POCUS journal最新文献

{"title":"Point of Care Ultrasound (POCUS) Used to Rapidly Diagnose Both Renal Colic and a Symptomatic Abdominal Aortic Aneurysm in an Elderly Man with Left Flank Pain.","authors":"Rie Seu, Ariella Gartenberg, Rachel Mirsky, Aamir Bandagi, Nicole J Leonard-Shiu, Reema Panjwani, Nora McNulty, Trevor Dixon, Michelle A Montenegro, Michael Halperin","doi":"10.24908/pocusj.v10i01.18461","DOIUrl":"https://doi.org/10.24908/pocusj.v10i01.18461","url":null,"abstract":"<p><p>Abdominal aortic aneurysms (AAAs) possess significant patient morbidity and mortality, but diagnosis can be missed or delayed given variable presenting symptoms. Renal colic is a potential \"red herring\" in cases of symptomatic AAA. This case involves an atypical presentation of flank pain likely due to both nephrolithiasis and an AAA. Prompt recognition of AAAs by the emergency department (ED) is critical to prevent misdiagnosis and initiate rapid treatment when indicated.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 1","pages":"131-133"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point of Care Ultrasound (POCUS) Applications Taught Within Canadian Internal Medicine Residency Programs: Results of a National Survey.","authors":"Ryan Marinovich, Michael G R Beyaert, Steven J Montague, Irene W Y Ma, Luke A Devine","doi":"10.24908/pocusj.v10i01.18220","DOIUrl":"https://doi.org/10.24908/pocusj.v10i01.18220","url":null,"abstract":"<p><strong>Background: </strong>Point of care ultrasound (POCUS) is an important tool for bedside diagnostics and procedures within internal medicine. In 2017 the Canadian Internal Medicine Ultrasound (CIMUS) group provided recommendations for applications to teach POCUS to internal medicine trainees. The way that training programs have implemented these recommendations has not been assessed. We aim to assess POCUS applications taught within internal medicine training programs, five years after the CIMUS group's recommendations.</p><p><strong>Methods: </strong>An anonymous survey was distributed in 2022 to POCUS leads at Canadian internal medicine residency and general internal medicine subspecialty training programs. This voluntary survey assessed which POCUS applications were being taught to trainees.</p><p><strong>Results: </strong>A total of 17 responses for the core training program and 12 responses for the subspecialty training program were collected. There was widespread uptake of the CIMUS-recommended POCUS applications within core and subspecialty level training. The compliance was higher for procedures than diagnostics. Many applications recommended at the subspecialty level were being incorporated into the core training program curriculum. Many applications that were not commented on by the CIMUS group were also incorporated into POCUS curricula.</p><p><strong>Conclusions: </strong>POCUS education within Canadian internal medicine residency programs are largely in sync with the CIMUS recommendations published in 2017. Many programs have expanded their training beyond the CIMUS group's recommendations.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 1","pages":"27-31"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point of Care Contrast Enhanced Ultrasound Utility in the Diagnosis of a Gallbladder Perforation: A Case Report.","authors":"Lauren Lu, Rebecca Leff, Tobias Kummer","doi":"10.24908/pocusj.v10i01.18166","DOIUrl":"https://doi.org/10.24908/pocusj.v10i01.18166","url":null,"abstract":"<p><p>We detail the case of a 61-year-old patient with a history of metastatic ovarian cancer who presented to our emergency department (ED) with findings consistent with localized gallbladder perforation and abscess development on an outpatient computed tomography (CT) scan. The differential etiology included primary cholecystitis or infiltrative metastatic mass in the setting of known peritoneal carcinomatosis. Point of care contrast-enhanced ultrasound (CEUS) examination was performed and was able to rule out local tumor infiltration, which was later confirmed by pathology after cholecystectomy. In this case, the identification and confirmation of gallbladder perforation on imaging allowed for more conservative management with image-guided drain placement in a patient who was not an optimal surgical candidate at the time and underwent delayed cholecystectomy. This case report emphasizes the role of CEUS in providing detailed information about gallbladder wall perfusion and integrity with the potential to predict impending gallbladder perforation by demonstrating areas of gallbladder wall hypoperfusion and necrosis as well as visualizing infiltrative lesions.