A, B, C, D, echo

Ferrada, Paula; Vanguri, Poornima; Anand, Rahul; Whelan, James; Duane, Therèse M.; Aboutanos, Michel B.; Malhotra, Ajai K.; Ivatury, Rao R.

doi:10.1097/ta.0b013e318278918a

Cited by 44 publications

(5 citation statements)

References 34 publications

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“…With the cutoff of 40 %, the IVC collapsibility index that is maximum IVC diameter minus minimum IVC diameter divided by maximum IVC diameter times 100 % would only give a sensitivity of 70 %, specificity of 80 %, positive predictive value of 72 %, and negative predictive value of 83 % [ 30 ]. In trauma patients with hemorrhage, IVC measurement in addition to FAST is also helpful for managing trauma patients with hypovolemia to guide fluid therapy and shorten the time to operation theater [ 33 , 34 ].…”

Section: Introductionmentioning

confidence: 99%

Make it SIMPLE: enhanced shock management by focused cardiac ultrasound

Mok

2016

j intensive care

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BackgroundShock is a spectrum of circulatory failure that, if not properly managed, would lead to high mortality. Special diagnostic and treatment strategies are essential to save lives. However, clinical and laboratory findings are always non-specific, resulting in clinical dilemmas.Main contentFocused cardiac ultrasound (FoCUS) has emerged as one of the power tools for clinicians to answer simple clinical questions and guide subsequent management in hypotensive patients. This article will review the development and utility of FoCUS in different types of shock. The sonographic features and ultrasound enhanced management of hypotensive patients by a de novo “SIMPLE” approach will be described. Current evidence on FoCUS will also be reviewed.ConclusionFocused cardiac ultrasound provides timely and valuable information for the evaluation of shock. It helps to improve the diagnostic accuracy, narrow the possible differential diagnoses, and guide specific management. SIMPLE is an easy-to-remember mnemonic for non-cardiologists or novice clinical sonographers to apply FoCUS and interpret the specific sonographic findings when evaluating patients in shock.

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Section: Introductionmentioning

confidence: 99%

Make it SIMPLE: enhanced shock management by focused cardiac ultrasound

Mok

2016

j intensive care

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“…( 16 ) Ferrada et al, reported US-based management changes in 96% of cases involving trauma patients aged over 65 years. ( 17 ) Hemodynamic resuscitation can also be easily be performed in all cases under US guidance, as it allows determination of crystalloid or vasoactive drug needs in shock reversion. ( 18 - 20 )…”

Section: Discussionmentioning

confidence: 99%

Assessing how emergency and trauma ultrasonography is taught to medical students

Neto¹,

Marcondes²,

Ribeiro³

2019

Einstein (São Paulo)

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Objective To evaluate a method aimed at teaching ultrasound techniques to medical students in emergency settings. Methods A prospective study conducted with 66 sixth-year undergraduate medical students. Students participated in theory and practicing sessions with a 5-hour load; knowledge acquisition was assessed through pre- and post-course and 90-day tests. A questionnaire were distributed to the students after course completion for theoretical and practical knowledge assessment. Results Average pre-test grade in theoretical content evaluation was 4.9, compared to 7.6 right after course completion, and 5.9 within 90 days (p<0.001). Questions addressing technical aspects and image acquisition were mostly answered correctly; in contrast, questions related to clinical management of patients tended to be answered incorrectly. In practical evaluation, 54 students (81.8%) were able to correctly interpret images. Conclusion Ultrasound applicability and image acquisition techniques can be taught to medical students in emergency settings. However, teaching should be focused on technical aspects rather than clinical management of patients.

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“…As POCUS is a relatively new diagnostic and procedural modality, previous literature has focused on investigating its emerging indications and clinical utility, and emphasis was more on demonstrating its advantage over physical examination alone [ 1 – 11 ]. Therefore, less attention was paid to the timing of POCUS and how POCUS is best incorporated in the clinical workflow.…”

Section: Discussionmentioning

confidence: 99%

“…Point-of-care ultrasound (POCUS) is a rapidly evolving diagnostic modality that is performed and interpreted by providers at the bedside [ 1 – 7 ]. An increasing number of reports have shown that POCUS can modify diagnoses, direct further testing, and change medical therapy [ 8 – 19 ].…”

Section: Introductionmentioning

confidence: 99%

When to incorporate point-of-care ultrasound (POCUS) into the initial assessment of acutely ill patients: a pilot crossover study to compare 2 POCUS-assisted simulation protocols

Bennett

Samavedam

Jayaprakash

et al. 2018

Cardiovasc Ultrasound

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BackgroundThe purpose of this study was to determine the ideal timing for providers to perform point-of-care ultrasound (POCUS) with the least increase in workload.MethodsWe conducted a pilot crossover study to compare 2 POCUS-assisted evaluation protocols for acutely ill patients: sequential (physical examination followed by POCUS) vs parallel (POCUS at the time of physical examination). Participants were randomly assigned to 2 groups according to which POCUS-assisted protocol (sequential vs parallel) was used during simulated scenarios. Subsequently, the groups were crossed over to complete assessment by using the other POCUS-assisted protocol in the same patient scenarios. Providers’ workloads, measured with the National Aeronautics and Space Administration Task Load Index (NASA-TLX) and time to complete patient evaluation, were compared between the 2 protocols.ResultsSeven providers completed 14 assessments (7 sequential and 7 parallel). The median (IQR) total NASA-TLX score was 30 (30–50) in the sequential and 55 (50–65) in the parallel protocol (P = .03), which suggests a significantly lower workload in the sequential protocol. When individual components of the NASA-TLX score were evaluated, mental demand and frustration level were significantly lower in the sequential than in the parallel protocol (40 [IQR, 30–60] vs 50 [IQR, 40–70]; P = .03 and 25 [IQR, 20–35] vs 60 [IQR, 45–85]; P = .02, respectively). The time needed to complete the assessment was similar between the sequential and parallel protocols (8.7 [IQR, 6–9] minutes vs 10.1 [IQR, 7–11] minutes, respectively; P = .30).ConclusionsA sequential POCUS-assisted protocol posed less workload to POCUS operators than the parallel protocol.

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A, B, C, D, echo

Abstract: Diagnostic study, level III.

Cited by 44 publications

References 34 publications

Make it SIMPLE: enhanced shock management by focused cardiac ultrasound

Make it SIMPLE: enhanced shock management by focused cardiac ultrasound

Assessing how emergency and trauma ultrasonography is taught to medical students

When to incorporate point-of-care ultrasound (POCUS) into the initial assessment of acutely ill patients: a pilot crossover study to compare 2 POCUS-assisted simulation protocols

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