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Thoracic Trauma
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Portable ultrasound, although operator dependent, may be of considerable use in the early or immediate diagnosis of pericardial and pleural fluid collections. By avoiding ionizing radiation, ultrasound techniques have the advantage of being repeatable as many times as required during the assessment and management of the trauma victim. The greatest benefit is in patients with blunt thoracic trauma, particularly suspected aortic injury, but it can also be used to evaluate intracardiac shunts, valvular injury and pericardial effusions/tamponade.25
Ultrasound Physics
Published in Debbie Peet, Emma Chung, Practical Medical Physics, 2021
Portable ultrasound machines and “pocket” handheld devices are increasingly attractive to non-imaging specialists (such as emergency physicians and GPs) who want to use ultrasound for a specific imaging purpose. For example, guided insertion of a chest drain or biopsy needle, or targeted anaesthesia (Figure 3.1). Ultrasound equipment can range from specialist medical equipment, such as bladder scanners and foetal heart-rate monitors, to versatile ultrasound scanners, offering full diagnostic imaging. At higher energies, ultrasound can be used therapeutically for physiotherapy, brain stimulation and tumour ablation. For example, High-Intensity Focused Ultrasound (HIFU) can be used to treat localised prostate cancer as an alternative to surgery. Ultrasound physics training and safety and QA processes therefore need to cover a wide range of clinical applications.
Ultrasonography of the Bovine Reproductive System: Ultrasound Management of the Male Reproductive System
Published in Juan Carlos Gardón, Katy Satué, Biotechnologies Applied to Animal Reproduction, 2020
Giovanni Gnemmi, Juan Carlos Gardón, Cristina Maraboli
Ultrasound of the bull’s reproductive system is performed with the same equipment used in bovine gynecological diagnosis. An ultra-portable, portable, or non-portable ultrasound machine with a linear transducer of 5.0–7.5 MHz (Gnemmi, 2007; Gnemmi and Lefebvre, 2010). Sectoral transducers are not normally used because their spherical surface is poorly adapted to the surface of the testicles. In addition to the 5.0–7.5 MHz linear transducer, an 8–11 MHz probe (T-Line), normally used in tendons and ligaments in equine clinics, can be used. This probe allows a more accurate evaluation of small lesions (Gnemmi 2007; Gnemmi and Lefebvre, 2010).
Pericardiocentesis by an Air Medical Service for Cardiac Tamponade Caused by Purulent Pericarditis
Published in Prehospital Emergency Care, 2023
Timothy Boardman, Nicholas North, Sara Sullivan
The frequently taught classic presentation of pericardial tamponade is Beck’s triad, which is the presence of muffled heart sounds, jugular venous distention, and hypotension. However, these findings are only found in 24-34%, 53-88%, and 14-35% of cases respectively (3). Other physical exam and diagnostic findings such as pulses paradoxus and electrical alternans on ECG are also variable and are present in a low percentage of cases (3). Point-of-care ultrasound (POCUS) has been shown to be an effective method of diagnosing pericardial tamponade. Systolic right atrial collapse and diastolic right ventricular collapse have high sensitivity and specificity for pericardial tamponade, and right atrial collapse was clearly identified in this case (3). The use of POCUS in the prehospital setting is becoming more widespread, and recent studies have demonstrated that prehospital clinicians can successfully and accurately perform a wide range of ultrasonographic exams (4). Of note, while the flight crew in this case used the emergency department’s ultrasound machine, our program has since purchased a portable ultrasound machine for use on our helicopter.
Implementation of an academic hospital medicine procedure service: 5-year experience
Published in Hospital Practice, 2021
Hillary Spangler, John R. Stephens, Emily Sturkie, Ria Dancel
The MPS established standardized procedure equipment. Most procedures are performed on inpatient medicine units where the MPS has procedure carts stocked with specific kits and equipment for the MPS. Importantly, while many hospital units in our institution have ultrasound machines, the MPS has a dedicated portable ultrasound machine for procedures that was supported through the capital budget. Ultrasound images are wirelessly uploaded to the EMR, which facilitates billing for ultrasound guidance. A limited diagnostic ultrasound exam is billed if a patient is evaluated but a procedure is not indicated or performed. Standardized procedure documentation facilitates consistent billing and chart reviews for complications. The MPS bills for the procedure itself and then performs a consult follow-up consult visit between 24 and 48 hours after the procedure to assess for complications. The follow-up consult is billed separately.
Production of acoustic radiation force using ultrasound: methods and applications
Published in Expert Review of Medical Devices, 2018
One limitation of using ARF in tissue is the need for a substantial power source in the scanner. Adequate power supplies exist in the market, but incorporation into different ultrasound scanners is necessary to sustain ultrasound transmissions at high power. This limits the use of ARF in more modest ultrasound scanners including portable ultrasound units because of space and cost constraints, and to date has been relegated to more premium systems. Regulatory limits set for diagnostic ultrasound are adhered to and to the knowledge of the ultrasound community prevent tissue damage, but could be revisited to open up new areas or make ARF-based applications more efficacious in application areas where success rates may be diminished such as elastographic measurements at depth. However, for specialized applications such as particle and cell manipulation, the acoustic fields and ARF do not need to be as strong, because the targets are usually in an aqueous solution with very low attenuation.