Ultrasound GEL

TEE in the ED

The benefits of transesophageal echocardiography (TEE) have been known a long time. It offers more consistent and superior image quality. However, because it is invasive and requires extra training, it has remained in the hands of specialists. Recently, it has been gaining use in the emergency department for special situations in which it has an advantage over transthoracic echo (TTE). This paper examines one department's experience and shows what TEE can offer.

Ultrasound in Cardiac Arrest

Ultrasound is used in cardiac arrest commonly. Often times people may stop a resuscitation based on the finding of no sonographic cardiac activity or continue a resuscitation if there are signs of cardiac activity. The question asked here is "really how well does ultrasound predict that this patient will live or die?". This is a high quality study taking a look at this important issue.

Echo for Right Ventricular Dysfunction in PE

Ultrasound is commonly used in patients with pulmonary embolism to determine if there are signs of right ventricular dysfunction. This is valuable information that can help with prognostication and determining if a patient may benefit from certain interventions. The authors here wanted to know if providers need to wait for an echocardiographer or if they can perform the study themselves accurately. What do you think?

Ultrasound for Shoulder Dislocation

Have you ever used ultrasound to diagnose a shoulder dislocation? Why not?! The shoulder is one of the most commonly dislocated joints. We rely heavily on xray to diagnose the dislocation and also to confirm reduction. What if there was a faster way to know? Newsflash - there is! In addition to diagnosing dislocation, ultrasound, using its dynamic powers, can actually confirm your reduction as well! Oh I get it....you are worried about missing fractures. Well maybe ultrasound can help with that too...better check out this study to see just how well ultrasound performs in all of these tasks.

Comparison of Four views versus Single View for Pneumothorax

Ultrasound is great at diagnosing pneumothorax. This is especially important in the trauma patient, where it has become integrated into the extended FAST exam. I think we are all wondering if we can (safely) get away with a quick look in a single space bilaterally to rule out a significant pneumothorax. This study prospectively evaluates this question to determine how well 1 view compares to 4 views in finding a pneumothorax in the trauma patient.

Extravasation of IVs placed by Ultrasound

This article examines an issue that we all face. It can be frustrating to take the time to place an IV only to have it blow during a vital CT scan. Is this a result of the IV being placed by ultrasound or a result of the underlying causes that led to the patient having poor venous access? Come find out.

Ultrasound in Pediatric Pneumonia

This study looks at how well point of care ultrasound performs in the evaluation for pneumonia in a pediatric emergency department. Two study arms were compared - an ultrasound first approach, in which patients did not necessarily require a chest xray, and a chest xray first approach, followed by an ultrasound. The authors hypothesized that using ultrasound could reduce the number of chest xrays needed. They performed follow up to see if there was any difference in return visits or antibiotic prescriptions. Impressive results followed!

Multiorgan Ultrasound for Pulmonary Embolism

We review a prospective study evaluating the accuracy of a combo ultrasound of the lung, heart, and veins to diagnose pulmonary embolism (PE) using CT pulmonary angiography as gold standard. Is it possible to use ultrasound to rule out a PE? Listen to our thoughts and let us know what you think!

Importance of the Left Upper Quadrant View in the FAST exam

The left upper quadrant view in the FAST (focused assessment with sonography for trauma) exam can be difficult to get just right. This paper examines how important it is in finding intraabdominal free fluid. The authors reviewed FAST exams to determine how often there is free fluid only in the left upper quadrant. Also, they looked to see which part of the left upper quadrant free fluid went to most often. Spoiler alert: its not the subphrenic space!

The Spine Sign

This paper examines the utility of the extension of the thoracic spine sign at detecting subtle pleural effusions on point-of-care lung ultrasound.