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"Ultrasound"

Brief Research Report

Imaging

Are two planes better than one? A comparative analysis of transverse versus sagittal suprapubic views in the Focused Assessment with Sonography in Trauma (FAST) examinations
Matthew Alfarano, Amy Marks, Daven Patel, Evelyn Schraft, Tina Sundaram, Aylin Ornelas Loredo, Ohm Shukla, Nhat Nguyen, Gary D. Peksa, Michael Gottlieb
In Press, Received September 22, 2025  Accepted December 29, 2025  Available online April 3, 2026  
DOI: https://doi.org/10.15441/ceem.25.215    [Accepted]

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Are two planes better than one? A comparative analysis of transverse versus sagittal suprapubic views in the Focused Assessment with Sonography in Trauma (FAST) examinations
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Are two planes better than one? A comparative analysis of transverse versus sagittal suprapubic views in the Focused Assessment with Sonography in Trauma (FAST) examinations
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Objective
This study aimed to assess the diagnostic value of the sagittal and transverse views of the suprapubic window during a Focused Assessment with Sonography in Trauma (FAST) or extended FAST (eFAST) examination.
Methods
This retrospective chart review analyzed suprapubic windows of FAST/eFAST images performed from August 15, 2017, to August 1, 2024. Each ultrasound video was reviewed for the presence or absence of free fluid, image quality, and diagnostic confidence. Reviewers were blinded to clinical information and did not assess more than one imaging plane in the same patient.
Results
Of the 958 FAST/eFAST studies identified, 497 met inclusion criteria. Of which, 433 (87.1%) were diagnostic, while 64 (12.9%) were nondiagnostic in at least one imaging plane. Among diagnostic images, 93 (21.5%) sagittal views and 74 (17.1%) transverse views were positive for free fluid. A total of 32 exams (34.3%) showed free fluid in the sagittal views but were negative on the transverse view, whereas 13 cases (17.6%) were positive on the transverse view but negative on the sagittal view. Using both views reduced overall nondiagnostic rate from 12.9% to 1.2%.
Conclusion
Using both sagittal and transverse views in the suprapubic window during a FAST/eFAST examination can reduce the nondiagnostic rates and improve identification of free fluid. The observed discrepancies between views and variability in the image quality and confidence support a multiview approach.
  • 502 View
  • 19 Download

Review Article

Ultrasound as a tool in prehospital settings: a scoping review
Jose Luis Piñeros-Alvarez, Jose Daniel Yusty Prada, Esteban Portuguez
Clin Exp Emerg Med 2025;12(4):320-330.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.374

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Ultrasound as a tool in prehospital settings: a scoping review
Clin Exp Emerg Med. 2025;12(4):320-330.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.374
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Ultrasound as a tool in prehospital settings: a scoping review
Clin Exp Emerg Med. 2025;12(4):320-330.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.374
Close
Point-of-care ultrasound (POCUS) is a valuable tool in the prehospital management of critically ill patients, particularly patients with trauma, dyspnea, or shock. This review aims to evaluate the diagnostic and therapeutic applications, limitations, and implementation challenges of POCUS in prehospital care. Key findings are that ultrasound, particularly the extended Focused Assessment with Sonography in Trauma (eFAST) protocol, offers high specificity in identifying severe hemorrhage in trauma cases, although its sensitivity varies depending on the clinical context and operator experience. In dyspnea, pulmonary ultrasound significantly enhances diagnostic accuracy, aiding early detection of heart failure and other respiratory conditions. For shock, focused echocardiography facilitates rapid diagnosis and timely therapeutic decisions, improving patient outcomes. However, the effectiveness of POCUS is highly dependent on the operator’s expertise, and challenges such as time, space, and resource limitations in prehospital settings may impact its use. Furthermore, local studies in Latin America assessing the impact of prehospital ultrasound on morbidity and mortality reduction are lacking. Based on our review, we recommend standardized training programs, increased availability of portable ultrasound devices, and prospective studies on cost-benefit analysis to optimize POCUS implementation in prehospital systems, particularly in resource-limited regions. Prehospital ultrasound has the potential to revolutionize patient care by improving diagnostic precision and reducing time to definitive treatment, but its successful implementation requires strategic integration of technology, education, and research.

