Diagnostic utility of point of care ultrasound in identifying cervical spine injury in emergency settings

Vk, Vishnu; Bhoi, Sanjeev; Aggarwal, Praveen; Murmu, L R; Agrawal, Deepak; Kumar, Atin; Sinha, Tej Prakash; Galwankar, Sagar

doi:10.1002/ajum.12274

Cited by 3 publications

(2 citation statements)

References 24 publications

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“… 5 , 6 Our group also has explored novel techniques such as water bath for identifying extremity fractures 7 and cervical spine injuries. 8 CT scan is the gold standard for the identification of complications after post-craniectomy, but it has its drawbacks and limitations, such as radiation hazard, being unavailable at the bedside, less repeatability, and being expensive. 9…”

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confidence: 99%

Correlation between Transcranial Ultrasound and CT Head to Detect Clinically Significant Conditions in Post-craniectomy Patients Performed by Emergency Physician: A Pilot Study

Aggarwal,

Kumar,

Agrawal

et al. 2024

Indian Journal of Critical Care Medicine

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Background The main objective is to detect clinically significant conditions by transcranial ultrasound (TCS) in post-decompressive craniectomy (DC) patients who come to the emergency department. Materials and methods This was a cross-sectional observational study. We studied 40 post-DC patients. After primary stabilization, TCS was done. Computer tomography of head was done within 2 hours of performing TCS. The correlation between both modalities were assessed by the measurement of lateral ventricle (LV) (Bland-Altman plot), Midline shift and mass lesion. Additionally, normal cerebral anatomy, 3rd and 4th ventricles and external ventricular drainage (EVD) catheter visualization were also done. Results About 14/40 patients came with non-neurosurgical complaints and 26/40 patients came with neurosurgical complaints. Patients with non-neurosurgical complaints (4/14) had mass lesions and 1/14 had MLS. Patients with neurosurgical complaints (11/26) had mass lesions and about 5 patients had MLS. A good correlation was found between TCS and CT of head in measuring LV right (CT head = 17.4 ± 13.8 mm and TCS = 17.1 ± 14.8 mm. The mean difference (95% CI) = [0.28 (–1.9 to 1.33), ICC 0.93 (0.88–0.96)], Left [CT head = 17.8 ± 14.4 mm and TCS = 17.1 ± 14.2 mm, the mean difference (95% CI) 0.63 (–1.8 to 0.61), ICC 0.96 (0.93–0.98)], MLS [CT head = 6.16 ± 3.59 ( n = 7) and TCS = 7.883 ± 4.17 ( n = 6)] and mass lesions (kappa 0.84 [0.72–0.89] [95% CI] p -value < 0.001). The agreement between both modalities for detecting mass lesions is 93.75%. Conclusion Point of care ultrasound (POCUS) is a bedside, easily operable, non-radiation hazard and dynamic imaging tool that can be used for TCS as a supplement to CT head in post-DC patients in emergency as well as in ICU. However, assessment of the ventricular system (pre/post-EVD insertion), monitoring of regression/progression of mass lesion, etc. can be done with TCS. Repeated scans are possible in less time which can decrease the frequency of CT head. How to cite this article Chouhan R, Sinha TP, Bhoi S, Kumar A, Agrawal D, Nayer J, et al . Correlation between Transcranial Ultrasound and CT Head to Detect Clinically Significant Conditions in Post-craniectomy Patients Performed by Emergency Physician: A Pilot Study. Indian J Crit Care Med 2024;28(3):299–306.

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Section: Introductionmentioning

confidence: 99%

Correlation between Transcranial Ultrasound and CT Head to Detect Clinically Significant Conditions in Post-craniectomy Patients Performed by Emergency Physician: A Pilot Study

Aggarwal,

Kumar,

Agrawal

et al. 2024

Indian Journal of Critical Care Medicine

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“…The growth of a point‐of‐care ultrasound (POCUS) continues, and clinicians are using POCUS in a variety of settings. In this AJUM issue, Bhoi et al 2 present a case series using POCUS to diagnose cervical spine injury.…”

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Sonography – anyone, anytime, anywhere?

Whalley

2021

Australas J Ultrason Med

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A s I reflect on this issue of the journal, I'm struck by the diversity of the papers we are publishing and I realise just how far and wide ultrasound imaging is being used. I am also reflecting on how far this technology has come: from a massive water bath in the 1950s; to A-mode scans displayed on an oscilloscope; to the first moving images using Mmode; through to two-dimensional (2D) and now three-dimensional (3D) imaging. We have gone from imaging whole organs to targeting cell motion, such as with shear wave technology as in this AJUM issue, where Laroia et al 1 present their experience of using shear wave electrography for the detection of liver fibrosis.Similarly, the engineering marvel that provides a point-ofcare ultrasound (POCUS) device with technology previously only available in a 200-kg cart is staggering. The growth of a point-of-care ultrasound (POCUS) continues, and clinicians are using POCUS in a variety of settings. In this AJUM issue, Bhoi et al 2 present a case series using POCUS to diagnose cervical spine injury.Yet, none of this technology is useful if it is not reliable in different patients, on different days and between different operators. Before we adopt new techniques in our own practice, ideally we would undertake studies to ensure we can do it with enough reproducibility to enable meaningful clinical changes to be detected. This is often done in research settings but less so in clinical practice in my experience. This is why I am particularly happy to see authors going to the trouble to document the reliability of techniques in their hands and publishing their results so we can all benefit, such as Farragher et al 3 have done in this issue.Another cross-over technology is ultrasound enhancing agents (UEAs), which are now used in different specialities. UEAs allow us to overcome the physical limitations of ultrasound imaging and yet at the same time exploit other physical characteristics to aid diagnosis. The helpful role of UEAs for diagnosing liver tumours in children is explored in a retrospective study by Torres et al 4 in this issue of the journal.Yet, as sonographers and sonologists we are facing changes. On one end of the ultrasound continuum, we have highly specialised technology that allows us to image in ways we have not routinely before. We 'see ' and, more importantly, understand

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Assessment and Improvement of a Novel ultrasound-based 3D Reconstruction Method: Registered for Lumbar Spine

2022

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Diagnostic utility of point of care ultrasound in identifying cervical spine injury in emergency settings

Cited by 3 publications

References 24 publications

Correlation between Transcranial Ultrasound and CT Head to Detect Clinically Significant Conditions in Post-craniectomy Patients Performed by Emergency Physician: A Pilot Study

Correlation between Transcranial Ultrasound and CT Head to Detect Clinically Significant Conditions in Post-craniectomy Patients Performed by Emergency Physician: A Pilot Study

Sonography – anyone, anytime, anywhere?

Assessment and Improvement of a Novel ultrasound-based 3D Reconstruction Method: Registered for Lumbar Spine

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