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 1","pages":"125-130"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Guided Nerve Blocks Have the Potential to Reduce Racial and Ethnic Disparities in Emergency Department Pain Management.","authors":"Kendall Lavin-Parsons, Zachary W Binder","doi":"10.24908/pocus.v9i2.17510","DOIUrl":"10.24908/pocus.v9i2.17510","url":null,"abstract":"","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"9 2","pages":"7-8"},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and Treatment of a Morel-Lavallee Lesion via Point of Care Ultrasound (POCUS).","authors":"Djoser Mack, Joselyn Miller, Frank Yuan, Edison Lee, Trent She","doi":"10.24908/pocus.v9i2.17699","DOIUrl":"10.24908/pocus.v9i2.17699","url":null,"abstract":"<p><p>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. The following case highlights the importance of the role of Emergency Medicine physicians using point-of-care ultrasound (POCUS) to recognize and treat a potentially life-threatening injury. Our patient was initially managed with a bedside needle aspiration with drainage of 25cc of serosanguinous fluid that resulted in immediate pain relief. Patient was then admitted for further Interventional Radiology drainage of 160cc of serosanguinous fluid by Interventional Radiology.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"9 2","pages":"27-29"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subclinical Congestion Evaluated by Point of Care Ultrasound (POCUS) at Discharge Predicts Readmission in Patients with Acute Heart Failure: Prognostic Cohort Study.","authors":"Sergio Velasco Malagón, Estivalis Acosta-Gutiérrez, José Atilio Nuñez Ramos, Sebastián Salinas, Guillermo Mora Pabón","doi":"10.24908/pocus.v9i2.17709","DOIUrl":"10.24908/pocus.v9i2.17709","url":null,"abstract":"<p><p><b>Background:</b> 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. <b>Outcomes:</b> The primary outcome was to address 30-day rehospitalization, and as a secondary outcome we investigated readmission and mortality in patients with residual congestion assessed with POCUS. <b>Methods:</b> A prospective prognostic cohort study was conducted at a tertiary-level institution in Colombia. Patients with acute decompensated heart failure (ADHF) at discharge were evaluated using POCUS through lung ultrasound (LUS), portal vein pulsatility (PVP), and a composite assessment of residual congestion. Inclusion criteria were ADHF, over 18 years old, with a \"warm-wet\" clinical profile. POCUS was performed using an ultraportable device using LUS and PVP. Statistical analysis used logistic regression models to estimate the association between ultrasound congestion and outcomes. <b>Results:</b> A total of100 patients were included. The population was mostly female, with a median age of 78 years; 59% were hypertensive, and 39% had type 2 diabetes. Median NT-ProBNP was 3878 pg/ml. At discharge, 55% of patient had an inferior vena cava (IVC) over 2 cm, 54% had interstitial syndrome, and 41% had PVP >30%. Regarding 30-day readmission, we found an odds ratio (OR) 7.22 (95% CI 2.7-19.3) for interstitial syndrome; for PVP >30%, an OR 24.61 (95% CI 7.7-78.1) and an OR 13.19 (95% CI 2.7-62.6) for composite of residual congestion. <b>Conclusion:</b> Patients with ADHF and sub-clinical congestion, evidenced in LUS and PVP, were more likely to have readmission within 30 days of discharge. These findings should be confirmed with clinical trials to assess the effectiveness of a POCUS-guided treatment.