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Ascites, an abnormal collection of fluid that appears as an anechoic image, observed in Morison's pouch (posterior subhepatic space).
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SUMMARY Point-of-care ultrasonography, which is performed at the bedside by physicians who are not specialists in imaging, has become possible thanks to recent technological advances that have allowed for a device with greater portability while maintaining image quality. The increasing use of point-of-care ultrasonography in different specialties h...
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... adjusting for image gain and depth, the FIPF search can be initiated in the upper right quadrant window, followed by the upper left quadrant and suprapubic regions, with the patient in the supine position. In the patient presented above, free liquid (appearing as an anechoic image) was observed in the Morison (Figure 1) and Douglas pouches, confirming the diag- nosis of ascites, which was not identified in the phys- ical examination. ...
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... but essential in the detection of intracavitary fluid, cardiac tamponade, and detection of pneumothorax [11,12]. POCUS images can be generated on cell phone and tablet screens [13]. ...
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
The objective was to determine the impact of a single dose of praziquantel on urogenital lesions caused by Schistosoma haematobium . Ultrasound (US) was performed on three age groups of subjects with a positive test for hematuria, with the first examination performed in November 2017 and a follow-up visit 7 months later. None of the subjects had previously received treatment. The participants were categorized into three distinct age groups: group 1 = 1–15 years, group 2 = 15–30 years, and group 3 = ≥ 30 years. A total of 250 people from these three groups underwent screening: 99 in group 1, 90 in group 2, and 61 in group 3, among whom 131 (52.4%) had at least one detectable lesion of the urogenital tract on US. Follow-up US after 7 months was possible in 60%, 67%, and 77% of the respective groups (with lesions). The anomalies disappeared in 80% of individuals in group 1, 76% of those in group 2, and 65% in group 3. With the exception of calcifications, most visible anomalies had been resolved. The total number of anomalies is low. Severe obstructive uropathy was not detected. We can conclude that single treatment with praziquantel is able to cure visible anomalies, with the exception of calcifications. The low rate of anomalies, compared with levels in the literature, is speculated to be due to undetected death by obstructive uropathy caused by S. haematobium . This requires further investigation.
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.
Introduction: Point-of-care ultrasonography (POCUS) has emerged as an essential supplement to physical examination in many specialties. In contrast, its use by infectious diseases (ID) specialists remains anecdotal. Here, we report on the acquisition of an ultrasonography device in a French ID ward, and we describe its everyday use.
Methods: A preliminary audit was conducted to evaluate the potential impact of the acquisition of an ultrasonography device. A second audit was performed during the first year following the acquisition of the device to quantify its everyday use. We also evaluated the impact of POCUS implementation on medical imaging requests by comparing the number of intra-hospital transports before and after the acquisition.
Results: According to the first audit, 81 of the 199 (41%) imaging examinations that were prescribed during a two-month period could have been replaced by POCUS. During the first year following the acquisition of the ultrasonography device, POCUS was performed 240 times by 31 different operators. The operators were a senior physician, an intern, and a medical student in 94 (39%), 135 (57%), and 11 (5%) cases, respectively. The organs most frequently explored were the genito-urinary tract (n=74), the joints (n=35), and the lungs/pleura (n=35). Acquisition of the device was followed by a significant decrease in the number of transports to the ultrasonography room, whereas the total number of transports to the medical imaging ward did not change.
Conclusion: Opportunities to use POCUS in the ID ward are numerous. POCUS training should be part of the ID specialist’s curriculum.
