Academic Emergency Medicine

Cover image for Vol. 21 Issue 4

Edited By: David C. Cone, MD

Online ISSN: 1553-2712

Ultrasound Virtual Issue


Welcome to the Ultrasound Virtual Issue

Compiled by Devjani Das, MD, Monica Kapoor, MD, Resa E. Lewiss, MD and Romolo Gaspari, MD

The ultrasound "virtual issue" is a collection of key articles from Academic Emergency Medicine on the use of ultrasound in emergency medicine. Ultrasound can be used by the emergency physician to help diagnose a range of conditions, often at the bedside, and perform a variety of procedures. This collection of papers focuses on the situations and conditions that the emergency physician may need to employ ultrasound in, as well as covering education and training. This virtual issue will be updated on an ongoing basis as new articles are published.

Education
Abdomen
Pelvis
Procedures
Thorax
Small
Superficial
Vascular
PEDIATRICS
General



Ultrasound Virtual Issue

Education

CORD-AEUS: consensus document for the emergency ultrasound milestone project

A porcine pnemothorax model for teaching ultrasound diagnostics

The Technical Errors of Physicians Learning to Perform Focused Assessment With Sonography in Trauma

Pediatric emergency medicine fellow training in ultrasound: consensus educational guidelines.

The current state of ultrasound training in Canadian emergency medicine programs: perspectives from program directors.

Comparison of a multimedia simulator to a human model for teaching FAST exam image interpretation and image acquisition.

Assessment of a training curriculum for emergency ultrasound for pediatric soft tissue infections.

The learning curve of resident physicians using emergency ultrasonography for cholelithiasis and cholecystitis.

Assessment of a new model for femoral ultrasound — guided central venous access procedural training : a pilot study.

Resident training in emergency ultrasound: consensus recommendation from the 2008 Council of Emergency Medicine Residency Directors Conference.

Hybrid simulation combining a high fidelity scenario with a pelvic ultrasound task trainer enhances the training and evaluation of endovaginal ultrasound skills.

Procedures can be learned on the Web: a randomized study of ultrasound-guided vascular access training.

Short-axis versus long-axis approaches for teaching ultrasound-guided vascular access on a new inanimate model.

Focused training of emergency medicine residents in goal-directed echocardiography: a prospective study.

Predictors of success in emergency medicine ultrasound education.

The status of bedside ultrasonography training in emergency medicine residency programs.

Residency training in emergency ultrasound: fulfilling the mandate.

Ultrasound training for emergency physicians — a prospective study.

Evaluation of an instructional model for emergency ultrasonography.



Abdomen

FAST 

The technical errors of physicians learning to perform focused assessment with sonography in trauma.

Test characteristics of focused assessment of sonography for trauma for clinically significant abdominal free fluid in pediatric blunt abdominal trauma.

Comparison of a multimedia simulator to a human model for teaching FAST exam image interpretation and image acquisition.

Ultrasound use in trauma: the FAST exam.

Anechoic stripe size influences accuracy of FAST examination interpretation.

Satellite and mobile wireless transmission of focused assessment with sonography in trauma. 

Selective use of ultrasonography for the detection of pneumoperitoneum

Tissue harmonic imaging improves organ visualization in trauma ultrasound when compared with standard ultrasound mode.

Emergency department right upper quadrant ultrasound is associated with a reduced time to diagnosis and treatment of ruptured ectopic pregnancies.

Potential errors in diagnosis of pericardial effusion on trauma ultrasound for penetrating injuries.

The focused abdominal sonography for trauma (FAST) examination: considerations and recommendations for training physicians in the use of a new clinical tool.

Emergency physician use of ultrasonography in blunt abdominal trauma.

Evaluation of hemoperitoneum using a single vs multiple-view ultrasonographic examination.

RENAL/BLADDER

Assessing bladder volumes in young children prior to instrumentation: accuracy of automated ultrasound device compared to real-time ultrasound.

