325: Access to Immediate Bedside Ultrasound in the Emergency Department

Talley, Brad; Ginde, Adit A.; Raja, Ali S.; Sullivan, A.; Camargo, Carlos A.

doi:10.1016/j.annemergmed.2009.06.356

Cited by 12 publications

(23 citation statements)

References 11 publications

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“…A national survey on PoC US use, based on this statewide survey and others like it, would provide valuable information about changes over time (2,20,23). Such information would be very helpful to clinicians and policy makers as they can potentially improve access to ED PoC US.…”

Section: Limitationsmentioning

confidence: 95%

Use of Point-of-Care Ultrasound in Connecticut Emergency Departments

Herbst¹,

Camargo²,

Pérez³

et al. 2015

The Journal of Emergency Medicine

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Section: Limitationsmentioning

confidence: 95%

Use of Point-of-Care Ultrasound in Connecticut Emergency Departments

Herbst¹,

Camargo²,

Pérez³

et al. 2015

The Journal of Emergency Medicine

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“…Ultrasonography currently has some limitations, but efforts are underway to improve its effectiveness for kidney stone imaging. Moving forward, use of point-of-care ultrasonography is rapidly increasing, which will probably increase operator experience and confidence with this modality 47,48 . Research efforts should continue, with a focus on improving stone visualization; increasing sensitivity, specificity and stone sizing; and decreasing user variability.…”

Section: Ultrasonographymentioning

confidence: 99%

An overview of kidney stone imaging techniques

2016

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Kidney stone imaging is an important diagnostic tool and initial step in deciding which therapeutic options to use for the management of kidney stones. Guidelines provided by the American College of Radiology, American Urological Association, and European Association of Urology differ regarding the optimal initial imaging modality to use to evaluate patients with suspected obstructive nephrolithiasis. Noncontrast CT of the abdomen and pelvis consistently provides the most accurate diagnosis but also exposes patients to ionizing radiation. Traditionally, ultrasonography has a lower sensitivity and specificity than CT, but does not require use of radiation. However, when these imaging modalities were compared in a randomized controlled trial they were found to have equivalent diagnostic accuracy within the emergency department. Both modalities have advantages and disadvantages. Kidney, ureter, bladder (KUB) plain film radiography is most helpful in evaluating for interval stone growth in patients with known stone disease, and is less useful in the setting of acute stones. MRI provides the possibility of 3D imaging without exposure to radiation, but it is costly and currently stones are difficult to visualize. Further developments are expected to enhance each imaging modality for the evaluation and treatment of kidney stones in the near future. A proposed algorithm for imaging patients with acute stones in light of the current guidelines and a randomized controlled trial could aid clinicians.

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“…One survey of ED directors in Colorado, Georgia, Massachusetts, and Oregon reported that only 39% of rural EDs had access to bedside ultrasound. 18 However, another survey of American rural emergency physicians (with a low response rate of 18%) in the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) region conducted by Bellows et al in 2015 discovered that 96% had access to an ultrasound machine in the ED. 19 …”

Section: Lack Of Equipmentmentioning

confidence: 99%

Barriers to point-of-care ultrasound use in rural emergency departments

Micks

Sue

Rogers

2016

CJEM

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Over the past few decades, point-of-care ultrasound (PoCUS) has come to play a major role in the practice of emergency medicine. Despite its numerous benefits, there has been a slow uptake of PoCUS use in rural emergency departments. Surveys conducted across Canada and the United States have identified a lack of equipment, training, funding, quality assurance, and an inability to maintain skills as major barriers to PoCUS use. Potential solutions include expanding residency training in ultrasound skills, extending funding for PoCUS training to rural physicians in practice, moving PoCUS training courses to rural sites, and creating telesonography training for rural physicians. With these barriers identified and solutions proposed, corrective measures must be taken so that the benefits of PoCUS are extended to patients in rural Canada where, arguably, it has the greatest potential for benefit when access to advanced imaging is not readily available.

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325: Access to Immediate Bedside Ultrasound in the Emergency Department

Cited by 12 publications

References 11 publications

Use of Point-of-Care Ultrasound in Connecticut Emergency Departments

Use of Point-of-Care Ultrasound in Connecticut Emergency Departments

An overview of kidney stone imaging techniques

Barriers to point-of-care ultrasound use in rural emergency departments

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