Archives

References

References

1. Alrajhi K, Woo MY, Vaillancourt C. Test characteristics of ultrasonography for the detection of pneumothorax: a systematic review and meta-analysis. Chest 2012;141:703-8. doi:10.1378/chest.11-0131.

2. Seow et al. Comparison of Upright Inspiratory and Expieratory Chest Radiographs for Detecting Pneumothoraces. AJR 1996; 166:313-316. doi: 10.2214/ajr.166.2.8553937.

3. Murphy et al. CT and Chest Radiography are Equally Sensitive in the Detection of Pneumothorax After CTGuided Pulmonary Interventional Procedures. AJR 1990;154:45-46. doi: 10.2214/ajr.154.1.2104723.

4. Raimondi et al. Lung Ultrasound for Diagnosing Pneumothorax in the Critically Ill Neonate. J Pediatr 2016;175:74-8. doi:10.1016/j.jpeds.201.04.018

5. Cattarossi et al. Lung Ultrasound Diagnostic Accuracy in Neonatal Pneumothorax. Canad Resp J. 2016. doi 10.1155/2016/6515069

6. Liu et al. Lung ultrasonography to diagnose pneumothorax of the newborn. AJEM 2017;35:1298-1302. doi: 10.1016/j.ajem.2017.04.001.

7. Volpicelli et al. Semi-quantification of pneumothorax volume by lung ultrasound. Int Care Med 2016;40:14607. doi:10.1007/s00134-014-3402-9.

Conclusion

Conclusion

Congratulations on taking the first step towards adopting PoCUS as a part of your practice! The key concepts in this chapter can be revisited regularly to help you understand how to generate and interpret different scans. Orienting yourself to a 2D representation of a 3D object will take some time, so take any opportunity you have to reach for an US probe to hone your skills. Image generation is the most difficult skill to obtain with respect to PoCUS but with a systematic approach you will be able to reliably create high-quality scans that can enhance your clinical decision-making.

