“…We evaluated both the frequency and speed that physicians at varying skill levels were able to obtain measurements to calculate both VTI and diastolic heart failure. As multiple prior studies have proven that FOCUS impacts decision making, this study only sought to prove feasibility of performance of advanced cardiac measurements, not the impact they have on decision making [ 16 – 18 ]. Fig.…”
BackgroundThis study aims to compare the increased time needed to perform advanced focused cardiac measurements in the emergency department, including diastolic heart failure evaluation via E/E′, and cardiac output with LVOT/VTI. Patients with pertinent cardiopulmonary symptoms in the emergency department had a focused cardiac ultrasound performed by the emergency department ultrasound team. The ability to obtain basic cardiac windows, evaluate for effusion, systolic ejection fraction, and right-sided heart pressures were recorded. Advanced measurements, along with time to obtain all images and the training level of the provider, were recorded.ResultsFifty-three patients were enrolled. Basic focused cardiac windows were able to be obtained in 80% of patients. The average 4-window focused cardiac ultrasound took 4 min and 49 s to perform. Diastolic measurements were able to be obtained in 51% of patients, taking an average of 3 min and 17 s. Cardiac output measurements were able to be obtained in 53% of patients, taking an average of 3 min and 8 s.ConclusionThe ability to obtain these images improved with increasing level of training. Performing both cardiac output and diastolic measurements increased the time with bedside ultrasound by 6 min and 25 s, and were able to be obtained in slightly over half of all ED patients.
“…We evaluated both the frequency and speed that physicians at varying skill levels were able to obtain measurements to calculate both VTI and diastolic heart failure. As multiple prior studies have proven that FOCUS impacts decision making, this study only sought to prove feasibility of performance of advanced cardiac measurements, not the impact they have on decision making [ 16 – 18 ]. Fig.…”
BackgroundThis study aims to compare the increased time needed to perform advanced focused cardiac measurements in the emergency department, including diastolic heart failure evaluation via E/E′, and cardiac output with LVOT/VTI. Patients with pertinent cardiopulmonary symptoms in the emergency department had a focused cardiac ultrasound performed by the emergency department ultrasound team. The ability to obtain basic cardiac windows, evaluate for effusion, systolic ejection fraction, and right-sided heart pressures were recorded. Advanced measurements, along with time to obtain all images and the training level of the provider, were recorded.ResultsFifty-three patients were enrolled. Basic focused cardiac windows were able to be obtained in 80% of patients. The average 4-window focused cardiac ultrasound took 4 min and 49 s to perform. Diastolic measurements were able to be obtained in 51% of patients, taking an average of 3 min and 17 s. Cardiac output measurements were able to be obtained in 53% of patients, taking an average of 3 min and 8 s.ConclusionThe ability to obtain these images improved with increasing level of training. Performing both cardiac output and diastolic measurements increased the time with bedside ultrasound by 6 min and 25 s, and were able to be obtained in slightly over half of all ED patients.
“…POCUS related to airways is used for detection of cricothyroid membranes or trachea rings for cricothyroidotomy or tracheostomy, tracheal or oesophageal placement of endotracheal tubes, and diaphragmatic movement or lung sliding for confirmation of tracheal placement[ 2 , 5 - 7 , 21 ]. The simulators related to POCUS of lungs will be introduced in the next section, “related to B- Breathing”.…”
Section: Simulators Of Specific Targetsmentioning
confidence: 99%
“…POCUS related to breathing such as dyspnoea is used for detection of hemothorax, pleural effusion, pneumothorax, pulmonary embolism, pneumonia, alveolar/interstitial disease, and thoracentesis by using a lung ultrasound[ 3 , 5 - 7 , 43 ]. The definition of the lung ultrasound findings was not described in this review article because they are out the scope of this review.…”
Section: Simulators Of Specific Targetsmentioning
confidence: 99%
“…POCUS related to circulation such as shock and vascular access for resuscitation is used for the detection of pericardial effusion such as cardiac tamponade. This can include pulmonary embolisms, severe dysfunction of left ventricle, regional wall motion abnormalities, evaluation of the aorta (aortic dissection or aortic aneurysm), or determine vascular access for resuscitation by using a vessel ultrasound[ 3 , 5 - 7 , 43 ]. In terms of focused echocardiography, four articles on cardiac tamponade and pericardio-centesis detection were found[ 20 , 26 , 37 , 38 ].…”
Section: Simulators Of Specific Targetsmentioning
confidence: 99%
“…These include cases of hemothorax, pneumothorax, cardiac tamponade, hemoperitoneum, rupture of abdominal aortic aneurysm or dissection, or resuscitation due to shock in an intensive care unit or emergency room. The importance of POCUS in a clinical practice context is well-established[ 3 , 5 - 7 ].…”
Point-of-care ultrasound (POCUS) is a powerful diagnostic tool and provides treatment guidelines in acute critical settings. However, the limitation of using POCUS is operator dependent. Appropriate and validated training for acquiring and using skills in practice must be conducted before using POCUS in clinical settings in order to keep patients safe. Simulation education models have been introduced as a way to solve and overcome these concerns. However, the commercial simulator with sufficiently secured fidelity is expensive and not always available. This review focused on the inexpensive and easily made simulators for education on POCUS in critical specific situations related to the airway, breathing, circulation, and disability. We introduced the simulators that used non-infectious materials, with easily transportable features, and that had a sonographic appearance reproducibility similar to human tissue. We also introduced the recipe of each simulator in two parts: Materials surrounding disease simulators (surrounding materials) and specific disease simulators themselves (target simulators). This review article covered the following: endotracheal or oesophageal intubation, lung (A-lines, B-lines, lung sliding, and pleural effusions such as hemothorax), central vein access, pericardial fluid (cardiac tamponade), the structure related to the eyes, soft tissue abscess, nerve (regional nerve block), and skull fracture simulators.
The advent of portable devices in the early 80s has brought ultrasonography to the patient's bedside. Currently referred to as 'point of care ultrasonography' (POCUS), it has become an essential tool for clinicians. Initially developed in the emergency and critical care settings, POCUS has gained increasing importance in internal medicine wards in the last decade, with both its growing diagnostic accuracy and portability making POCUS an optimal instrument for everyday clinical assessment and procedures. There is large body of evidence to confirm POCUS' superiority when compared to clinical examination and standard X-ray imaging in a variety of clinical situations. On the contrary, only few indications, such as procedural guidance, have a proven additional benefit for patients. Since POCUS is highly user-dependent, pre-and post-graduate curricula are needed and the range of use should be clearly defined. This review focuses on trends and perspectives of POCUS in the management of diseases frequently encountered in emergency and internal medicine. In addition, questions are raised regarding the teaching and supervision of POCUS needing to be addressed in the near future.
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