The learning curve of resident physicians using emergency ultrasonography for obstructive uropathy.

Diagnosis and removal of urethral calculi using bedside ultrasound in the emergency department.

Caregiver and health care provider satisfaction with volumetric bladder ultrasound.

Emergency ultrasound and urinalysis in the evaluation of flank pain.

Bladder ultrasound increases catheterization success in pediatric patients.

Bedside emergency department ultrasonography plus radiography of the kidneys, ureters and bladder vs intravenous pyelography in the evaluation of suspected ureteral colic.

GALLBLADDER

Emergency physician-performed ultrasound to diagnose cholelithiasis: a systematic review.

The learning curve of resident physicians using emergency ultrasonography for cholelithiasis and cholecystitis.

Biliary ultrasound instructional video.

Decreasing length of stay with emergency ultrasound examination of the gallbladder.

Emergency Department evaluation of geriatric patients with acute cholecystitis.

APPENDIX  

Performance of Ultrasound in the Diagnosis of Appendicitis in Children in a Multicenter Cohort.

Prospective evaluation of a clinical practice guideline for diagnosis of appendicitis in children.

Emergency ultrasound diagnosis of acute appendicitis.

An interdisciplinary initiative to reduce radiation exposure: evaluation of appendicitis in a pediatric emergency department with clinical assessment supported by a staged ultrasound and computed tomography pathway.

Does the use of ultrasonography improve the outcome of children with appendicitis?

Ultrasonography to evaluate adults for appendicitis: decision making based on meta-analysis and probabilistic reasoning.

GI

Emergency ultrasound identification of pneumoperitoneum.

Sonographic features of small-bowel intussusception in pediatric patients.



Pelvis

OBSTETRICS/GYNECOLOGY

Emergency ultrasound diagnosis of ruptured ectopic pregnancy.

Emergency department diagnosis of an interstitial ectopic pregnancy aided by goal-directed bedside ultrasound.

Hybrid simulation combining a high fidelity scenario with a pelvic ultrasound task trainer enhances the training and evaluation of endovaginal ultrasound skills.

Free fluid in Morison's pouch on bedside ultrasound predicts need for operative intervention in suspected ectopic pregnancy.

Outcome of patients with an indeterminate emergency department first-trimester pelvic ultrasound to rule out ectopic pregnancy.

Emergency department right upper quadrant ultrasound is associated with a reduced time to diagnosis and treatment of ruptured ectopic pregnancies.

Do emergency physicians save time when locating a live intrauterine pregnancy with bedside ultrasonography?

Ruptured ectopic pregnancy after elective termination of intrauterine pregnancy discovered by use of ultrasonography in the emergency department.

Gestational outcome in patients with first-trimester pregnancy complications and ultrasound-confirmed live intrauterine pregnancy.

The predictive value of endometrial stripe thickness in patients with suspected ectopic pregnancy who have an empty uterus at ultrasonography.

Normal intrauterine pregnancy is unlikely in patients who have echogenic material identified within the endometrial cavity at transvaginal ultrasonography.

Transvaginal ultrasonography by emergency physicians decreases patient time in the emergency department.

Subclassification of indeterminate pelvic ultrasonograms: stratifying the risk of ectopic pregnancy.

Serum progesterone and endovaginal sonography by emergency physicians in the evaluation of ectopic pregnancy.

Normal intrauterine pregnancy is unlikely in emergency department patients with either menstrual days >38 days or beta-hcg >3,000 mIU/mL, but without a gestational sac on ultrasonography.

Ectopic Pregnancy – Part II: Diagnostic Procedures and Imaging.

Ultrasonographic examination by emergency physicians of patients at risk of ectopic pregnancy.

SCROTAL

Bedside ultrasound of a painful testicle: before and after manual detorsion by an emergency physician.

Emergency evaluation of patients presenting with acute scrotum using bedside ultrasonography.

