#1
RANDOMIZED CONTROLLED TRIAL
Lindsay A Taylor, Robert Stenberg, Jordan Tozer, Michael J Vitto, Michael Joyce, Jason Jennings, Christopher L Carpenter, Robert Fuchs, Zachary Deuell, David P Evans
OBJECTIVES: Thoracostomy is often a required treatment in patients with thoracic trauma; however, performing a thoracostomy using traditional techniques can have complications. Ultrasound can be a beneficial tool for identifying the correct thoracostomy insertion site. We designed a randomized prospective study to assess if ultrasound guidance can improve thoracostomy site identification over traditional techniques. METHODS: Emergency medicine residents were randomly assigned to use palpation or ultrasound to identify a safe insertion site for thoracostomy placement...
March 2022: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
#2
JOURNAL ARTICLE
Leily Naraghi, Judy Lin, Kay Odashima, Simran Buttar, Lawrence Haines, Eitan Dickman
BACKGROUND: Ultrasound-guided regional anesthesia (UGRA) is increasingly used by emergency physicians to provide safe and effective pain relief for patients. However, one of the factors limiting its widespread use is the lack of realistic models available for learners to train on. There are currently no inexpensive nerve block models available that are injectable and that closely mimic nerves, fascial planes, muscles, and other landmarks. Our aim is to create inexpensive, injectable nerve block models that can be used as effective medical training tools for UGRA...
May 15, 2019: BMC Medical Education
#3
RANDOMIZED CONTROLLED TRIAL
Alannah L Cooper, Yusuf Nagree, Adrian Goudie, Peter R Watson, Glenn Arendts
OBJECTIVE: To determine if an ultrasound-guided femoral nerve block (FNB) is superior to an ultrasound-guided fascia iliaca compartment block (FICB) in providing pain relief to patients with a neck of femur or proximal femoral fracture. METHODS: A double-blind randomised controlled trial was conducted. All participants received two blocks, one active and one placebo. An active FICB was administered to 52 participants and 48 participants received an active FNB. RESULTS: Analysis was completed on data collected from 100 participants...
June 2019: Emergency Medicine Australasia: EMA
#4
REVIEW
G Reusz, P Sarkany, J Gal, A Csomos
Real-time ultrasound guidance for any intervention relies on visualization of needle advancement towards a target. Unfortunately, correct identification of the needle tip is not straightforward, as artifacts always distort the image. The ultrasonic appearance of the needle is often degraded by reverberation, comet tail, side-lobe, beam-width, or bayonet artifacts, which can easily confuse an unprepared operator. Furthermore, the typical needle image, that is, a dot or a straight line (out-of-plane and in-plane approaches, respectively), is also a result of artifacts that hide the real dimensions of the needle...
May 2014: British Journal of Anaesthesia
#5
JOURNAL ARTICLE
Andrew A Herring, Michael B Stone, Arun D Nagdev
INTRODUCTION: The anterolateral abdominal wall is innervated by the T7 to L1 anterior rami, whose nerves travel in the fascial plane between the internal oblique and transversus abdominus muscles, known as the transversus abdominus plane (TAP). Ultrasound-guided techniques of regional anesthesia that target the TAP are increasingly relied upon by anesthesiologists for pain management related to major abdominal and gynecologic surgeries. Our objective was to explore the potential utility of these techniques to provide anesthesia for abdominal wall procedures in the emergency department (ED)...
June 2012: American Journal of Emergency Medicine
#6
RANDOMIZED CONTROLLED TRIAL
John W Norbury, Natalie C Karr, Vivek Sindhi, Kimberly M Rathbun, Stephen C Charles, Michael B McIver, Eric J Morrison
OBJECTIVES: To determine whether the line-of-sight approach improved the performance time and accuracy of ultrasound (US)-guided needle placement targeting the subdeltoid bursa in a cadaver among novice operators compared to the side approach. A secondary objective was to determine whether participants thought the APPLES (angle, position, perpendicular, line up, entry, sweep) mnemonic was a helpful guide for performing the procedure. METHODS: Medical students and residents were randomized into either a line-of-sight or side approach group and then crossed over to the other group...
