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Early Screening for Aortic Dissection With Point-of-Care Ultrasound by Emergency Physicians: A Prospective Pilot Study

journal club Jan 31, 2020
 

Wang Y, Yu H, Cao Y, Wan Z.

J Ultrasound Med. 2020

Abstract

OBJECTIVES:

To investigate the effect of point-of-care ultrasound (POCUS) use by emergency physician (EPs) on the diagnosis, treatment, and safety of POCUS in patients with aortic dissection (AD) in emergency settings.

METHODS:

Patients presenting to the emergency department of West China Hospital of Sichuan University with suspected AD from July 1, 2016, to December 31, 2016 were divided into a control group and an ultrasound (US) group. The control group was evaluated by routine procedures for triage, diagnosis, and treatment. In addition, an EP POCUS examination was performed in the US group. The patients in the US group were furtherly divided into subgroup A and subgroup B according to the Stanford type of AD. The sensitivity and specificity of EP POCUS compared to computed tomographic angiography (CTA) were compared. The door-to-CTA examination time, door-to-diagnosis time, door-to-targeted treatment time, and outcome...

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Risk of contrast extravasation with vascular access in computed tomography

journal club Jan 31, 2020
 

Jeffrey R. Stowell, Daniel Rigdon, Roy Colglazier, Levi Filler, Daniel Orosco, Mary Connell, Murtaza Akhter & Carl Mitchell

Emergency Radiology (2020)

Abstract

Purpose

Diagnostic computed tomography (CT) imaging, utilizing intravenous (IV) contrast administration, has become increasingly common. Potential IV contrast-associated complications include local skin and soft tissue reactions due to extravasation. The goal of this study is to describe the risk of contrast extravasation based on IV catheter anatomic location in patients receiving contrast-enhanced CT imaging.

Methods

The study was conducted as a retrospective cohort study of patients receiving contrast-enhanced CT imaging performed over a 26-month period at a single institution. The rate of contrast extravasation was calculated by IV catheter vessel anatomic location and compared by relative risk (RR) and absolute risk reduction (ARR).

Results

Of 17,767 contrast administrations for CT imaging studies performed, 14,558...

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A 36-year-old male with blunt chest trauma and dyspnea

case trauma Dec 21, 2019
 
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