Emergency ultrasonography in the evaluation of the acute scrotum.

Emergency Management of blunt testicular trauma.



Procedures

VASCULAR ACCESS

Another WIN for point-of-care ultrasound: the wire-in-needle modified Seldinger technique for ultrasound-guided central venous access.

The vanishing target sign: confirmation of intraluminal needle position for ultrasound guided vascular access.

Single-operator sterile sheathing of ultrasound probes for ultrasound-guided procedures.

Incidence of posterior vessel wall puncture during ultrasound-guided vessel cannulation in a simulated model.

Risk factors for acute adverse events during ultrasound-guided central venous cannulation in the emergency department.

Rapid confirmation of central venous catheter placement using an ultrasonographic “bubble test.”

The “Ski Lift”: A technique to maximize needle visualization with the long-axis approach for ultrasound guided vascular access.

A descriptive comparison of ultrasound-guided central venous cannulation of the internal jugular vein to landmark-based subclavian vein cannulation.

Assessment of a new model for femoral ultrasound – guided central venous access procedural training : a pilot study.

What you see (sonographically) is what you get: vein and characteristics associated with successful ultrasound-guided peripheral intravenous placement in patients with difficult access.

Procedures can be learned on the Web: a randomized study of ultrasound-guided vascular access training.

Success of ultrasound-guided peripheral intravenous access with skin marking.

The anatomic relationship of femoral vein to femoral artery in euvolemic pediatric patients by ultrasonography: implications for pediatric femoral central venous access.

Ultrasonographic investigation of the effect of inguinal compression on the cross-sectional area of the femoral vein.

A pilot study of ultrasound analysis before pediatric peripheral vein cannulation attempt.

A prospective comparison of ultrasound-guided and blindly placed radial arterial catheters.

Randomized Controlled trial of single-operator vs two-operator ultrasound guidance for internal jugular central venous cannulation.

Ultrasound with topical anesthetic rapidly decreases pain of intravenous cannulation.

Emergency nurses’ utilization of ultrasound guidance for placement of peripheral intravenous lines in difficult-access patients.

Short-axis versus long-axis approaches for teaching ultrasound-guided vascular access on a new inanimate model.

Ultrasound guidance versus the landmark technique for the placement of central venous catheters in the emergency department.

ULTRASOUND GUIDED REGIONAL ANESTHESIA 

A comparison of ultrasound-guided three-in-one femoral nerve block versus parenteral opioids alone for analgesia in emergency department patients with hip fractures: a randomized controlled trial

A prospective comparison of procedural sedation and ultrasound-guided interscalene nerve block for shoulder reduction in the emergency department.

Ultrasound-guided ulnar nerve block in the management of digital abscess and hand cellulitis.

OTHER PROCEDURES

Pilot study to determine the utility of point-of-care ultrasound in the assessment of difficult laryngoscopy.

Ultrasound-assisted lumbar puncture in infants.

Evaluating infant positioning for lumbar puncture using sonographic measurements.

Emergency ultrasound for the detection of esophageal intubation.

Intraarticular injection and closed glenohumeral reduction with emergency ultrasound.

Ultrasound guided pericardiocentesis of cardiac tamponade.

Ultrasonographic diagnosis and facilitated reduction of an abdominal wall hernia.

Colles fracture reduction using ultrasound.

Confirmation of endotracheal tube placement after intubation using the ultrasound sliding lung sign.

Ultrasound-guided breast abscess aspiration in difficult case.

Identification and description of esophageal intubation using ultrasound.

Emergency physician-performed ultrasonography-guided hip arthrocentesis.



Thorax

CARDIAC

Emergency ultrasound identification of loculated pericardial effusion: the importance of multiple cardiac views.

The heart point sign: description of a new ultrasound findings suggesting pneumothorax.

Bedside transthoracic sonography in suspected pulmonary embolism: a new tool for emergency physicians.