December 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
#7
JOURNAL ARTICLE
Andrew A Herring, Michael B Stone, Oron Frenkel, Annie Chipman, Arun D Nagdev
The ultrasound-guided superficial cervical plexus (SCP) block may be useful for providers in emergency care settings who care for patients with injuries to the ear, neck, and clavicular region, including clavicle fractures and acromioclavicular dislocations. The SCP originates from the anterior rami of the C1-C4 spinal nerves and gives rise to 4 terminal branches--greater auricular, lesser occipital, transverse cervical, and suprascapular nerves--that provide sensory innervation to the skin and superficial structures of the anterolateral neck and sections of the ear and shoulder...
September 2012: American Journal of Emergency Medicine
#8
JOURNAL ARTICLE
Eben Clattenburg, Andrew Herring, Christoper Hahn, Brian Johnson, Arun Nagdev
No abstract text is available yet for this article.
June 2016: American Journal of Emergency Medicine
#9
JOURNAL ARTICLE
Edward Durant, Brittany Dixon, Josh Luftig, Daniel Mantuani, Andrew Herring
No abstract text is available yet for this article.
January 2017: American Journal of Emergency Medicine
#10
Gabriel Rose, Vincent Costa, Aaran Drake, Sebastian D Siadecki, Turandot Saul
Injury to the penis resulting from zipper entrapment is a painful condition that presents a unique anesthetic challenge to the emergency physician and may even require procedural sedation for removal. In this case report, we describe successful removal of zipper entrapment from the penis of a 34-year-old patient after the application of an ultrasound-guided dorsal penile nerve block. We discuss the anatomy, sonographic features, and steps required for the nerve block procedure. © 2017 Wiley Periodicals, Inc...
November 12, 2017: Journal of Clinical Ultrasound: JCU
#11
JOURNAL ARTICLE
Rebecca Milligan, Stephen Houmes, Lisa C Goldberg, Arun Nagdev, Richard Amini
No abstract text is available yet for this article.
April 2017: Internal and Emergency Medicine
#12
JOURNAL ARTICLE
Kalev Freeman, Andreas Dewitz, William E Baker
In patients presenting with atraumatic joint pain and swelling, diagnosis is typically made by synovial fluid analysis. Management of an acute suspected hip joint arthritis can present a challenge to the emergency physician (EP). Hip joint effusions are somewhat more difficult to identify and aspirate than effusions in other joints that are commonly managed by EPs. Identification and aspiration of a hip joint effusion under ultrasound guidance is a well-established procedure in the fields of orthopedic surgery and interventional radiology...
January 2007: American Journal of Emergency Medicine
#13
RANDOMIZED CONTROLLED TRIAL
Jennifer L Wiler, Thomas G Costantino, Lisa Filippone, Wayne Satz
BACKGROUND: Ultrasound is a useful adjunct to many Emergency Department (ED) procedures. Arthrocentesis is typically performed using a landmark technique but ultrasound may provide an opportunity to improve arthrocentesis performance. OBJECTIVE: To assess the success of emergency physicians performing landmark (LM) vs. ultrasound (US)-guided knee arthrocentesis techniques. METHODS: This was a prospective, randomized, controlled study of patients requiring knee arthrocentesis who presented to one urban university ED and two community EDs between June 2005 and February 2007...
July 2010: Journal of Emergency Medicine
#14
RANDOMIZED CONTROLLED TRIAL
Esmaeil Raeyat Doost, Mohammad Mehdi Heiran, Mitra Movahedi, Amirhossein Mirafzal
BACKGROUND: Few studies were performed to compare ultrasound guided brachial plexus block with procedural sedation for reduction of shoulder dislocations in the Emergency Department (ED). This study was done to provide further evidence regarding this comparison. METHODS: This was a randomized clinical trial performed on patients presenting with anterior shoulder dislocations to the emergency department of an academic level 2 trauma center. Exclusion criteria were any contraindications to the drugs used, any patient which may not be potentially assigned into both groups because of an underlying medical condition, presence of neurovascular compromise related to the dislocation, presence of concomitant fractures, and patient refusal to participate in the study...
