数: 0