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'Bedside Ultrasonography Abdominal Aortic Aneurysm' (48)


Dec
2017

To assess the impact of an ultrasound hypotension protocol in identifying life-threatening diagnoses that were missed in the initial evaluation of patients with hypotension and shock.
A subset of cases from a previously published prospective study of hypotensive patients who presented at the Emergency Department in a single, academic tertiary care hospital is described. An ultrasound-trained emergency physician performed an ultrasound on each patient using a standardized hypotension protocol.

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Dec
1969

Quantification of changes in optic nerve sheath diameter (ONSD) using ocular sonography (OS) constitutes an elegant technique for estimating intracranial and intraspinal pressure. Aortic aneurysm repair (AAR) is associated with a reasonable risk of increased spinal fluid pressure, which is largely dependent on the extent of aneurysm repair (supra- vs. infrarenal).

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Dec
2015

Point-of-care ultrasound (POCUS) can be used to provide rapid answers to specific and potentially life-threatening clinical questions, and to improve the safety of procedures. The rate of POCUS access and use in Canada is unclear. The objective of this study was to examine access to POCUS and potential barriers/facilitators to its use among rural physicians in Quebec.

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Jan
2016

Contrast-enhanced ultrasound (CEUS) is increasingly being used to evaluate patients with known or suspected atherosclerosis. The administration of a microbubble contrast agent in conjunction with ultrasound results in an improved image quality and provides information that cannot be assessed with standard B-mode ultrasound. CEUS is a high-resolution, noninvasive imaging modality, which is safe and may benefit patients with coronary, carotid, or aortic atherosclerosis.

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Jan
2016

Abdominal pain is a common complaint in the emergency department and accurate diagnosis of its etiology may affect the patient's outcome.
Patients with abdominal pain underwent ultrasound study first by trained emergency physicians and then by radiologists blinded to emergency physician's results.
Emergency physician who performed bedside ultrasound had 78% diagnostic accuracy.

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Jun
2014

Ultrasound is an easy to learn and highly efficient diagnostic tool to complete the clinical examination and improve bedside decision-making. In the trauma room, surgeons are often required to make a quick decision as to whether or not a patient needs an emergency intervention or whether further diagnostics are required. For this reason, education of surgeons in performing focused emergency ultrasound is pivotal.

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Dec
2013

A timely diagnosis of aortic dissection is associated with lower mortality. The use of emergent bedside ultrasound has been described to diagnose aortic dissection. However, there is limited literature regarding the use of bedside ultrasound to identify superior mesenteric artery dissection, a known high-risk feature of aortic dissection.

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Feb
2013

The use of ultrasound (US) to diagnose an abdominal aortic aneurysm (AAA) has been well studied in the radiology literature, but has yet to be rigorously reviewed in the emergency medicine arena.
This was a systematic review of the literature for the operating characteristics of emergency department (ED) ultrasonography for AAA.
The authors searched PubMed and EMBASE databases for trials from 1965 through November 2011 using a search strategy derived from the following PICO formulation: Patients-patients (18+ years) suspected of AAA.

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Dec
2012

Bedside ultrasonography performed by the Emergency Physician is a safe procedure for evaluating patients with trauma, hypotension, chest or abdominal pain, and dyspnea of unknown origin.
To present a case with apparent concordance between the patient's history, symptoms, signs, and ultrasound imaging, that lead to diagnostic error.
A 74-year-old man was admitted to the hospital due to epigastric pain, radiating to the back.

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Nov
2012

Aortic dissection (AD) is one of the most challenging diagnoses in emergency medicine. This is due, in part, to its variable presentation, ranging from abrupt tearing chest pain in a hemodynamically unstable patient to back pain in a stable patient, as well as its high mortality rates. (1) With the expanding role of ultrasound (U/S) performed by emergency physicians, it is possible to make the diagnosis of AD at the bedside before any other imaging modality has been accessed.

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Mar
2011

Paramedics bring into the ED an elderly man who is complaining of right-sided chest and abdominal pain. Earlier this morning, a friend had arrived at the patient's home and found him on the floor at the bottom of the stairs. The patient is in pain, somewhat altered, and unable to provide further details about what happened.