October 2017: American Journal of Emergency Medicine
#15
RANDOMIZED CONTROLLED TRIAL
Phillip D Levin, Olga Sheinin, Yaacov Gozal
OBJECTIVE: To assess the role of a portable ultrasound device in the insertion of radial artery catheters. DESIGN: Prospective, randomized, comparative study. SETTING: Tertiary university hospital. PATIENTS: Elective surgery patients requiring arterial catheter insertion for intraoperative monitoring. INTERVENTIONS: A portable ultrasound device was used to visualize the radial artery at the wrist and to direct arterial catheter insertion...
February 2003: Critical Care Medicine
#16
RANDOMIZED CONTROLLED TRIAL
Stephen Shiver, Michael Blaivas, Matthew Lyon
BACKGROUND: Arterial cannulation for continuous blood-pressure measurement and frequent arterial-blood sampling commonly are required in critically ill patients. OBJECTIVES: To compare ultrasound (US)-guided versus traditional palpation placement of arterial lines for time to placement, number of attempts, sites used, and complications. METHODS: This was a prospective, randomized interventional study at a Level 1 academic urban emergency department with an annual census of 78,000 patients...
December 2006: Academic Emergency Medicine
#17
REVIEW
Ariel L Shiloh, Richard H Savel, Laura M Paulin, Lewis A Eisen
BACKGROUND: Ultrasound guidance commonly is used for the placement of central venous catheters (CVCs). The Agency for Healthcare Research and Quality recommends the use of ultrasound for CVC placement as one of its 11 practices to improve patient care. Despite increased access to portable ultrasound machines and comfort with ultrasound-guided CVC access, fewer clinicians are familiar with ultrasound-guided techniques of arterial catheterization. The goal of this systematic review and meta-analysis was to determine the utility of real-time two-dimensional ultrasound guidance for radial artery catheterization...
March 2011: Chest
#18
JOURNAL ARTICLE
Pankaj A Patel, Frank R Ernst, Candace L Gunnarsson
PURPOSE.: We performed an analysis of hospitalizations involving thoracentesis procedures to determine whether the use of ultrasonographic (US) guidance is associated with differences in complications or hospital costs as compared with not using US guidance. METHODS.: We used the Premier hospital database to identify patients with ICD-9 coded thoracentesis in 2008. Use of US guidance was identified using CPT-4 codes. We performed univariate and multivariable analyses of cost data and adjusted for patient demographics, hospital characteristics, patient morbidity severity, and mortality...
March 2012: Journal of Clinical Ultrasound: JCU
#19
JOURNAL ARTICLE
Phillip W Jones, J Phillip Moyers, Jeffrey T Rogers, R Michael Rodriguez, Y C Gary Lee, Richard W Light
STUDY OBJECTIVES: The objectives of this study are as follows: (1) to determine the incidence of complications from thoracentesis performed under ultrasound guidance by interventional radiologists in a tertiary referral teaching hospital; (2) to evaluate the incidence of vasovagal events without the use of atropine prior to thoracentesis; and (3) to evaluate patient or radiographic factors that may contribute to, or be predictive of, the development of re-expansion pulmonary edema after ultrasound-guided thoracentesis...
February 2003: Chest
#20
JOURNAL ARTICLE
Alfredo Tirado, Teresa Wu, Vicki E Noble, Calvin Huang, Resa E Lewiss, Jennifer A Martin, Michael C Murphy, Adam Sivitz, Stephanie G Cohen
Bedside ultrasound is an extremely valuable and rapidly accessible diagnostic and therapeutic modality in potentially life- and limb-threatening situations in the emergency department. In this report, the authors discuss the role of ultrasound in quick assessment of pathologic conditions and its use to aid in diagnostic and therapeutic interventions.
February 2013: Emergency Medicine Clinics of North America
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