Emergency Department versus Radiology Department Pelvic Ultrasound and Effect on Patient Length of Stay: A Randomized Control Trial

Bertoglio, Kiah; Fischetti, Chanel; Cruz, Amanda Fonseca; Vandordaklou, N.; Alotis, A.; Mervis, E.; Fox, Charles J.

doi:10.1016/j.annemergmed.2013.07.040

Cited by 1 publication

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“…[12] Much research has been done regarding POCUS in the ED including its accuracy and impact on efficiency. [1314151617] The number of residency programs that offer fellowships in emergency ultrasound has grown and has, therefore, increased the number of ultrasound fellowship-trained emergency physicians and residency-graduated emergency physicians comfortable for performing POCUS. [12] In recent years with the promulgation of ultrasound, it has become evident that POCUS may be used to measure optic nerve sheath diameter (ONSD), which serves as a reliable marker for elevated ICP when ONSD is increased.…”

Section: Introductionmentioning

confidence: 99%

The influence of cervical collar immobilization on optic nerve sheath diameter

Yard

Richman

Leeson

et al. 2019

J Emerg Trauma Shock

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Background: Prior research has revealed that cervical collars elevate intracranial pressure (ICP) in patients with traumatic brain injury. Two recent small studies evaluated the change in optic sheath nerve diameter (ONSD) measured by ultrasound as a proxy for ICP following cervical collar placement in healthy volunteers. Objective: We sought to validate the finding that ONSD measured by ultrasound increases after cervical collar placement within an independent data set. Methods: This was a prospective, crossover study involving volunteers. Participants were randomized to either have the ONSD measured first without a cervical collar or initially with a cervical collar. Two sonographers performed independent ONSD diameter measurements. Continuous data were analyzed by matched-paired t -tests. Alpha was set at 0.05. The primary outcome parameter was the overall mean difference between ONSD measurements with the cervical collar on and off. Multiple linear regression was performed to examine the relationship between variables and the primary outcome parameter. Results: There were 30 participants enrolled in the study. Overall mean ONSD for participants without the collar was 0.365 ± 0.071 cm and with the collar was 0.392 ± 0.081 cm. The mean change in ONSD for participants with and without the collar was 0.026 ± 0.064 cm (95% confidence interval of difference: 0.015–0.038; P < 0.001). Multiple regression analysis did not identify any variables associated with the variation in ONSD observed for collar versus noncollar. Conclusions: We confirmed that ONSD does vary by a measurable amount with placement of a rigid cervical collar on healthy volunteers when assessed by ultrasound.

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