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The Importance of Serial POCUS Exams - Dual Pathologies in Play. 系列 POCUS 检查的重要性--双重病理在起作用。
POCUS journal Pub Date : 2023-11-27 eCollection Date: 2023-01-01 DOI: 10.24908/pocus.v8i2.16595
Rahul Nair, Jonathan Zuo, Ariel L Shiloh
{"title":"The Importance of Serial POCUS Exams - Dual Pathologies in Play.","authors":"Rahul Nair, Jonathan Zuo, Ariel L Shiloh","doi":"10.24908/pocus.v8i2.16595","DOIUrl":"https://doi.org/10.24908/pocus.v8i2.16595","url":null,"abstract":"<p><p>Serial point of care ultrasound (POCUS) exams are essential to assess acute pericardial effusions which can rapidly evolve into cardiac tamponade. A typical presentation includes dyspnea, tachycardia, and chest pain. Importantly, serial cardiac exams in such high-risk patients can detect other concurrent pathologies. We present an unusual case of a patient who initially presented with an acute circumferential pericardial effusion and upon serial POCUS exams developed an unexpected Takotsubo cardiomyopathy in the setting of cardiac tamponade.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10721285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814338","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}
引用次数: 0
Troubleshooting Paracentesis Using POCUS. 使用 POCUS 解决胎盘穿刺术的故障。
POCUS journal Pub Date : 2023-11-27 eCollection Date: 2023-01-01 DOI: 10.24908/pocus.v8i2.16265
Angelina Voronina, Nachelle Aurelien, Edward Bergin, Paula Roy-Burman
{"title":"Troubleshooting Paracentesis Using POCUS.","authors":"Angelina Voronina, Nachelle Aurelien, Edward Bergin, Paula Roy-Burman","doi":"10.24908/pocus.v8i2.16265","DOIUrl":"https://doi.org/10.24908/pocus.v8i2.16265","url":null,"abstract":"<p><p>Paracentesis is a procedure routinely performed at the bedside in the evaluation and management of ascites. While point of care ultrasound (POCUS) assistance during paracentesis is known to reduce the risk of procedure-related complications, intraprocedural POCUS to overcome commonly occurring issues, such as obstructed flow through the centesis catheter, remain poorly described. In this report, we present two cases in which bowel adhered to the catheter during paracentesis. POCUS was used in an attempt to restore flow. Based on our literature review and procedural experience, we propose an algorithm to surmount this routinely encountered problem.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10721288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814428","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}
引用次数: 0
Recommendations for POCUS Curriculum in Canadian Undergraduate Medical Education: Consensus from the Inaugural Seguin Canadian POCUS Education Conference. 加拿大本科医学教育中的 POCUS 课程建议:首届 Seguin 加拿大 POCUS 教育会议达成的共识。
POCUS journal Pub Date : 2023-04-26 eCollection Date: 2023-01-01 DOI: 10.24908/pocus.v8i1.16153
Sacha Weill, Daniel Armand Picard, Daniel J Kim, Michael Y Woo
{"title":"Recommendations for POCUS Curriculum in Canadian Undergraduate Medical Education: Consensus from the Inaugural Seguin Canadian POCUS Education Conference.","authors":"Sacha Weill, Daniel Armand Picard, Daniel J Kim, Michael Y Woo","doi":"10.24908/pocus.v8i1.16153","DOIUrl":"10.24908/pocus.v8i1.16153","url":null,"abstract":"<p><p>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. Attending schools were divided into delegations consisting of a pre-clerkship student, a clerkship student and a staff physician. Recommendations were developed via a modified consensus development panel. Delegations submitted school-specific POCUS education summary documents for roundtable discussions, which yielded an initial set of recommendations. These were then summarized in a large group setting and voted upon for adoption with an a priori agreement threshold of 80%. Conference attendees developed 14 recommendations which 87% of participants agreed to adopt. Conference recommendations reflect the opinions of Canadian trainees and POCUS education experts thus serving as a framework for UGME POCUS education in Canada.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9798988","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}
引用次数: 0
Virtual Supervision of Third Year Medical Students Using Handheld POCUS Devices and Cloud-based Image Archiving Provides Opportunity for Feedback and Skill Improvement. 使用手持 POCUS 设备和云图像存档对三年级医学生进行虚拟督导,为反馈和技能改进提供了机会。
POCUS journal Pub Date : 2023-04-26 eCollection Date: 2023-01-01 DOI: 10.24908/pocus.v8i1.16195
Sydney Murray, Krista Trinder, Linden Kolbenson, Jeremy Katulka, Paul Olszynski
