Traditional and ultrasound physical examinations: a hybrid approach to improve clinical care

Bastos, Marcus Gomes; Novaes, Ana Karine Brandão; Pazeli, José Muniz

doi:10.1590/1806-9282.64.05.474

Cited by 3 publications

(1 citation statement)

References 39 publications

(23 reference statements)

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“…but essential in the detection of intracavitary fluid, cardiac and detection of pneumothorax [11,12]. POCUS images can be generated on cell phone and tablet screens [13].…”

Section: Introductionmentioning

confidence: 99%

Current evidence on the use of pocus in the diagnosis of pneumothorax in emergency rooms: a systematic review

Nani,

Servin,

Reis

et al. 2024

MedNEXT

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Introduction: Point of Care Ultrasound (POCUS) is currently recognized as useful and, in some cases, mandatory, such as during invasive procedures. Its bedside application includes differential diagnosis and therapeutic management of complex clinical conditions during hemodynamic instability. The emergence of portable devices with superior image quality and their applicability in emergency rooms and intensive care units has demonstrated high diagnostic effectiveness. Objective: It was to highlight the use of POCUS in the diagnosis of pneumothorax in emergency rooms, through a systematic review of meta-analytic articles, systematic reviews, and observational studies from the last 11 years (2012 to 2023). Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October to December 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 127 articles were found, 43 articles were evaluated in full and 31 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 22 studies with a high risk of bias and 26 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=61.5%<50%. It was concluded that the POCUS method is operator-dependent and has greater sensitivity (78 to 90%) and specificity greater than 98% in chest radiography. However, when performed correctly by trained professionals, following protocols, it proved to be useful for identifying and treating pneumothorax. POCUS is a portable, fast, and low-cost bedside examination that does not involve ionizing radiation, in addition to identifying a precise location for performing thoracentesis in cases of pneumothorax, which assists clinical physicians in urgent and emergency rooms, as well as in external environments such as rescue helicopters. There is a consensus among the authors researched that, to obtain clinical evidence on the use of POCUS in the diagnosis of pneumothorax, more randomized controlled studies are necessary, which reinforce the use of this versatile equipment in different urgent and emergency scenarios

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“…but essential in the detection of intracavitary fluid, cardiac and detection of pneumothorax [11,12]. POCUS images can be generated on cell phone and tablet screens [13].…”

Section: Introductionmentioning

confidence: 99%

Current evidence on the use of pocus in the diagnosis of pneumothorax in emergency rooms: a systematic review

Nani,

Servin,

Reis

et al. 2024

MedNEXT

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JCS/JSCVS/JATS/JSVS 2020 Guideline on Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection

Ogino,

Iida,

Akutsu

et al. 2023

Circ J

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▋ 1.3.2 Location of AneurysmsAneurysms are classified into thoracic, thoracoabdominal, and abdominal aneurysms, which are further classified as follows: Thoracic: It is further classified into ascending, arch, and descending aortic aneurysms. Thoracoabdominal: The Crawford classification based on the range of replacement in thoracoabdominal aneurysm surgery (Figure 5). Abdominal: Abdominal aortic aneurysms are classified using the renal artery as the reference into the supra-and infra-renal segments. ▋ 1.3.3 CauseBased on the cause of the aneurysm, aortic aneurysms are classified into atherosclerotic, traumatic, inflammatory, infected, congenital, etc. Most of them are atherosclerotic aortic aneurysms. Advance Publication13 JCS/JSCVS/JATS/JSVS 2020 Guideline on Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection is indicated for saccular aneurysms regardless of the size of the thickening (See PQ 1). Inflammatory aortic aneurysm: Aneurysm caused by inflammation. Although, in general, "inflammation" is a concept that includes infection, however, inflammatory aortic aneurysm does not include the aortic aneurysm with infection. Inflammatory periaortitis: A case with inflammation around the aorta but with less aortic dilation that does not meet the criteria of aneurysm. Infected aortic aneurysm: Aneurysm caused by infection. Rupture: Extravascular blood leakage due to damage to the arterial wall. Impending rupture: The absence of damage to the arterial wall despite the presence of aneurysmal pain. ▋ 4.2 Aortic DissectionDissecting aneurysm: Aortic dissection with aneurysmal formation. A general term that was previously used for overall aortic dissection. However, because in many cases with aortic dissection in acute phase does not meet the criteria for an aneurysm, aortic dissection in acute phase is now called, "acute aortic dissection." True lumen: The original arterial cavity. False lumen: A new cavity formed in the arterial wall (the term "dissection cavity" is not appropriate). Dissection flap: The (intima-media) septal wall. It used to be called "intimal dissection." However, it actually consists of intima and a part of the media. Tear: Intimal and medial tears of aortic dissection which is the site of communication between the true lumen and the false lumen. "Intimal tear" is also regularly used as a synonym for "tear". Entry: A site where blood flow enters from the true lumen to the false lumen. Re-entry: A site where blood flow enters from the false lumen to the true lumen. ("communication window" that is also used as a term for both entry and re-entry) Aortic dissection with patent false lumen: It is a synonym for "communicating aortic dissection", a type of aortic dissection in Europe classification. It is also called "classic dissection" or "double barrel aorta." One of the three types of aortic dissection in Japanese Aortic dissection with thrombosed false lumen: It is a synonym for "noncommunicating aortic dissection", a type of aortic dissection in Europe classification. One of the three ty...

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Benefícios E Aplicações Da Ultrassonografia Point of Care No Departamento De Emergência

Bezerra¹,

Farias²

2022

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A ultrassonografia é um exame de grande valor para a prática médica, de maneira ambulatorial seu uso já está consolidado. Outrossim, está provando seu valor diante do contexto das emergências médicas, sob a forma da ultrassonografia point of care, isso pois é um exame de baixíssimo custo, alta sensibilidade, especificidade e acurácia. Ademais, a técnica de insonação é facilmente apreendida por estudantes, médicos residentes e profissionais experientes. Diante do exposto, este trabalho visa esclarecer os benefícios e aplicações da ultrassonografia point of care no departamento de emergência. Para tanto, foi adotado o método da revisão sistemática, que através da pesquisa em bases de dados da Biblioteca Virtual em Saúde, IBECS e LILACS proporcionou a seleção de 14 publicações. Ao contemplar os artigos foi possível perceber que as aplicações do POCUS são inúmeras, em todas as áreas em que foi aplicado no departamento de emergência mostrou benefícios, revelando ser uma ferramenta agregadora de velocidade, precisão e segurança no atendimento do paciente grave, e além disso foi útil em toda sorte de atendimentos perpassando emergências neurológicas, cardiovasculares, urológicas, oftalmológicas e outras tantas.

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Traditional and ultrasound physical examinations: a hybrid approach to improve clinical care

Cited by 3 publications

References 39 publications

Current evidence on the use of pocus in the diagnosis of pneumothorax in emergency rooms: a systematic review

Current evidence on the use of pocus in the diagnosis of pneumothorax in emergency rooms: a systematic review

JCS/JSCVS/JATS/JSVS 2020 Guideline on Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection

Benefícios E Aplicações Da Ultrassonografia Point of Care No Departamento De Emergência

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