Point-of-care ultrasound may expedite diagnosis and revascularization of occult occlusive myocardial infarction

Xu, Curtis; Melendez, Andrew; Nguyen, Thuy D.; Ellenberg, Justin; Anand, Ambika; Delgado, João; Herbst, Meghan Kelly

doi:10.1016/j.ajem.2022.06.010

Cited by 6 publications

(4 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…53,55,[73][74][75] Current evidence has demonstrated the accuracy and clinical relevance of POCUS in detecting and characterizing regional wall motion abnormalities. [76][77][78][79] It allows for real-time visualization of myocardial segments, enabling clinicians to assess regional wall motion and identify abnormalities indicative of ischemia, infarction, or other cardiac pathologies. The evidence supporting the use of POCUS in assessing regional wall motion The evidence supporting the use of thoracic ultrasound in pulmonary edema, pneumonia, atelectasis, and chronic obstructive pulmonary disease (COPD) is derived from observational studies, systematic reviews, and meta-analyses.…”

Section: Discussionmentioning

confidence: 99%

“…The accuracy of focused cardiac ultrasound in assessing diastolic function has been validated through comparisons with comprehensive echocardiography 53,55,73–75 . Current evidence has demonstrated the accuracy and clinical relevance of POCUS in detecting and characterizing regional wall motion abnormalities 76–79 . It allows for real‐time visualization of myocardial segments, enabling clinicians to assess regional wall motion and identify abnormalities indicative of ischemia, infarction, or other cardiac pathologies.…”

Section: Discussionmentioning

confidence: 99%

“… 53 , 55 , 73 , 74 , 75 Current evidence has demonstrated the accuracy and clinical relevance of POCUS in detecting and characterizing regional wall motion abnormalities. 76 , 77 , 78 , 79 It allows for real‐time visualization of myocardial segments, enabling clinicians to assess regional wall motion and identify abnormalities indicative of ischemia, infarction, or other cardiac pathologies. The evidence supporting the use of POCUS in assessing regional wall motion abnormalities includes comparisons with standard echocardiography and other imaging modalities.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The 2023 Core Content of advanced emergency medicine ultrasonography

Adhikari,

Leo,

Liu

et al. 2023

JACEP Open

View full text Add to dashboard Cite

In February 2023, the American Board of Emergency Medicine (ABEM) approved modifications to the Advanced Emergency Medicine Ultrasonography (AEMUS) Core Content, which defines the areas of knowledge considered essential for the practice of AEMUS. This manuscript serves as a revision of the AEMUS Core Content originally published in 2014. The revision of the Core Content for AEMUS training aims to establish standardized education and qualifications necessary for AEMUS fellowship program leadership, clinical application, administration, quality improvement, and research. The Core Content provides the organizational framework and serves as the basis for the development of content for the Focused Practice Examination (FPE) administered by ABEM. AEMUS fellowship directors may reference the Core Content when designing AEMUS fellowship curricula to help prepare graduates for the autonomous practice of AEMUS and the FPE. In this article, an updated revision of the previously published AEMUS Core Content is detailed, and the entire development of the Core Content is presented.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The 2023 Core Content of advanced emergency medicine ultrasonography

Adhikari,

Leo,

Liu

et al. 2023

JACEP Open

View full text Add to dashboard Cite

show abstract

“…For example, in one study a PoCUS assessment for patients with dyspnea took up to 9 min, similar to our study results, whereas the standard clinical workflow excluding PoCUS required over 3 h. 6 Numerous studies support the time invested in performing PoCUS decreased ED visit time across applications. [14][15][16][17][18] PoCUS additionally incorporates human connection, strengthening the physician-patient relationship, increasing the perceived time spent in the patient's room, and improving communication and patient understanding of their disease process, much more than the brief history and physical examination followed by hours of wait time that occurs with traditional workup strategies. 19 Physicians who incorporate PoCUS into their practice also experience higher levels of satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Minutes matter: Time it takes to perform point‐of‐care ultrasound

Patrick,

Bradley,

Wolek

et al. 2023

AEM Education and Training

Self Cite

View full text Add to dashboard Cite

BackgroundWhile point‐of‐care ultrasound (PoCUS) is a safe, versatile tool that can improve patient care, the perceived time investment needed to incorporate PoCUS into clinical care is cited as a barrier to performance. We sought to determine the time it takes to perform a PoCUS examination and whether this time was influenced by training level and prior ultrasound experience.MethodsThis was a retrospective study looking at time stamps of all emergency medicine (EM) provider‐performed PoCUS examinations during clinical shifts from August 10, 2019, to June 7, 2022, at a suburban academic emergency department that is the site for a 3‐year EM residency. Our workflow is order‐based; when PoCUS is ordered, that patient's information populates the ultrasound machine worklist. Selecting the patient's name from the worklist generates a time‐stamped patient information page (PIP). We defined the PIP time stamp as the start of the PoCUS examination. The duration of one PoCUS examination was defined as the time of the last image acquired minus the time of the PIP. General estimating equations were used to estimate differences between training level and between prior scan status using an exchangeable correlation and Tukey adjusted pairwise comparisons. A two‐tailed chi‐square analysis was used for comparing accuracy according to training level.ResultsOf 4187 PoCUS examinations abstracted, 2144 met study criteria. The median (IQR) time spent per examination was 6.0 (3–9) min. First‐year residents took the longest to perform PoCUS among all providers (p < 0.0001). Residents with fewer than 250 prior scans took longer than residents with 501–800 (p = 0.0002) and >800 (p = 0.0013). Resident accuracy was not significantly different according to training level.ConclusionsOverall median time to perform PoCUS was 6.0 min. EM residents became more efficient in performing PoCUS as they advanced from first‐ to third‐year, without compromising accuracy.

show abstract