{"title":"Virtual Supervision of Third Year Medical Students Using Handheld POCUS Devices and Cloud-based Image Archiving Provides Opportunity for Feedback and Skill Improvement.","authors":"Sydney Murray, Krista Trinder, Linden Kolbenson, Jeremy Katulka, Paul Olszynski","doi":"10.24908/pocus.v8i1.16195","DOIUrl":"10.24908/pocus.v8i1.16195","url":null,"abstract":"<p><p><b>Background</b> <b>:</b> Feedback on Point of Care Ultrasound (POCUS) skills is essential for skill development. Providing feedback can be difficult in a large province with several distributed medical education sites. Use of handheld POCUS devices and a cloud-based image archiving enables virtual supervision. We evaluated the quality of uploaded images as well as feedback provided to students. <b>Methods:</b> Volunteer third year students were given access to handheld POCUS devices at various training sites. Students were encouraged to upload educational POCUS scans to their accounts where they would then receive feedback from faculty. Subsequently, images that met inclusion criteria were randomized and reviewed by a blinded expert using a global rating scale. Feedback was also analyzed. Finally, students completed a questionnaire on their technology-enhanced POCUS learning experience. <b>Results:</b> An independent-sampled t-test comparing mean ratings for initial images submitted prior to any feedback with those submitted after three rounds of feedback showed significant effect on image scores (2.60 vs 3.50, p = .040, d = .93). Feedback included 4 performance domains (indications, image generation, interpretation, and integration). Students found the technology easy to use and felt feedback was tailored to their learning needs. <b>Conclusions:</b> We observed that virtual feedback provided to medical students through a cloud-based work platform can be effective for enhancing POCUS skills.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9798991","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}
引用次数: 0
POCUS for Diastolic Dysfunction: A Review of the Literature. POCUS治疗舒张功能不全:文献综述。
POCUS journal Pub Date : 2023-01-01 DOI: 10.24908/pocus.v8i1.15803
Samantha A King, Alexis Salerno, Jessica V Downing, Zachary R Wynne, Jordan T Parker, Taylor E Miller, Semhar Z Tewelde
{"title":"POCUS for Diastolic Dysfunction: A Review of the Literature.","authors":"Samantha A King,&nbsp;Alexis Salerno,&nbsp;Jessica V Downing,&nbsp;Zachary R Wynne,&nbsp;Jordan T Parker,&nbsp;Taylor E Miller,&nbsp;Semhar Z Tewelde","doi":"10.24908/pocus.v8i1.15803","DOIUrl":"https://doi.org/10.24908/pocus.v8i1.15803","url":null,"abstract":"Abstract Emergency and critical care physicians frequently encounter patients presenting with dyspnea and normal left ventricular systolic function who may benefit from early diastolic evaluation to determine acute patient management. The current American Society of Echocardiography Guidelines approach to diastolic evaluation is often impractical for point of care ultrasound (POCUS) evaluation, and few studies have evaluated the potential use of a simplified approach. This article reviews the literature on the use of a simplified diastolic evaluation to assist in determining acute patient management.","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9430632","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}
引用次数: 1
POCUS Confirmation of Intraosseous Line Placement: Visualization of Agitated Saline within the Right Heart in a Critically Ill Infant. POCUS确认骨内线放置:危重婴儿右心内搅拌盐水的可视化。
POCUS journal Pub Date : 2023-01-01 DOI: 10.24908/pocus.v8i1.16200
Inbar S Y Plaut, Zachary W Binder
{"title":"POCUS Confirmation of Intraosseous Line Placement: Visualization of Agitated Saline within the Right Heart in a Critically Ill Infant.","authors":"Inbar S Y Plaut,&nbsp;Zachary W Binder","doi":"10.24908/pocus.v8i1.16200","DOIUrl":"https://doi.org/10.24908/pocus.v8i1.16200","url":null,"abstract":"<p><p>Intraosseous (IO) line placement can be a life-saving procedure in the management of critically ill patients. Confirmation of correct IO line placement can be difficult. Prior studies have examined the use of point of care ultrasound (POCUS) to confirm IO line placement by using power Doppler over bone to detect flow within the intraosseous space. This case illustrates a novel use of POCUS in which agitated saline is visualized within the right heart as a means of confirming correct IO placement.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9798984","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}
引用次数: 1
Acute Upper Extremity Arterial Occlusion Diagnosed on POCUS in the Emergency Department. 急诊科诊断急性上肢动脉闭塞的POCUS。
POCUS journal Pub Date : 2023-01-01 DOI: 10.24908/pocus.v8i1.15902
Derrick Huang, Jacob Ruzicka, Leoh León, Latha Ganti
{"title":"Acute Upper Extremity Arterial Occlusion Diagnosed on POCUS in the Emergency Department.","authors":"Derrick Huang,&nbsp;Jacob Ruzicka,&nbsp;Leoh León,&nbsp;Latha Ganti","doi":"10.24908/pocus.v8i1.15902","DOIUrl":"https://doi.org/10.24908/pocus.v8i1.15902","url":null,"abstract":"<p><p>Upper extremity acute limb ischemia (ALI) is a limb-threatening and potentially lethal pathology that is most commonly caused by vascular embolization. Outcomes of limb ischemia are time-sensitive due to the correlation between a longer time from symptom onset to intervention with a vastly higher risk of amputation. In this report, point of care ultrasound (POCUS) was utilized to rapidly diagnose a patient with a proximal right brachial artery embolic occlusion, prompting expedited surgical consultation and successful embolectomy. POCUS can provide a focused vascular examination of the limbs to expedite diagnosis of time-sensitive ALI and facilitate timely medical intervention and surgical consultation.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9783528","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}
