990624_Challenging Cases & Journal Reading

8/9/2019 990624_Challenging Cases & Journal Reading

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EUS_990624

Challenging cases & Journal Reading


2/29

US is superior to radiography for

diagnosing sternal fracture

J Clin Ultrasound 2010; 38:135137

Sternal fracture: 24/36 patients

Sensitivity and specificity

Plain radiographs: 70.8%; 75.0%

US: both 100%


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Comparison of Web-versus Classroom-Based Basic

Ultrasonographic and EFAST Training in 2 European Hospitals

Ann Emerg Med. 2010. In press


4/29

Bedside ultrasonographic measurement of caval

index greater than or equal to 50% is strongly

associated with a low central venous pressure

Ann Emerg Med. 2010;55:290-295


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Bedside ultrasonographic measurement of caval

index greater than or equal to 50% is strongly

associated with a low central venous pressure

Caval index: (IVCe

IVCi )/IVCe Ann Emerg Med. 2010;55:290-295


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US for CVC_CLEAR databaseCentral Line Emergency Access Registry Database

AJEM 2010; 28, 561567


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US for CVC_CLEAR databaseCentral Line Emergency Access Registry Database

AJEM 2010; 28, 561567

1. did not observe improved success with the use of

ultrasound for CVC cannulation on the first attempt

2. observe a reduced number of total punctures per attempt


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An initial description of a sonographic sign that

verifies intrathoracic chest tube placement

AJEM 2010; 28, 626630


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Disappearance/Intrathoracic,

Continuation/ Extrathoracic (DICE) sign

Sensitivity 100%; Specificity 100% AJEM 2010; 28, 626630


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Ultrasound-guided femoral nerve

blocks are feasible to perform in the ED

AJEM 2010 28, 7681N=13; Median age: 82


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Significant and sustained decreases in

pain scores were achieved

AJEM 2010 28, 7681


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Needle tip visualization during ultrasound-guided

vascular access: short-axis vs long-axis approach

9/39, 23%

AJEM 2010;28: 343347


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Needle tip visualization during ultrasound-guided

vascular access: short-axis vs long-axis approach

24/39, 62%

AJEM 2010;28: 343347


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Kinetic Echography in the

Evaluation of Retinal Detachment

ACAD EMERG MED June 2010

Video clip: right eye

Video clip: left eye
http://retinal%20detachment/sm001_rihgt%20eye.movhttp://retinal%20detachment/sm002_left%20eye.movhttp://retinal%20detachment/sm002_left%20eye.movhttp://retinal%20detachment/sm001_rihgt%20eye.mov


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Emergency Ultrasound

Identification of Pneumoperitoneum

ACAD EMERG MED 2010
http://ppu/sm002_PPU.movhttp://ppu/sm001_PPU.mov


17/29

Soft Tissue Ultrasound and the

Comet Tail Artifact

ACAD EMERG MED 2010
http://comet%20tail%20artifact/sm001_comet%20tail%20artifact.movhttp://comet%20tail%20artifact/sm001_comet%20tail%20artifact.mov


18/29

Needle Aspiration of Spontaneous

Pneumothorax

Video Clip S1. Absent pleural sliding

Video Clip S2. Aspiration PTX

Video Clip S3. Repeat ultrasound examination

demonstrated partial resolution of the

pneumothorax, with lung point sign

Video Clip S4. Confirmation of return of normalpleuralsliding anteriorly
http://ptx/sm001_PTX.movhttp://ptx/sm002_PTX.movhttp://ptx/sm003_PTX.movhttp://ptx/sm004_PTX.movhttp://ptx/sm004_PTX.movhttp://ptx/sm003_PTX.movhttp://ptx/sm003_PTX.movhttp://ptx/sm002_PTX.movhttp://ptx/sm001_PTX.mov


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Diagnosis ofLemierres Syndrome

by Bedside Sonography

ACAD EMERG MED 2010
http://lemierre%20syndrome/sm001_IVJ%20thrombus.mov


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Challenging Cases


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68F_abdominal pain with leukocytosis
http://emphysematous%20cystitis_68f_03776507/CT_1_01.jpghttp://emphysematous%20cystitis_68f_03776507/Emphysematous%20cystitis_68F_03776507.wmvhttp://emphysematous%20cystitis_68f_03776507/CT_1_01.jpg


22/29

79F, c/o whole abdominal pain
http://ileus_79f_05600743_diverticulitis%20rupture/05600743_20100531_CT_1_01.jpghttp://ileus_79f_05600743_diverticulitis%20rupture/Free%20air_diverticulitis%20rupture_79F_05600743.wmvhttp://ileus_79f_05600743_diverticulitis%20rupture/05600743_20100531_CT_1_01.jpg


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70M, RLQ pain

SKH_ER
http://appendicitis_70m_16517483/CT_1_01.jpghttp://appendicitis_70m_16517483/CT_1_01.jpg


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32M, RLQ pain
http://terminal%20ileum%20diverticulitis_32m_16478615/CT_1_01.jpghttp://terminal%20ileum%20diverticulitis_32m_16478615/Terminal%20ileum%20diverticulitis_32M_16478615.wmvhttp://terminal%20ileum%20diverticulitis_32m_16478615/CT_1_01.jpg


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55F, LLQ pain
http://epiploic%20appendagitis_55f_16465469/CT_1_01.jpghttp://epiploic%20appendagitis_55f_16465469/Epiploic%20appendagitis_56F_16465469.wmvhttp://epiploic%20appendagitis_55f_16465469/CT_1_01.jpg


26/29

18M, severe epigastralgia
http://ppu_18m_16452446/16452446_20100419_CR_1_1.jpghttp://ppu_18m_16452446/PPU_18m_16452446.wmvhttp://ppu_18m_16452446/16452446_20100419_CR_1_1.jpghttp://ppu_18m_16452446/16452446_20100419_CR_1_1.jpg


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45F, right 3rd finder swollen

SKH_ER


28/29

67F, persistent fever

SKH_ER
http://psoas%20muscle%20abscess_66f_05168834/990504_CT_1_01.jpghttp://psoas%20muscle%20abscess_66f_05168834/990504_CT_1_01.jpg


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Cases of this month

1. Emphysematous cystitis

2. Diverticulitis rupture & pneumoperitoneum

3. Appendicitis rupture

4. Terminal ileum diverticulitis

5. Epiploic appendagitis

6. PPU with pneumoperitoneum

7. Finger abscess

8. Psoas muscle abscess

Documents

990624_Challenging Cases & Journal Reading