Diagnostic Emergency Ultrasound: Assessment Techniques In The Pediatric Patient
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Diagnostic Emergency Ultrasound: Assessment Techniques In The Pediatric Patient
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Diagnostic Emergency Ultrasound: Assessment Techniques In The Pediatric Patient - $39.00

Publication Date

January 2016 (Volume 13, Number 1)

CME

This issue includes 4 AMA PRA Category 1 Credits™, 4 ACEP Category I credits, 4 AAP Prescribed credits, and 4 AOA Category 2A or 2B credits.

Authors
 
Joshua Guttman, MD, FRCPC
Department of Emergency Medicine, Division of Emergency Ultrasound, Long Island Jewish Medical Center, New Hyde Park, NY
 
Bret P. Nelson, MD, RDMS, FACEP
Director, Emergency Ultrasound, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
 
Peer Reviewers
 
Delia L. Gold, MD
Assistant Professor of Pediatrics, Division of Emergency Medicine, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH
 
Thomas Mailhot, MD
Assistant Professor of Clinical Emergency Medicine, Keck School of Medicine of USC, Emergency Ultrasound Fellowship Director, Los Angeles County + USC Medical Center, Los Angeles, CA

Abstract

Emergency ultrasound is performed at the point of care to answer focused clinical questions in a rapid manner. Over the last 20 years, the use of this technique has grown rapidly, and it has become a core requirement in many emergency medicine residencies and in some pediatric emergency medicine fellowships. The use of emergency ultrasound in the pediatric setting is increasing due to the lack of ionizing radiation with these studies, as compared to computed tomography. Utilizing diagnostic ultrasound in the emergency department can allow clinicians to arrive at a diagnosis at the bedside rather than sending the patient out of the department for another study. This issue focuses on common indications for diagnostic ultrasound, as found in the pediatric literature or extrapolated from adult literature where pediatric evidence is scarce. Limitations, current trends, controversies, and future directions of diagnostic ultrasound in the emergency department are also discussed.

Excerpt From This Issue

You are working in a small community ED on an overnight shift. It is 2:00 AM, and an 8-year-old boy with no significant past medical history arrives with his parents after 2 days of abdominal pain and vomiting that has worsened over the past 24 hours. They deny fever or a change in his bowel movements. His triage vital signs are normal, other than a temperature of 37.8°C. He is lying on the stretcher, reluctant to move. His head and neck, cardiac, respiratory, and skin examinations are all normal. His abdominal examination reveals a soft abdomen, with tenderness at McBurney point and a positive Rovsing sign. You believe your patient has appendicitis. Your practice is to send the patient for an ultrasound as the first diagnostic test; however, ultrasound is not available overnight at your hospital. You want to avoid radiation exposure for this child, but you also want to quickly disposition the patient to the operating room if appendicitis is confirmed. You order basic laboratory work, a urinalysis, intravenous morphine, ondansetron, and normal saline to relieve the patient’s symptoms. You consider performing a bedside emergency ultrasound…

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