引用次数: 0
Sonographic Features of a Tuberculous Cold Abscess: A Case Report and Literature Review. 结核性冷脓肿的声像图特征:1例报告并文献复习。
POCUS journal Pub Date : 2023-01-01 DOI: 10.24908/pocus.v8i1.15831
Amir Alzarrad, Salman Naeem, Serena Rovida
{"title":"Sonographic Features of a Tuberculous Cold Abscess: A Case Report and Literature Review.","authors":"Amir Alzarrad,&nbsp;Salman Naeem,&nbsp;Serena Rovida","doi":"10.24908/pocus.v8i1.15831","DOIUrl":"https://doi.org/10.24908/pocus.v8i1.15831","url":null,"abstract":"<p><p>The use of point of care ultrasound (POCUS) to aid diagnosis of tuberculosis has been investigated in countries where concomitant endemic prevalence of HIV increases the incidence of extrapulmonary tuberculosis (EPTB). In such cases, using a focused assessment with sonography for HIV-associated tuberculosis (FASH) scan has found to be immensely advantageous as a rapid diagnostic tool in low resource settings where other imaging modalities are scarce. The prevalence of EPTB in immunocompetent patients in industrialised countries is growing. Since EPTB can manifest itself in almost any part of the human body, symptomatic patients present with constitutional and non-specific symptoms. In our case, a 44-year-old male presented to the emergency department (ED) with a 3-month history of left-sided chest pain and swelling of the chest wall. Clinical examination revealed a swollen and tender lump above the left first rib. Palpation of the thoracic (T7) vertebral body demonstrated localised pain. POCUS showed a collection of heterogenous material with fluid content and specks of hyperechoic 'ring-like' structures. Further investigations led to the diagnosis of EPTB. The patient was admitted and treated for EPTB where he went on to make a full recovery. This case report highlights the role of integrating POCUS in clinical examination of patients with suspected EPTB, which can expedite its diagnosis and management.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9430636","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}
引用次数: 0
A Case of Pediatric Sternal Fracture Diagnosed by POCUS. POCUS诊断小儿胸骨骨折1例。
POCUS journal Pub Date : 2023-01-01 DOI: 10.24908/pocus.v8i1.15824
Takaaki Mori, Sung Shin Teng
{"title":"A Case of Pediatric Sternal Fracture Diagnosed by POCUS.","authors":"Takaaki Mori,&nbsp;Sung Shin Teng","doi":"10.24908/pocus.v8i1.15824","DOIUrl":"https://doi.org/10.24908/pocus.v8i1.15824","url":null,"abstract":"<p><p>A previously healthy, 4-year-old boy visited our emergency department due to chest pain after a fall from a skate scooter. Physical examination revealed tenderness over the sternal body. Point of care ultrasound (POCUS) of the sternum demonstrated a discontinuation of a hyperechoic structure of the sternal cortex, suggesting a sternal fracture. POCUS did not detect intraperitoneal fluid, pericardiac effusion, or pneumothorax. Plain radiograph confirmed the diagnosis of isolated sternal fracture and the patient was discharged with conservative treatment. POCUS was useful not only in diagnosing a sternal fracture but also to rule out concurrent injuries.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9430635","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}
引用次数: 0
Delayed Iatrogenic Bladder Rupture Diagnosed by POCUS in the Emergency Department. 急诊科POCUS诊断迟发性医源性膀胱破裂。
POCUS journal Pub Date : 2023-01-01 DOI: 10.24908/pocus.v8i1.16239
Helen J Lu, Edward H Lee, Stephen Alerhand
{"title":"Delayed Iatrogenic Bladder Rupture Diagnosed by POCUS in the Emergency Department.","authors":"Helen J Lu,&nbsp;Edward H Lee,&nbsp;Stephen Alerhand","doi":"10.24908/pocus.v8i1.16239","DOIUrl":"https://doi.org/10.24908/pocus.v8i1.16239","url":null,"abstract":"<p><p>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. In our emergency department, a 48 year-old male with history of bladder cancer and TURBT two weeks prior to arrival presented with severe abdominal pain and difficulty urinating for 3 days. Point of care ultrasound (POCUS) revealed an irregularly shaped bladder, likely site of bladder rupture, and large amount of abdominal free fluid with sediment. These findings prompted an expedited diagnostic CT scan with cystography. Emergent exploratory laparotomy ultimately confirmed a small bladder defect with 2.5 L of urinary ascites. The diagnosis of non-traumatic bladder rupture can be overlooked in patients presenting with a peritonitic abdominen. The typically ordered test for such patients is standard CT, which carries a high false-negative rate for bladder rupture. This case highlights the utility of POCUS in facilitating a rapid diagnosis.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9798987","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}
引用次数: 0
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