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Jul
2012

Patients with acute myocardial infarction (AMI) represent a high-risk population in which screening for abdominal aortic aneurysm (AAA) is recommended but only occasionally performed. Transthoracic echocardiography (TTE) may offer the unique opportunity to evaluate the cardiac function and to screen for AAA during the same examination. We aimed to evaluate the feasibility of AAA screening at bedside using a portable cardiac ultrasound (US) echo machine and to determine the prevalence of AAA in population with AMI.

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Mar
2012

Ultraminiaturization of echographic systems extraordinarily provides the image "within" the clinical examination. Abdominal aorta aneurysm (AAA) diagnosis based on conventional evaluation with a dedicated operator and ultrasound machine is still controversial due to the lack of evidence of the proposed management and guidelines' cost-effectiveness. We hypothesized that less expensive ultraportable devices could identify AAA with the same level of accuracy as conventional approaches.

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Sep
2011

To study the reliability and feasibility of point-of-care pocket-sized echocardiography (POCKET) at the bedside in patients admitted to a medical department at a non-university hospital.
One hundred and eight patients were randomized to bedside POCKET examination shortly after admission and later high-end echocardiography (HIGH) in the echo-lab. The POCKET examinations were done by cardiologists on their ward rounds.

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Jun
2011

The aims of this study were to examine the association between emergency department (ED) providers' experience with bedside ultrasound after achieving credentialing for abdominal aortic aneurysm (AAA) sonography, and their successful visualisation rate of the abdominal aorta among consecutive patients who presented asymptomatically but with risk factors for AAA.
Study coordinators enrolled asymptomatic men > 50 years presenting to a single ED with AAA risk factors. One of 20 AAA credentialed ED sonographers screened each subject for AAA.

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Jun
2010

Aortocaval fistula (ACF) is a rare, life threatening complication of abdominal aortic aneurysms. Time to diagnosis is crucial as preoperative diagnosis and early surgical intervention significantly improve the outcome. The clinical spectrum being varied, the challenge of prompt and reliable diagnosis rests on emergency radiology.

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Dec
1969

Endoleaks following endovascular aneurysm repair (EVAR) are common and present a diagnostic challenge in the follow-up after EVAR. Contrast-enhanced ultrasound (CEUS) with low mechanical index (low MI) is a promising new method for the diagnosis and follow-up of endoleaks. CEUS with SonoVue allows a more rapid and noninvasive diagnosis, especially in critical patients owing to its bedside availability.

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Dec
1969

The purpose of this study was to compare color coded duplex sonography (CCDS), contrast-enhanced ultrasound (CEUS) and multislice computed tomography (MS-CT) angiography in pathological aortic lesions.
36 patients with a mean age of 71 years (range 51-87 yrs) with known or suspected treated and untreated aortic lesions detected by CTA were included in this prospective study. Standardized MS-CTA using a 16 or 64 row scanner (Somatom Sensation 16 or 64, Siemens Medical Systems, Forchheim, Germany) served as reference standard.

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May
2010

An aortic dissection is a life-threatening process that must be diagnosed and treated expeditiously. Imaging modalities used for diagnosis in the emergency department include computed tomography, magnetic resonance imaging, and trans-esophageal echocardiography. There are significant limitations to these studies, including patient contraindications (intravenous contrast dye allergies, renal insufficiency, metal-containing implants, hemodynamic instability) and the length of time required for study completion and interpretation by a radiologist or cardiologist.

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Oct
2008

Abdominal aortic aneurysm (AAA) is a deadly but often clinically silent disease. Patients at increased risk are elderly men with risk factors for vascular disease who may not have adequate screening through primary care. We sought to examine the prevalence and feasibility of screening for AAA in at-risk patients presenting for unrelated complaints using emergency physician-performed bedside ultrasound.

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Dec
1969

Ultrasound (US) has been recognized as a powerful tool for use in the diagnosis and evaluation of many diseases in clinical practice. The possibility of immediate bedside US examinations in the evaluation of specific emergent complaints makes it an ideal tool for the emergency specialist. Correct diagnosis of potential life-threatening emergencies such as hematoperitoneum following blunt trauma, abdominal emergencies, ectopic pregnancy, pericardial tamponade, and aortic aneurysms with US evaluation can be easily made.

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May
2008

Bedside emergency ultrasound has been used by emergency physicians for >20 years for a variety of conditions. In adult centers, emergency ultrasound is routinely used in the management of victims of blunt abdominal trauma, in patients with abdominal aortic aneurysm and biliary disease, and in women with first-trimester pregnancy complications. Although its use has grown dramatically in the last decade in adult emergency departments, only recently has this tool been embraced by pediatric emergency physicians.