Emergency department diagnosis of submassive pulmonary embolism using bedside ultrasonography.

Emergency department diagnosis of mitral stenosis and left atrial thrombus using bedside ultrasonography.

Massive right atrial thrombus masquerading as cardiac tamponade.

Emergency ultrasound diagnosis of cardiogenic shock due to acute mitral regurgitation.

Ultrasound guided pericardiocentesis of cardiac tamponade.

Diagnosis of acute mitral valve insufficiency using emergency bedside echocardiography.

Diagnosing infective endocarditis by emergency department echocardiogram.

Emergency department echocardiogram of right ventricle thrombus and McConnell's sign in a patient with dyspnea.

Prehospital ultrasound diagnosis of traumatic pericardial effusion.

Diagnosis of pulmonary embolism using emergency department bedside echocardiogram.

Emergency department echocardiography demonstrates large pericardial effusion and pendulous cardiac motion in patient with shortness of breath and electrical alternans.

Diagnosis and treatment of pulmonary embolism using bedside ultrasound.

Bedside echocardiography in the management of a thoracic stab wound with early pericardial tamponade.

Emergency bedside ultrasound diagnosis of nontraumatic cardiac tamponade – a case of Type A aortic dissection.

Emergency bedside ultrasound diagnosis of traumatic cardiac tamponade – a case of blunt cardiac rupture.

Emergency department diagnosis of pericardial tamponade by goal-directed bedside echocardiography.

Emergency department bedside echocardiography in diagnosis of Ebstein's anomaly with Wolff-Parkinson-White syndrome and atrial fibrillation.

Diagnosis of ascending aortic dissection using emergency department bedside echocardiogram.

Current issues with emergency cardiac ultrasound probe and image conventions.

Cardiac wheezing diagnosed with bedside echocardiogram.

The use of a dissected bovine heart to teach cardiac sonography.

Focused training of emergency medicine residents in goal-directed echocardiography: a prospective study.

Accuracy of emergency physician assessment of left ventricular ejection fraction and central venous pressure using echocardiography.

Determination of left ventricular function by emergency physician echocardiography of hypotensive patients.

Incidence of pericardial effusion in patients presenting to the emergency department with unexplained dyspnea.

Outcome in cardiac arrest patients found to have cardiac standstill on the bedside emergency department echocardiogram.

Can cardiac sonography and capnography be used independently and in combination to predict resuscitation outcome?

Potential errors in diagnosis of pericardial effusion on trauma ultrasound for penetrating injuries.

Prospective evaluation of two-dimensional transthoracic echocardiography in emergency department patients with suspected pulmonary embolism.

PULMONARY

The heart point sign: description of a new ultrasound findings suggesting pneumothorax.

Bedside transthoracic sonography in suspected pulmonary embolism: a new tool for emergency physicians.

Lung ultrasound in postprocedural pnemothorax.

Emergency department diagnosis of submassive pulmonary embolism using bedside ultrasonography.

Emergency ultrasound diagnosis of lobar consolidation.

Sensitivity of bedside ultrasound and supine anteroposterior chest radiographs for the identification of pneumothorax after blunt trauma.

Emergency department diagnosis of pneumothorax using goal-directed ultrasound.

Emergency thoracic ultrasound in the differentiation of the etiology of shortness of breath (ETUDES): sonographic B-lines and N-terminal pro-brain-type natriuretic peptide in diagnosing congestive heart failure.

Diagnosis of pulmonary embolism using emergency department bedside echocardiogram.

Diagnosis and treatment of pulmonary embolism using bedside ultrasound.

A prospective comparison of supine chest radiography and bedside ultrasound for the diagnosis of traumatic pneumothorax.

Emergency bedside ultrasound to detect pneumothorax.



Small

OCULAR 

Point-of-Care Ultrasound to Detect Optic Disc Swelling

Bedside ocular ultrasound for the detection of retinal detachment in the emergency department.