References

References

  1. Thamburaj R, Sivitz A. Does the use of bedside pelvic ultrasound decrease length of stay in the emergency department? Pediatr Emerg Care. 2013 Jan;29(1):67-70. doi: 10.1097/PEC.0b013e31827b53f9. PubMed PMID: 23283267.
  2. Howard ZD, Noble VE, Marill KA, Sajed D, Rodrigues M, Bertuzzi B, Liteplo AS. Bedside ultrasound maximizes patient satisfaction. J Emerg Med. 2014 Jan;46(1):46-53. doi: 10.1016/j.jemermed.2013.05.044. Epub 2013 Aug 12. PubMedPMID: 23942153.
  3. Ramirez-Schrempp D, Dorfman DH, Baker WE, Liteplo AS. Ultrasound soft-tissue applications in the pediatric emergency department: to drain or not to drain? Pediatr Emerg Care. 2009 Jan;25(1):44-8. doi: 10.1097/PEC.0b013e318191d963. Review. PubMed PMID: 19148015.
  4. Squire BT, Fox JC, Anderson C. ABSCESS: applied bedside sonography for convenient evaluation of superficial soft tissue infections. Acad Emerg Med. 2005 Jul;12(7):601-6. PubMed PMID: 15995090.
  5. Subramaniam S, Bober J, Chao J, Zehtabchi S. Point-of-care Ultrasound for Diagnosis of Abscess in Skin and Soft Tissue Infections. Acad Emerg Med. 2016 Nov;23(11):1298-1306. doi: 10.1111/acem.13049. Epub 2016 Nov 1. Review. PubMed PMID: 27770490.
  6. Marin et al. Emergency Ultrasound-assisted Examination of Skin and Soft Tissue Infections in the Pediatric Emergency Department. Acad Emerg Med. 2006; 20:545-53. doi: 10.1111/acem.12148
  7. Iverson et al. The effect of bedside ultrasound on diagnosis and management of soft tissue infections in a pediatric ED. Am J of Emerg Med. 2012; 30: 1347-51. doi:10.1016/j.ajem.2011.09.020.
  8. Tayal VS, Hasan N, Norton HJ, Tomaszewski CA. The effect of soft-tissue ultrasound on the management of cellulitis in the emergency department. Acad Emerg Med. 2006 Apr;13(4):384-8. Epub 2006 Mar 10. PubMed PMID: 16531602.
  9. Sivitz et al. Effect of Bedside Ultrasound on Management of Pediatric Soft Tissue Infection. J of Emerg Med. 2010; 39(5): 637-43. doi:10.1016/j.jemermed.2009.05.013.
  10. Yen ZS, Wang HP, Ma HM, Chen SC, Chen WJ. Ultrasonographic screening of clinically-suspected necrotizing fasciitis. Acad Emerg Med. 2002 Dec;9(12):1448-51. PubMed PMID: 12460854.
  11. Jacobson JA, Powell A, Craig JG, Bouffard JA, van Holsbeeck MT. Wooden foreign bodies in soft tissue: detection at US. Radiology. 1998 Jan;206(1):45-8. PubMed PMID: 9423650.9.     Davis J, Czerniski B, Au A, Adhikari S, Farrell I, Fields JM. Diagnostic Accuracy of Ultrasonography in Retained Soft Tissue Foreign Bodies: A Systematic Review and Meta-analysis. Acad Emerg Med. 2015 Jul;22(7):777-87. doi: 10.1111/acem.12714. Epub 2015 Jun 25. Review. PubMed PMID: 26111545.
  12. Fabiszewska, E., Pasicz, K., Grabska, I., Skrzyński, W., Ślusarczyk-Kacprzyk, W., & Bulski, W. (2017). Evaluation of Imaging Parameters of Ultrasound Scanners: Baseline for Future Testing. Polish journal of radiology, 82, 773-782. doi:10.12659/PJR.904135
  13. Lee MC, Rios AM, Aten MF, Mejias A, Cavuoti D, McCracken GH Jr, Hardy RD. Management and outcome of children with skin and soft tissue abscesses caused by community-acquired methicillin-resistant Staphylococcus aureus. Pediatr Infect Dis J. 2004 Feb;23(2):123-7. PubMed PMID: 14872177.
  14. Tayal VS, Hasan N, Norton HJ, Tomaszewski CA. The effect of soft-tissue ultrasound on the management of cellulitis in the emergency department. Acad Emerg Med. 2006 Apr;13(4):384-8. Epub 2006 Mar 10. PubMed PMID: 16531602.
  15. Barbaric D et al. In patients presenting to the emergency department with skin and soft tissue infections what is the diagnostic accuracy of point-of-care ultrasonography for the diagnosis of abscess compared to the current standard of care? A systematic review and meta-analysis. 2017. BMJ Open. Jan 10;7(1):e013688.
  16. Dean AJ et al. Techniquefor emergency medicine bedside ultrasound identification of a radiolucent foreign body. 2003. J Emerg Med. Apr;24(3):303-8.
  17. Gaspari RJ and Sanseverino A. Ultrasound-Guided Drainage for Pediatric Soft Tissue. 2018. J Ultrasound Med. Jan;37(1):131-136.
  18. Lin MJ et al. Point-of-Care Ultrasound is Associated With Decreased Length of Stay in Children Presenting to the Emergency Department With Soft Tissue Infection. 2018. J Emerg Med. Jan;54(1):96-101
  19. Mallin M and Dawson M. “Introduction to Bedside Ultrasound: Volume 2.” Emergency Ultrasound Solutions, 2013. iBooks. https://itunes.apple.com/us/book/introduction-to-bedside-ultrasound-volume-2/id647356692?mt=11
  20. Nienaber A et al. Accuracyof bedside ultrasound for the detection of soft tissue foreign bodies by emergency doctors. Emerg Med Australas. 2010 Feb;22(1):30-4.

 

Note: Videos and images thanks to Amanda Toney at Denver Health, Jon Orsborn at Children’s Hospital Colorado and personal images of the author Julia Brant from Children’s Hospital Co.

Summary

Summary

Bedside ultrasound is useful for diagnosing and managing many skin soft tissue conditions. It can help distinguish cellulitis from abscess more reliably than clinical exam alone as well as guide drainage. It also helps to identify and locate foreign bodies. In addition to adding diagnostic value, bedside ultrasound has also been shown to decrease length of stay in the emergency department, increase patient perception of emergency physician skill, and improve patient satisfaction with ED care. Mastering skin and soft tissue sonography will improve your clinical skills and enhance the care you provide to you patients.

 

References

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