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Nov
2007

The TER system is a robot-based tele-echography system allowing remote ultrasound examination. The specialist moves a mock-up of the ultrasound probe at the master site, and the robot reproduces the movements of the real probe, which sends back ultrasound images and force feedback. This tool could be used to perform ultrasound examinations in small health care centers or from isolated sites.

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Sep
2007

Bedside ultrasound examinations performed by emergency physicians are goal-directed studies meant to answer specific questions. These studies are frequently performed in critically ill patients with undifferentiated abdominal pain who are suspected of having intra-abdominal hemorrhage or a ruptured abdominal aortic aneurysm. Patients presenting with a perforated hollow viscus may have a similar clinical presentation.

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Mar
2004

Ultrasonography is a useful tool for the immediate evaluation of patients with suspected ruptured ectopic pregnancy, abdominal aortic aneurysm, traumatic intra-abdominal hemorrhage or cardiac tamponade. The 1999 Canadian Association of Emergency Physicians position statement states that bedside emergency department ultrasonography should be available 24 hours per day. This case study illustrates how emergency physicians properly trained in emergency bedside ultrasonography can use this tool effectively to dramatically impact patient care.

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Nov
2007

Aortic abnormalities are commonly encountered and may represent a diagnostic challenge in patients with acute or chronic clinical symptoms. Contrast-enhanced ultrasound (CEUS) with low mechanical index (low MI) is a new promising method in the diagnosis and follow-up of pathological aortic lesions. CEUS with SonoVue allows a more rapid and noninvasive diagnosis, especially in critical patients because of its bedside availability.

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Nov
2007

An aorto-caval fistula is a rare complication of a symptomatic or ruptured infrarenal aortic aneurysm having a frequency of 3-6%. Patients typically present with clinical signs of diffuse abdominal pain associated with increasing venous congestion and tachycardia, rapid cardiopulmonary decompensation with acute dyspnea, and an audible machinerylike bruit. Perioperative mortality is high, ranging from 20% to 60%.

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Oct
2006

A short-cut review was carried out to establish whether emergency department ultrasound scanning had clinical utility for the diagnosis of abdominal aortic aneurysm (AAA). A total of 73 papers were found using the reported searches, of which 4 presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated.

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Nov
2005

Patients presenting with hypotension may be evaluated with a FAST (Focused Abdominal Sonography for Trauma) examination as recent literature has suggested its utility in the unstable patient. Those who are found to have intraperitoneal fluid on the FAST examination may have solid organ injury from unknown trauma, ruptured abdominal aortic aneurysm (AAA), hemorrhaging ovarian cyst, ruptured ectopic pregnancy, or other disease process responsible for intra-periteal blood. However, because ultrasound does not assist in fluid identification, it is possible that the fluid present is not blood, but ascites.

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Nov
2005

Emergency department ultrasound and echocardiography.

Emerg Med Clin North Am 2005 Nov;23(4):1179-94
Alice Tang, Brian Euerle
Bedside sonography has become an important tool in the emergency physician's diagnostic armamentarium. Sonography is useful in the evaluation of a number of conditions, including cholecystitis, abdominal aortic aneurysm, and ectopic pregnancy. Applied to the heart, sonography aids in the assessment of pericardial tamponade, electromechanical dissection, pulmonary embolus, and other cardiorespiratory emergencies.

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Feb
2005

We describe the contrast-specific sonography features of ruptured abdominal aortic aneurysm, and we hypothesize that this technique would be useful for emergency imaging of patients with suspected aneurysm rupture.
We used contrast-specific sonography to assess eight patients with ruptured abdominal aortic aneurysm. Five of these cases were correlated with CT findings.

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Feb
2004

Bedside ultrasound is the diagnostic method of choice for unstable patients with suspected abdominal aortic aneurysm. Its ability to provide rapid and accurate diagnosis is critical in an emergency setting. Previous studies have documented the ability of Emergency Physicians to accurately diagnose abdominal aortic aneurysms, thus potentially saving lives.

