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4 results

  • Chapter 9 - Point-of-Care Abdominal Ultrasound

  • Edited by Andrew B. Leibowitz, Suzan Uysal
  • Book:
    Modern Monitoring in Anesthesiology and Perioperative Care
    Published online:
    28 April 2020
    Print publication:
    07 May 2020, pp 92-99

  • Summary

    Abdominal ultrasonography is an extremely valuable diagnostic tool for all perioperative physicians. While the FAST exam was designed for use in patients with blunt abdominal trauma, its principles are applicable in a wide variety of perioperative settings and can be used to narrow the differential diagnosis in unstable patients. Aortic ultrasound is easy to perform and rapidly confirms or rules out the presence of abdominal aortic aneurysm or dissection. Other uses include gallbladder imaging and evaluation for free intra-peritoneal air. Perioperative and intensive care unit patients will benefit from point-of-care ultrasound, including detailed examination of the abdominal cavity.

  • Portable Handheld Ultrasound in Austere Environments: Use in the Haiti Disaster

  • Meghan Shorter, Darryl J. Macias
  • Journal:
    Prehospital and Disaster Medicine / Volume 27 / Issue 2 / April 2012
    Published online by Cambridge University Press:
    17 May 2012, pp. 172-177
    Print publication:
    April 2012
  • Introduction

    A 7.0 magnitude earthquake struck Haiti on January 12, 2010, resulting in 222,000 deaths and 300,000 injuries. Three weeks after the initial quake, the New Mexico Disaster Medical Assistance Team (NM DMAT-1) was deployed to Haiti for ongoing medical relief. During this deployment, a portable handheld ultrasound machine was tested for usefulness in aiding with patient care decisions.

    Objective

    The utility of portable ultrasound to help with triage and patient management decisions in a major disaster setting was evaluated.

    Methods

    Retrospective observational non-blinded images were obtained on 51 patients voluntarily presenting to the Gheskio Field clinic at Port-au-Prince. Ultrasound was used for evaluation of undifferentiated hypotension, torso trauma, pregnancy, non-traumatic abdominal pain, deep venous thrombosis and pulmonary embolism, and dyspnea-chest pain, as well as for assisting with procedures. Scans were obtained using a Signos personal handheld ultrasound machine with images stored on a microSD card. Qualitative data were reviewed to identify whether ultrasound influenced management decisions, and results were categorized in terms of percent of scans that influenced management.

    Results

    Fifty-one ultrasound scans on 50 patients were performed, with 35% interpreted as positive, 41% as negative, and 24% as equivocal. The highest yields of information were for abdominal ultrasound and ultrasound related to pregnancy. Ultrasound influenced decisions on patient care in 70% of scans. Most of these decisions were reflected in the clinician's confidence in discharging a patient with or without non-emergent follow-up.

    Conclusion

    The use of a handheld portable ultrasound machine was effective for patient management decisions in resource-poor settings, and decreased the need to triage selected patients to higher levels of care. Ultrasound was very useful for evaluation of non-traumatic abdominal pain. Dynamic capability is necessary for ultrasound evaluation of undifferentiated hypotension and cardiac and lung examinations. Ultrasound also was useful for guidance during procedural applications, and for aiding in the diagnosis of parasitic diseases.

    Shorter M, Macias D. Portable handheld ultrasound in austere environments: use in the Haiti disaster. Prehosp Disaster Med. 2012;27(2):1-6.

  • 24 - Abdominal Ultrasound

  • from PART II - ULTRASOUND
  • Edited by J. Christian Fox, University of California, Irvine
  • Book:
    Clinical Emergency Radiology
    Published online:
    07 December 2009
    Print publication:
    29 September 2008, pp 337-346

  • Summary

    Abdominal ultrasound has become an extremely useful imaging modality in emergency medicine. Acute appendicitis can be diagnosed with ultrasound and is the preferred initial imaging modality by some clinicians for certain populations, such as in pregnant patients, to avoid ionizing radiation. Ultrasound can be a useful imaging modality for evaluation of abdominal wall hernias, such as ventral wall hernias, incisional hernias, spigelian hernias, femoral hernias, and inguinal hernias. The diseases of the GI tract that can be detected by ultrasound, but may be more appropriately detected by CT scan, are diverticulitis, bowel obstruction, and Crohn disease. Ultrasound imaging of the pancreas is not routinely sought in the ED, but rather more often done on an inpatient or outpatient basis for ultrasound-guided procedures. Ultrasound can be a challenging modality in obese patients and thus has some limitation in the evaluation of various intraabdominal diseases, such as appendicitis.

  • Cystic echinococcosis: analysis of the serological profile related to the risk factors in individuals without ultrasound liver changes living in an endemic area of Tacuarembó, Uruguay

  • A. HERNÁNDEZ, G. CARDOZO, S. DEMATTEIS, A. BAZ, N. TRIAS, H. NUÑEZ, A. BARRAGUÉ, L. LÓPEZ, J. FUENTES, O. LÓPEZ, C. FERREIRA
  • Journal:
    Parasitology / Volume 130 / Issue 4 / April 2005
    Published online by Cambridge University Press:
    02 November 2004, pp. 455-460

  • Cystic echinococcosis (CE) is a high prevalence zoonosis among the rural population of Tacuarembó (Uruguay). The correlation between serological data and the incidence of risk factors was studied in a survey carried out in 1998 among rural communities where 480 individuals were examined by means of abdominal sonography (local prevalence=0·8%). Serum samples (305) were analysed by ELISA to determine specific IgG against crude antigens from Echinococcus granulosus. A total of 27 individuals exhibiting no detectable changes in abdominal sonographic examination were found to be seropositive (‘ultrasound normal group’). Of these individuals 9 were seroreactive against purified antigen B. A significant degree of correlation was found between seroreactivity and the incidence of some risk factors (CE antecedent in the family, P<0·005 and use of rural water, P<0·0001) among this group. Follow-up of individuals of the ‘ultrasound normal group’ was carried out after 2 years to evaluate the implications of this serological reactivity. No predictive value for cyst development was assessed with complementary image study; in contrast transient antibodies were observed with both crude and purified antigen as approximately 60% of individuals became negative when re-sampled.