Emergency Medicine Clinics of North America

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

One cannot successfully employ point-of-care ultrasound (POCUS) without a process to provide support and guidance. POCUS administration is a multifaceted topic that demands the utmost attention from those responsible for program implementation and long-term execution. This article delves into POCUS administration and is meant to serve as a guide for the practitioner seeking to start, maintain, or augment their POCUS program.

The management of patients in shock or arrest is a critical aspect of emergency medicine and critical care. Rapid and accurate assessment is paramount in determining the underlying causes and initiating timely interventions. This article provides a summary of essential ultrasound protocols for the critically ill patient including the extended focused assessment with sonography for trauma (EFAST), rapid ultrasound for shock and hypotension (RUSH), and sonography in hypotension and cardiac arrest in the emergency department (SHoC-ED)...

Ultrasound guidance is fundamental to procedural safety and success. For many emergency department (ED) procedures, the use of ultrasound improves first-pass success rate, time-to-completion, and complication rate when compared with traditional landmark-based techniques. Once learned, the general principles of ultrasound guidance may be adapted across a broad range of bedside procedures.

Ultrasound-guided nerve blocks serve as a valuable component of multimodal pain management for acutely injured patients in the emergency department and offer a potentially more efficient alternative to time-consuming procedural sedation.

Point-of-care ultrasound may be used to assist in the diagnosis of ocular complaints in the emergency department. With the use of a linear probe, the emergency physician can view anterior and posterior chamber structures of the patient's eye and evaluate for signs of pathology.

Point-of-care ultrasound may be used to assist in the diagnosis of skin, soft tissue, and musculoskeletal concerns in the emergency department. Frequently, linear or curvilinear probes are used to perform these studies and ultrasound may be used to assist in common emergency department procedures related to these conditions.

Point-of-care ultrasound is a useful tool in the evaluation of women with pelvic complaints in the emergency department. Transabdominal and transvaginal approaches may be employed to assess a variety of obstetric or gynecologic pathologies.

Renal and genitourinary (GU) complaints are common reasons for presentation to the emergency department (ED). This article reviews the approach to renal, bladder, and testicular point-of-care ultrasound (POCUS) with specific discussions of commonly encountered ED pathology. It presents algorithms highlighting the clinical integration of renal and GU POCUS into the evaluation and management of these patients.

Vascular point-of-care ultrasound is a useful tool for emergency department (ED) clinicians to evaluate lower extremity pain and swelling. It can quickly and safely detect deep vein thrombosis, a serious condition that can lead to pulmonary embolism and post-thrombotic syndrome as well as diagnose pseudoaneurysm, hematoma, and acute arterial occlusion, a vascular emergency that requires urgent surgical intervention. Point-of-Care Ultrasound can be a useful tool for the evaluation of ED patients with vascular emergencies...

This article reviews the use of point-of-care ultrasound (POCUS) for evaluating the aorta from anatomy and image acquisition to the diagnosis of aortic pathology, including aneurysms and dissection. Ruptured aortic aneurysm and aortic dissection are associated with high mortality and often experience a delay in time to diagnosis. Traditionally diagnosis was made through computed tomography which takes time and removes the patient from the emergency department. Incorporating POCUS into the evaluation of patients with suspected aortic pathology allows for rapid, accurate diagnosis and earlier definitive treatment...

Point-of-care ultrasound has been shown to have excellent diagnostic accuracy for a variety of gastrointestinal and biliary pathologies. This review explores the evidence and scanning techniques for hypertrophic pyloric stenosis, intussusception, appendicitis, small bowel obstruction, diverticulitis, hernias, pneumoperitoneum, and biliary pathology.

Airway and thoracic ultrasound applications can provide critical information to improve patient safety for procedures and management of pulmonary conditions. Emergency physicians should utilize airway ultrasound in the preparation for an anatomically and/or physiologically difficult airway, which may include site demarcation for surgical airway planning. Thoracic ultrasound is useful in the prompt evaluation of a dyspneic patient. This article underscores the crucial role of airway and thoracic ultrasound in emergency medicine, emphasizing its utility for assessing difficult airways, planning surgical airways, and promptly evaluating dyspneic patients...

Cardiac point-of-care ultrasound (POCUS) can make critical diagnoses and monitor the response to interventions. In contrast with consultative echocardiography, cardiac POCUS serves to answer a specific clinical question. This imaging modality can be used to evaluate for left ventricular systolic and diastolic dysfunction, pericardial effusion and tamponade, acute and chronic right ventricular dysfunction, valvular dysfunction, and cardiac activity in cardiac arrest.

With the growing use of point-of-care ultrasound (POCUS) in various clinical settings, it is essential for users of ultrasound to have a thorough understanding of the basics of ultrasound physics, including sound wave properties, its interaction with various tissues, common artifacts, and knobology. The authors introduce and discuss these concepts in this article, with a focus on clinical implications.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

The safety and health of individuals who may be exposed to the spaceflight environment are first and foremost cared for through prevention. This environment, which encompasses microgravity, radiation, and alternobaric factors, can have physiologic impacts on every human system. Available medical care and resources in the spaceflight environment are currently limited by mass and volume constraints, with available medical resources thereby focusing on a patient's stabilization and evacuation. An understanding of the spaceflight environment and its possible effects is crucial for the treatment of individuals prior to, during, and after spaceflight...