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Jan
2004

To determine how often emergency physicians (EPs) scanning the abdominal aorta (AA) of nonfasted emergency department (ED) patients are able to visualize the entire AA.
The authors performed a retrospective study of patients receiving ultrasound (US) by EPs to rule out abdominal aortic aneurysm (AAA) at a suburban Level I ED. For patients being evaluated for possible AAA, EPs evaluated the entire length of the AA with US in short axis, making standard proximal, middle, and distal measurements.

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Mar
2003

Although more than 5% of the geriatric male population is thought to have an abdominal aortic aneurysm, no study has evaluated the ability of ED physician sonographers to screen for this condition. The purpose of this study was to evaluate whether a screening program to sonographically identify abdominal aortic aneurysms would result in increased identification of this potentially lethal disease. This prospective clinical study used a convenience sample and was performed in a community teaching hospital ED.

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Feb
2002

Acute aortic dissection is an emergency that may not only cause significant morbidity but often results in death. A timely diagnosis can prove difficult in the event of an atypical presentation. Classically, aortic dissection presents as sudden, severe chest, back, or abdominal pain that is characterized as ripping or tearing in nature.

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Aug
2001

We report a case of a patient who presented to the Emergency Department with pulseless electrical activity. A rapid diagnosis of ruptured abdominal aortic aneurysm was made by Emergency Medicine bedside ultrasonography. On arrival, the patient was without palpable pulses and bradycardic.

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Sep
2000

This study was conducted to determine whether emergency physicians with relatively limited training and experience can accurately identify the presence or absence of abdominal aortic aneurysms (AAAs) by performing bedside ultrasound scanning, and to assess the potential impact of ultrasound scanning on clinical management.
Patients in whom AAAs were suspected, including those patients older than 50 years presenting with abdominal/back pain of unclear origin or presumed renal colic, were eligible for study entry. Consenting adults had ultrasound scanning by an emergency physician who was not responsible for their primary care.

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Mar
1999

Ruptured abdominal aortic aneurysms currently have a high rate of both mortality and misdiagnosis. Aneurysms smaller than 4 cm are not commonly considered for surgical repair. This report describes the case of a ruptured abdominal aneurysm measuring less than 4 cm diagnosed by the emergency physician utilizing bedside ultrasound.

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Apr
1998

As the role of the general surgeon continues to evolve, the surgeon's use of ultrasound will surely influence practice patterns, particularly for the evaluation of patients in the acute setting. With the use of real-time imaging, the surgeon receives "instantaneous" information to augment the physical examination, narrow the differential diagnosis, or initiate an intervention. With select ultrasound examinations, the surgeon can rapidly evaluate adult and pediatric patients who present with an acute abdomen, especially those in shock.

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Apr
1998

Ultrasound has an increasingly important role in evaluation of the vascular system. Ultrasound is especially useful for intensive care patients because of the frequency of vascular complications developing in the ICU setting, as well as the ability of ultrasound to be performed at the patient's bedside. Ultrasound is the method of choice for evaluation of deep vein thromboembolic disease of the lower extremity in all patients; it demonstrates excellent sensitivity and specificity for this condition.

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Feb
1992

Ultrasonography in emergency medicine.

Emerg Med Clin North Am 1992 Feb;10(1):27-46
M B Heller, V P Verdile
The use of ultrasonography in emergency medicine is an area of rapid growth and controversy. This article reviews the current and future applications of emergency ultrasonography with particular emphasis on the role of bedside scanning by the emergency practitioner. Abdominal, pelvic, and cardiac ultrasonographic applications are reviewed, as are the uses of ultrasonography as an adjunct to the performance of procedures in the Emergency Department.

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Aug
1988

The accuracy of combined M-mode and two-dimensional echocardiography in the diagnosis of aortic dissection was evaluated in 673 patients with a clinical suspicion of aortic dissection, over a six-year period. In 128 cases, the diagnosis of aortic dissection was confirmed by angiographic, tomographic (CT scan), or autopsy findings, or during surgery. Two echocardiographic features were found to support a diagnosis of aortic dissection: a dilation of at least one segment of the aorta (sensitivity 95%, specificity 51%) and a typical abnormal linear intraluminal echo corresponding to the intimal flap (sensitivity 67%, specificity 100%).

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Aug
1980

Aneurysms and dissections of the aorta--depending on their location--are the cause for a variety of cardiovascular symptoms. In most cases they are the result of a generalised disease of the vessel wall. Consequently, echographic examinations should include the entire aorta from the root to the bifurcation, systematically utilising all accessibilities.

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