BACKGROUND: The objective of this study is to determine if point-of-care ultrasound(POCUS) pre-procedure identification of landmarks can decrease failure rate, reduce procedural time, and decrease the number of needle...BACKGROUND: The objective of this study is to determine if point-of-care ultrasound(POCUS) pre-procedure identification of landmarks can decrease failure rate, reduce procedural time, and decrease the number of needle redirections and reinsertions when performing a lumbar puncture(LP).METHODS: This was a prospective, randomized controlled trial comparing POCUS preprocedure identifi cation of landmarks versus traditional palpation for LP in a cohort of patients in the emergency department and intensive care unit.RESULTS: A total of 158 patients were enrolled. No signifi cant difference was found in time to completion, needle re-direction, or needle re-insertion when using POCUS when compared to the traditional method of palpation.CONCLUSION: Consistent with fi ndings of previous studies, our data indicate that there was no observed benefi t of using POCUS to identify pre-procedure landmarks when performing an LP.展开更多
BACKGROUND: The current standard for con? rmation of correct supra-diaphragmatic central venous catheter(CVC) placement is with plain ? lm chest radiography(CXR). We hypothesized that a simple point-of-care ultrasound...BACKGROUND: The current standard for con? rmation of correct supra-diaphragmatic central venous catheter(CVC) placement is with plain ? lm chest radiography(CXR). We hypothesized that a simple point-of-care ultrasound(POCUS) protocol could effectively con? rm placement and reduce time to con? rmation.METHODS: We prospectively enrolled a convenience sample of patients in the emergency department and intensive care unit who required CVC placement. Correct positioning was considered if turbulent flow was visualized in the right atrium on sub-xiphoid, parasternal or apical cardiac ultrasound after injecting 5 cc of sterile, non-agitated, normal saline through the CVC.RESULTS: Seventy-eight patients were enrolled. POCUS had a sensitivity of 86.8%(95%CI 77.1%–93.5%) and speci? city of 100%(95%CI 15.8%–100.0%) for identifying correct central venous catheter placement. Median POCUS and CXR completion were 16 minutes(IQR 10–29) and 32 minutes(IQR 19–45), respectively.CONCLUSION: Ultrasound may be an effective tool to confirm central venous catheter placement in instances where there is a delay in obtaining a con? rmatory CXR.展开更多
BACKGROUND: The study aimed to compare the time to overall length of stay(LOS) for patients who underwent point-of-care ultrasound(POCUS) versus radiology department ultrasound(RDUS).METHODS: This was a prospective st...BACKGROUND: The study aimed to compare the time to overall length of stay(LOS) for patients who underwent point-of-care ultrasound(POCUS) versus radiology department ultrasound(RDUS).METHODS: This was a prospective study on a convenience sample of patients who required pelvic ultrasound imaging as part of their emergency department(ED) assessment.RESULTS: We enrolled a total of 194 patients who were on average 32 years-old. Ninety-eight(51%) patients were pregnant(<20 weeks). Time to completion of RDUS was 66 minutes longer than POCUS(95%CI 60–73, P<0.01). Patients randomized to the RDUS arm experienced a 120 minute longer ED length of stay(LOS)(95%CI 66–173, P<0.01)CONCLUSION: In patients who require pelvic ultrasound as part of their diagnostic evaluation, POCUS resulted in a signifi cant decrease in time to ultrasound and ED LOS.展开更多
文摘BACKGROUND: The objective of this study is to determine if point-of-care ultrasound(POCUS) pre-procedure identification of landmarks can decrease failure rate, reduce procedural time, and decrease the number of needle redirections and reinsertions when performing a lumbar puncture(LP).METHODS: This was a prospective, randomized controlled trial comparing POCUS preprocedure identifi cation of landmarks versus traditional palpation for LP in a cohort of patients in the emergency department and intensive care unit.RESULTS: A total of 158 patients were enrolled. No signifi cant difference was found in time to completion, needle re-direction, or needle re-insertion when using POCUS when compared to the traditional method of palpation.CONCLUSION: Consistent with fi ndings of previous studies, our data indicate that there was no observed benefi t of using POCUS to identify pre-procedure landmarks when performing an LP.
文摘BACKGROUND: The current standard for con? rmation of correct supra-diaphragmatic central venous catheter(CVC) placement is with plain ? lm chest radiography(CXR). We hypothesized that a simple point-of-care ultrasound(POCUS) protocol could effectively con? rm placement and reduce time to con? rmation.METHODS: We prospectively enrolled a convenience sample of patients in the emergency department and intensive care unit who required CVC placement. Correct positioning was considered if turbulent flow was visualized in the right atrium on sub-xiphoid, parasternal or apical cardiac ultrasound after injecting 5 cc of sterile, non-agitated, normal saline through the CVC.RESULTS: Seventy-eight patients were enrolled. POCUS had a sensitivity of 86.8%(95%CI 77.1%–93.5%) and speci? city of 100%(95%CI 15.8%–100.0%) for identifying correct central venous catheter placement. Median POCUS and CXR completion were 16 minutes(IQR 10–29) and 32 minutes(IQR 19–45), respectively.CONCLUSION: Ultrasound may be an effective tool to confirm central venous catheter placement in instances where there is a delay in obtaining a con? rmatory CXR.
文摘BACKGROUND: The study aimed to compare the time to overall length of stay(LOS) for patients who underwent point-of-care ultrasound(POCUS) versus radiology department ultrasound(RDUS).METHODS: This was a prospective study on a convenience sample of patients who required pelvic ultrasound imaging as part of their emergency department(ED) assessment.RESULTS: We enrolled a total of 194 patients who were on average 32 years-old. Ninety-eight(51%) patients were pregnant(<20 weeks). Time to completion of RDUS was 66 minutes longer than POCUS(95%CI 60–73, P<0.01). Patients randomized to the RDUS arm experienced a 120 minute longer ED length of stay(LOS)(95%CI 66–173, P<0.01)CONCLUSION: In patients who require pelvic ultrasound as part of their diagnostic evaluation, POCUS resulted in a signifi cant decrease in time to ultrasound and ED LOS.