Real-time B-mode ultrasound in the ED saves time in the diagnosis of deep vein thrombosis (DVT)

Theodoro, Daniel; Blaivas, Michael; Duggal, Sandeep; Snyder, Graham E.; Lucas, Michael

doi:10.1016/j.ajem.2004.02.007

Cited by 91 publications

(71 citation statements)

References 19 publications

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“…The literature supports the ability of general emergency physicians to use point-of-care US to improve the care of adult patients by accurately diagnosing time-sensitive and common ED conditions, decreasing patient lengths of stay, 15,[39][40][41] and reducing complications. 15,[42][43][44][45] Furthermore, emergency physicians are able to achieve competency in performing point-of-care US for various indications after completing adequate training.…”

Section: Diagnostic and Procedural Indicationsmentioning

confidence: 97%

Point-of-Care Ultrasonography by Pediatric Emergency Medicine Physicians

2015

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Emergency physicians have used point-of-care ultrasonography since the 1990s. Pediatric emergency medicine physicians have more recently adopted this technology. Point-of-care ultrasonography is used for various scenarios, particularly the evaluation of soft tissue infections or blunt abdominal trauma and procedural guidance. To date, there are no published statements from national organizations specifically for pediatric emergency physicians describing the incorporation of point-of-care ultrasonography into their practice. This document outlines how pediatric emergency departments may establish a formal point-of-care ultrasonography program. This task includes appointing leaders with expertise in point-of-care ultrasonography, effectively training and credentialing physicians in the department, and providing ongoing quality assurance reviews.Point-of-care ultrasonography (US) is a bedside technology that enables clinicians to integrate clinical examination findings with real-time sonographic imaging. General emergency physicians and other specialists have used point-of-care US for many years, and more recently, pediatric emergency medicine (PEM) physicians have adopted point-of-care US as a diagnostic and procedural adjunct. This technical report and accompanying policy statement 1 provide a framework for point-of-care US training and point-of-care US integration into pediatric care by PEM physicians.

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Section: Diagnostic and Procedural Indicationsmentioning

confidence: 97%

Point-of-Care Ultrasonography by Pediatric Emergency Medicine Physicians

2015

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“…The gold standard for diagnosing DVT of the lower extremities is "venography." However, today, due to being invasive and the need for intravenous contrast agents, the tendency to use this method is very low and is limited to specific cases (Jacobson, Patel, & Lewis, 1997;Theodoro, Blaivas, Duggal, Snyder, & Lucas, 2004;Tomkowski et al, 2007). Another method to detect DVT of the lower limbs is using duplex sonography.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Precision of Compression Ultrasonography and Duplex Sonography in Deep Venous Thrombosis Patients

Reihani¹,

Ahmadi²,

Rezanejad³

et al. 2016

GJHS

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Deep venous thrombosis is a prevalent disease and difficult being detected which can be lethal if developed. Ultrasonography and duplex ultrasonography are two of the diagnostic methods with their restrictions. The present study addresses the analysis of the succession of compression ultrasonography as a method with less restrictions in comparison with ultrasonography and duplex ultrasonography. The present study was conducted in the central urgency section of Imam Reza Hospital, Mashhad, Iran, which is a public academic institute, on 70 patients in 2014. All patients were subjected to compression ultrasonography before duplex ultrasonography and those who had previous duplex ultrasonography sessions with available results were excluded from the investigations. Finally, the results of 63 patients were analyzed, 7 being excluded due to their inaccessible data. According to the results, 52 percent of subjects were males and 48 percent were females. The result of the regular ultrasonography was positive for 37 and negative for 26 patients. Duplex ultrasonography, however, led to positive results for 35 patients (equivalent to 37 lower limb organs) and negative results for 28 subjects (equivalent to 41 lower limb organs). The sensitivity, specificity, and precision of the diagnosis via compression ultrasonography were found to be 97, 90, and 93.5 percent, respectively, and the positive and negative predictive values were calculated to be 90 and 97 percent, respectively, with a CI of 95 percent. The diagnostic accuracy of 96.8% suggests that the use of compression sonography can be a good accuracy in the diagnosis of deep vein thrombosis of the lower extremities, but it cannot replace more accurate methods that are currently used as available selected diagnostic methods.

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“…Emergency Medicine bedside ultrasound (EMBU) has been shown to improve health care delivery in the Emergency Department (ED) by reducing time to life-saving diagnoses, costs, and throughput times, and improving safety of invasive procedures and patient satisfaction (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). In 2001, "Bedside Ultrasonography" was included as an "integral procedure and skill" by the Core Content Task Force II in a document endorsed by the major professional organizations of the specialty of Emergency Medicine (EM), including the American Board of Emergency Medicine, the American College of Emergency Physicians, the Society for Academic Emergency Medicine, and the Council of Emergency Medicine Residency Directors (12).…”

Section: Introductionmentioning

confidence: 99%