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"9 2","pages":"125-132"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"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.","authors":"Priyanka Modi, Sanjeev Bhoi","doi":"10.24908/pocus.v9i2.17449","DOIUrl":"10.24908/pocus.v9i2.17449","url":null,"abstract":"<p><p><b>Background:</b> 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 parameters to predict GCS of the patients by point of care ultrasound (POCUS). <b>Materials and methods:</b> In this prospective, cross-sectional study, 200 patients were recruited in the emergency department. The inclusion criteria were patients older than 18 years with acute presentation of altered mental status. Exclusion criteria were patients who had partial globe rupture or dementia. The patients underwent a B-mode POCUS-guided evaluation at rest and after light stimulation. Statistical analysis of relationship between pupillary assessment parameters and GCS was performed using Spearman's Rank correlation coefficient, Kruskal-Wallis equality-of-populations rank test, and area under the receiver operating characteristic. <b>Results:</b> The study consisted of 200 (42 female, 158 male) patients with mean (± standard deviation) of age and GCS of 43.56 ± 16.50 years and 5.54 ± 3.00, respectively. Majority of non-reactive pupils had a GCS Score of 3-8 (74 cases, 97.37%). The Pupillary diameter (PD) and PD variation showed statistically significant agreement with pupil reactivity to light stimulation and GCS, with Spearman's correlation coefficient ranging from 0.28 to 0.33 for PD, and -0.55 to -0.50 (p-value <0.05) for PD variation, respectively. PD variation rate (PDVR) is the percentage change in the magnitude of constriction of PD on light stimulation. PDVR of >19.68% had a sensitivity of 86.96% (95% CI: 82.04 - 91.88%) and specificity of 64.97% (95% CI: 58.00 - 71.94%) to detect GCS>8. <b>Conclusion:</b> PD variation and PDVR measured by POCUS has significant correlation with GCS >8. The study showed good sensitivity and low specificity of PDVR on light stimulation to detect GCS >8.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"9 2","pages":"68-79"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11614402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RA) and Gastric Point Of Care Ultrasound (POCUS).","authors":"Sivasenthil Arumugam, Hari Kalagara","doi":"10.24908/pocus.v9i2.17700","DOIUrl":"10.24908/pocus.v9i2.17700","url":null,"abstract":"<p><p>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. Gastric point of care ultrasound (POCUS)   can provide information regarding nature and volume of gastric contents in these patients during the perioperative period. In this case series, we present three patients where gastric POCUS helped formulate a safer, alternative anesthetic plan. Anesthetic management varied depending on the situation, urgency and needs of the procedure. We recommend gastric POCUS in this group of patients to provide objective assessment of gastric contents.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"9 2","pages":"39-41"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Young Man with Chest Pain.","authors":"Anderson Wang, Aalap Shah","doi":"10.24908/pocus.v9i2.17500","DOIUrl":"10.24908/pocus.v9i2.17500","url":null,"abstract":"<p><p>Acalculous 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 of care ultrasound (POCUS). This case demonstrates the importance of conducting a thorough history and physical as well as the importance of POCUS to aid in clinical decision making and its value in diagnosing acute biliary pathology in the ED.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":" 2","pages":"22-23"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11614492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Point of Care Ultrasound (POCUS) in Cardiorespiratory Physiotherapy and Respiratory Therapy Practices: Current Status and Future Directions.","authors":"George Ntoumenopoulos, Georgina A Pizimolas, Sarine Mani, Simon Hayward, Jane Lockstone","doi":"10.24908/pocus.v9i2.17854","DOIUrl":"10.24908/pocus.v9i2.17854","url":null,"abstract":"<p><p>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 implementation. The safe and appropriate integration of Lung POCUS into physiotherapy and respiratory therapy clinical practice may be achieved by various means. This article describes the pathway for physiotherapists to become Lung POCUS-accredited in Australia, focusing on a novel fast-track approach that may apply internationally and in other professions, such as respiratory therapy. While a fast-track approach is resource intensive, such resource allocation may be justified to support the growth of Lung POCUS in physiotherapy and respiratory therapy practice where mentor support may be inconsistent, lacking, or absent.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"9 2","pages":"9-11"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}