Diagnosing amaurosis fugax with emergency ultrasound.

Kinetic echocardiography in the evaluation of retinal detachment.

Focused bedside ocular ultrasound.

Correlation of optic nerve sheath diameter with direct measurement of intracranial pressure.

Elevated intracranial pressure detected by bedside emergency ultrasonography of the optic nerve sheath.

A study of bedside ocular ultrasonography in the emergency department.

Bedside emergency department ultrasonography in the evaluation of ocular pathology.

EAR/ NOSE / THROAT 

Randomized Trial Comparing Intraoral Ultrasound to Landmark-based Needle Aspiration in Patients with Suspected Peritonsillar Abscess

Pilot study to determine the utility of point-of-care ultrasound in the assessment of difficult laryngoscopy.

Diagnosis of Lemierre's syndrome by bedside sonography.

Intraoral ultrasound in the diagnosis and treatment of suspected peritonsillar abscess in the emergency department.

Sonographic assessment of the epiglottis.



Superficial

SOFT TISSUE/SUPERFICIAL

Emergency Ultrasound-assisted Examination of Skin and Soft Tissue Infections in the Pediatric Emergency Department

Assessment of a training curriculum for emergency ultrasound for pediatric soft tissue infections.

Soft tissue ultrasound and the comet tail artifact.

Ultrasound identification of reactive lymphadenopathy.

Early diagnosis of necrotizing fasciitis with soft tissue ultrasound.

The effect of soft-tissue ultrasound on management of cellulitis in the emergency department.

ABSCESS: applied bedside sonography for convenient evaluation of superficial soft tissue infections.

Ultrasonographic screening of clinically-suspected necrotizing fasciitis.

Ultrasound-guided breast abscess aspiration in difficult case.

MUSCULOSKELETAL 

Diagnostic accuracy of history, physical examination, and bedside ultrasound for diagnosis of extremity fractures in the emergency department: a systematic review.

A prospective comparison of procedural sedation and ultrasound-guided interscalene nerve block for shoulder reduction in the emergency department.

Bedside ultrasound diagnosis of clavicle fractures in the pediatric emergency department.

Intraarticular injection and closed glenohumeral reduction with emergency ultrasound.

Bedside ultrasound of a painful finger: Kanavel's fifth sign?

Colles fracture reduction using ultrasound.

Targeted musculoarticular sonography in the detection of joint effusions.

Emergency physician-performed ultrasonography-guided hip arthrocentesis.



Vascular

AORTA

 Systematic Review: emergency department bedside ultrasonography for diagnosing suspected abdominal aortic aneurysm. 

Point-of-care Focused Cardiac Ultrasound for the Assessment of Thoracic Aortic Dimensions, Dilation, and Aneurysmal Disease.

Emergency ultrasound diagnosis of type a aortic dissection and apical pleural cap.

Emergency department diagnosis of aortic dissection by bedside transabdominal ultrasound.

Emergency bedside ultrasound diagnosis of nontraumatic cardiac tamponade – a case of Type A aortic dissection.

Diagnosis of ascending aortic dissection using emergency department bedside echocardiogram.

Ultrasound use in the diagnosis of abdominal aortic aneurysm.

Frequency of incomplete abdominal aorta visualization by emergency department bedside ultrasound.

Prospective study of accuracy and outcome of emergency ultrasound for abdominal aortic aneurysm over two years.

Case report of an intraperitoneal ruptured abdominal aortic aneurysm diagnosed with bedside ultrasonography.

LOWER EXTREMITY DUPLEX

Cost-effectiveness of lower extremity compression ultrasound in emergency department patients with a high risk of hemodynamically stable pulmonary embolism.

Systemic review of emergency physician-performed ultrasonography for lower-extremity deep vein thrombosis.

Duplex ultrasound in the emergency department for the diagnostic management of clinically suspected deep vein thrombosis.

