An overview of point-of-care ultrasound for soft tissue and musculoskeletal applications in the emergency department

Chen, Kuo-Chih; Lin, Aming Chor-Ming; Chong, Chee-Fah; Wang, Tzong-Luen

doi:10.1186/s40560-016-0173-0

Cited by 45 publications

(33 citation statements)

References 50 publications

(41 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…37,55 Echo guidance can be used to identify the vessel or to advance the needle under real-time ultrasound guidance. 56 The use of real-time ultrasound and experience with the procedure reduce the complication rate. 46,52,54 Real-time ultrasound guidance was not yet available at the time of all studies we included, and this may have caused bias between studies.…”

Section: Discussionmentioning

confidence: 99%

Central venous catheter placement in coagulopathic patients: risk factors and incidence of bleeding complications

Weerdt¹,

Biemond

Baake³

et al. 2017

Transfusion

View full text Add to dashboard Cite

BACKGROUND Central venous catheters are frequently inserted into patients with coagulation disorders. It is unclear whether preprocedural correction of hemostasis is beneficial. We determined the incidence of bleeding complications after central venous catheter placement in patients who had severe coagulopathy and identified potential risk factors for bleeding. STUDY DESIGN AND METHODS The MEDLINE and Cochrane Library databases were systematically searched through November 2015. To be included, articles must have reported on hemorrhagic complications with specification of abnormal coagulation testing results. Severe coagulopathy was defined as a reduced platelet count of 50 × 109/L or less, and/or an elevated international normalized ratio of 1.5 or greater, and/or a partial thromboplastin time of 45 seconds or greater. RESULTS We included one randomized controlled trial and 21 observational studies. In total, there were 13,256 catheter insertions, including 4213 in patients with severe coagulopathy. Before 3150 central venous catheter placements, coagulopathy was not corrected. The bleeding incidence varied from 0 to 32%. The severity of coagulopathy did not predict the risk of bleeding. No study demonstrated a beneficial effect from the prophylactic administration of platelets or fresh‐frozen plasma to prevent bleeding complications. Retrospective observational studies suggested that no preprocedural correction is required up to a platelet count of 20 × 109/L and an international normalized ratio of 3.0. CONCLUSION The incidence of major bleeding complications after central venous catheter placement is low, even in coagulopathic patients. Based on a systematic research of the literature, strong evidence supporting the correction of hemostatic defects before central venous catheter insertion is lacking. However, well‐powered randomized controlled trials will be necessary to determine the minimal platelet count, the maximal international normalized ratio, and an activated partial thromboplastin time that is safe before central venous catheter insertion.

show abstract

Section: Discussionmentioning

confidence: 99%

Central venous catheter placement in coagulopathic patients: risk factors and incidence of bleeding complications

Weerdt¹,

Biemond

Baake³

et al. 2017

Transfusion

View full text Add to dashboard Cite

show abstract

“…Recently, point-of-care ultrasound (POCUS) has been increasingly used at patients’ bedside for diagnostic and therapeutic purposes [10, 11] . POCUS also enables emergency or primary care physicians to quickly recognize musculoskeletal and soft tissue disorders and to provide better and safer cares [12]. Kelm et al revealed that a longitudinal curriculum for POCUS enhanced knowledge retention and the ability to recognize pathological findings for internal medicine residents [13].…”

Section: Introductionmentioning

confidence: 99%

Musculoskeletal ultrasound workshops in postgraduate physician training: a pre- and post-workshop survey of 156 participants

Chang

Han

et al. 2019

BMC Med Educ

View full text Add to dashboard Cite

Background Use of ultrasonography has revolutionized diagnosis of musculoskeletal disorders. Until now, few studies have investigated usefulness of a short-period workshop for musculoskeletal ultrasound (MSKUS) education. In this research, we attempted to explore (1) whether the physicians felt it useful to attend this type of courses for improving knowledge of sonoanatomy and scanning skills, (2) if the attendees’ perceived confidence in musculoskeletal diagnoses by using ultrasound increased following the program and (3) whether differences existed in perceived usefulness and confidence regrading different sessions of the course. Methods The target participants of the courses were postgraduate physicians without limitation of their specialties. The attendees’ responses to questionnaires before and after the course were reviewed. The workshop contained didactic and practical sessions on 6 major joints in accordance with the scanning protocols of EURO-MUSCULUS/USPRM. The course usefulness and perceived confidence in MSKUS examination were evaluated using a 5-point Likert scale. Data relevant to participants’ pre-workshop confidence levels were also analyzed. If any participant attended the course for more than 1 time, only their first survey was used for analysis. Results The study included 156 participants. The average rating for the course usefulness ranged between 4 (useful) to 5 (very useful). There was no difference in perceived usefulness between the didactic and hands-on practical sessions. Participants’ perceived confidence significantly increased after the workshop but appeared to be lowest for evaluation on the hip joint. Previous experience in performing MSKUS (in years) was consistently associated with the level of pre-workshop confidence. Conclusion A short period ultrasound workshop might be useful regarding making musculoskeletal diagnoses by using ultrasound based on an increase in post-workshop confidence in MSKUS examinations. The perceived confidence of hip scanning was lower than that of other joints after the course, indicating inadequacy of education in hip sonoanatomy and intensity of hand-on practice in the present program. An increase in the faculty-to-student ratio or length of practice in the hip section should be implemented in the future course.

show abstract

“…Diagnosis can often be made by history and clinical examination alone, however, up to 20% of these ruptures can be missed in the initial hyperacute phase [ 10 ]. A delay in diagnosis will lead to a delay in treatment which in turn can lead to a difficult repair; this leads to a poorer function in performance and strength for the patient [ 10 , 11 ].…”

Section: Reviewmentioning

confidence: 99%

The Role of Point of Care Ultrasound (PoCUS) in Orthopaedic Emergency Diagnostics

Oluku¹,

Stagl²,

Cheema³

et al. 2021

Cureus

View full text Add to dashboard Cite

Ultrasound has been described as the “stethoscope” of the radiologist; its ability to aid in clinical diagnosis with both static and dynamic imaging has allowed fast and accurate diagnosis. However, traditionally unlike a stethoscope, a large and bulky ultrasound machine made it difficult to use portably in a hospital environment where patients can be scattered across a hospital. With the development of innovative ultrasound technology, Point of Care Ultrasound (PoCUS) can readily be carried by a clinician to make a quick and timely diagnosis. In this review article we look at the uses of PoCUS within orthopaedic emergencies. Diagnosis in orthopaedics often requires further imaging beyond history taking, clinical examination and plain radiographs. In these cases PoCUS can be useful for ruling out occult fractures, diagnosing joint effusions and tendon ruptures. By aiding a speedy diagnosis, we can reduce unnecessary immobilisation, reduce inpatient stays, introduce early mobilisation and reduce harm to patients. With PoCUS becoming increasingly cheaper and more portable we feel this really can become the stethoscope of an orthopaedic surgeon.

show abstract

An overview of point-of-care ultrasound for soft tissue and musculoskeletal applications in the emergency department

Cited by 45 publications

References 50 publications

Central venous catheter placement in coagulopathic patients: risk factors and incidence of bleeding complications

Central venous catheter placement in coagulopathic patients: risk factors and incidence of bleeding complications

Musculoskeletal ultrasound workshops in postgraduate physician training: a pre- and post-workshop survey of 156 participants

The Role of Point of Care Ultrasound (PoCUS) in Orthopaedic Emergency Diagnostics

Contact Info

Product

Resources

About