Resident-performed compression ultrasonography for the detection of proximal deep vein thrombosis : fast and accurate.

Lower-extremity Doppler for deep venous thrombosis – can emergency physicians be accurate and fast?

Color Doppler ultrasonography by emergency physicians for the diagnosis of acute deep venous thrombosis.

INFERIOR VENA CAVA

The interrater reliability of inferior vena cava ultrasound by bedside clinician sonographers in emergency department patients.

Use of bedside ultrasound to assess degree of dehydration with gastroenteritis.

Ultrasound assessment of severe dehydration in children with diarrhea and vomiting.

Inferior vena cava percentage collapse during respiration is affected by the sampling location: an ultrasound study in healthy volunteers.

Use of ultrasound measurement of the inferior vena cava diameter as an objective tool in the assessment of children with clinical dehydration.

OTHER

Emergency ultrasound diagnosis of a pseudoaneurysm associated with an arteriovenous fistula.



PEDIATRICS

Emergency Ultrasound-assisted Examination of Skin and Soft Tissue Infections in the Pediatric Emergency Department

Evaluation of Hypertrophic Pyloric Stenosis by Pediatric Emergency Physician Sonography

Performance of Ultrasound in the Diagnosis of Appendicitis in Children in a Multicenter Cohort

Pediatric emergency medicine fellow training in ultrasound: consensus educational guidelines.

Prospective evaluation of a clinical practice guideline for diagnosis of appendicitis in children.

Assessing bladder volumes in young children prior to instrumentation: accuracy of automated ultrasound device compared to real-time ultrasound.

Test characteristics of focused assessment of sonography for trauma for clinically significant abdominal free fluid in pediatric blunt abdominal trauma.

Ultrasound-assisted lumbar puncture in infants.

Evaluating infant positioning for lumbar puncture using sonographic measurements.

Assessment of a training curriculum for emergency ultrasound for pediatric soft tissue infections.

Ultrasound assessment of severe dehydration in children with diarrhea and vomiting.

Bedside ultrasound diagnosis of clavicle fractures in the pediatric emergency department.

Emergency ultrasound diagnosis of acute appendicitis.

Use of bedside ultrasound to assess degree of dehydration with gastroenteritis.

An interdisciplinary initiative to reduce radiation exposure: evaluation of appendicitis in a pediatric emergency department with clinical assessment supported by a staged ultrasound and computed tomography pathway.

The anatomic relationship of femoral vein to femoral artery in euvolemic pediatric patients by ultrasonography: implications for pediatric femoral central venous access.

Use of ultrasound measurement of the inferior vena cava diameter as an objective tool in the assessment of children with clinical dehydration.

A pilot study of ultrasound analysis before pediatric peripheral vein cannulation attempt.

Bladder ultrasound increases catheterization success in pediatric patients.

Sonographic features of small-bowel intussusception in pediatric patients.

Does the use of ultrasonography improve the outcome of children with appendicitis?



General

Not-so-old dogs and not-so-new tricks: is there a middle ground for ED ultrasound.

Keeping up with emergency department ultrasound.

Emergency department ultrasound: a resident's perspective.

Motivations, job procurement, and job satisfaction among current and former ultrasound fellows.

Financial impact of emergency department ultrasound.

Ultrasound Image quality comparison between an inexpensive handheld emergency department (ED) ultrasound machine and a large mobile ED ultrasound system.

Comparison of perceived and actual times spent by residents performing ultrasound examinations on patients.

Ultrasound training for emergency physicians – a prospective study.

Ultrasonography in Emergency Medicine.

GERIATRICS AND PALLIATIVE CARE

Hospice and palliative medicine ultrasound: a new horizon for emergency medicine?

Palliative ultrasound for home care hospice patients.

REMOTE ENVIRONMENT ULTRASOUND

Prehospital ultrasound by paramedics: results of field trial.

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