Citations

Citations to this article as recorded by  Crossref logo
  • Meta-analysis of the effectiveness of portable imaging diagnostics for multiple fractures and chest injuries in combat zones: mobile X-ray systems and ultrasound devices (literature review)
    V. V. Chorna, L. D. Kotsur, N. I. Gumeniuk, M. O. Cherniak, I. V. Kachur
    Reports of Vinnytsia National Medical University.2026; 30(1): 156.     CrossRef
  • 5,294 View
  • 184 Download
  • 1 Crossref

Original Articles

Procedures | Pain Management & Sedation

Femoral nerve blocks versus standard pain control for hip fractures: a retrospective comparative analysis
Solomon Geizhals, You Shou, Simone Rudnin, Maria Tama, Josh Greenstein, Barry Hahn, Jerel Chacko, Joseph Basile, Joseph Marino
Clin Exp Emerg Med 2024;11(2):181-187.   Published online January 29, 2024
DOI: https://doi.org/10.15441/ceem.23.112

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Femoral nerve blocks versus standard pain control for hip fractures: a retrospective comparative analysis
Clin Exp Emerg Med. 2024;11(2):181-187.   Published online January 29, 2024
DOI: https://doi.org/10.15441/ceem.23.112
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Femoral nerve blocks versus standard pain control for hip fractures: a retrospective comparative analysis
Clin Exp Emerg Med. 2024;11(2):181-187.   Published online January 29, 2024
DOI: https://doi.org/10.15441/ceem.23.112
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Objective
Pain control for hip fractures is often achieved via intravenous opioids. However, opioids can have dangerous adverse effects, including respiratory depression and delirium. Peripheral nerve blockade is an alternative option for pain control that reduces the need for opioid analgesia. The purpose of this study was to compare the use of femoral nerve blocks versus standard pain control for patients with hip fractures. Methods This retrospective study included adult patients presenting to the emergency department with isolated hip fractures between April 2021 and September 2022. The intervention group included all patients who received a femoral nerve block during this time. An equivalent number of patients who received standard pain control during that period was randomly selected to represent the control group. The primary outcome was preoperative opioid requirement, assessed by morphine milligram equivalents (MMEs). Results During the study period, 90 patients were included in each group. Mean preoperative MME was 10.3 (95% confidence interval [CI], 7.4–13.2 MME) for the intervention group and 14.0 (95% CI, 10.2–17.8 MME) for the control group (P=0.13). Patients who received a femoral nerve block also had shorter time from emergency department triage to hospital discharge (7.2 days; 95% CI, 6.2–8.0 days) than patients who received standard care (8.6 days; 95% CI, 7.210.0 days). However, this difference was not statistically significant (P=0.09). Conclusion Femoral nerve blockade is a safe and effective alternative to opioids for pain control in patients with hip fractures.

Citations

Citations to this article as recorded by  Crossref logo
  • Femoral Nerve Block Versus Pericapsular Nerve Group Block for Pain Management in Emergency Department Patients with Extracapsular Hip Fractures
    Kar Mun Cheong, Hua Li, Su Weng Chau, Cheng-Han Chiang, Yi-Kung Lee, Tou-Yuan Tsai
    Journal of Clinical Medicine.2026; 15(4): 1454.     CrossRef
  • Femoral Nerve Block: A Review of the Relevant Applied Anatomy, Anatomical Variations, and Procedural Considerations
    Yuqian Dai, Michael J. Montalbano, Ewarld Marshall, Marios Loukas
    Clinical Anatomy.2026;[Epub]     CrossRef
  • Ultrasound-guided fascia iliaca compartment block versus intravenous analgesia in geriatric hip fractures: a systematic review and meta-analysis of randomized trials demonstrating superior pain control
    Chang Liu, Shunyu Han, Ai Wei, Lina Yang, Mengchang Yang
    Frontiers in Medicine.2025;[Epub]     CrossRef
  • 13,362 View
  • 160 Download
  • 4 Web of Science
  • 3 Crossref

Imaging

The predictive value of point-of-care ultrasonography versus magnetic resonance imaging in assessing medial meniscal tears in patients with acute knee injury
Omid Ahmadi, Mehdi Motififard, Farhad Heydari, Saeed Hatami, Azita Azimi Meibody
Clin Exp Emerg Med 2024;11(2):188-194.   Published online January 29, 2024
DOI: https://doi.org/10.15441/ceem.23.111

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The predictive value of point-of-care ultrasonography versus magnetic resonance imaging in assessing medial meniscal tears in patients with acute knee injury
Clin Exp Emerg Med. 2024;11(2):188-194.   Published online January 29, 2024
DOI: https://doi.org/10.15441/ceem.23.111
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The predictive value of point-of-care ultrasonography versus magnetic resonance imaging in assessing medial meniscal tears in patients with acute knee injury
Clin Exp Emerg Med. 2024;11(2):188-194.   Published online January 29, 2024
DOI: https://doi.org/10.15441/ceem.23.111
Close
Objective
Musculoskeletal ultrasound is increasingly used as the modality of choice in diagnosing many medical situations. The present study aimed to compare the accuracy of point-of-care ultrasonography (POCUS) and magnetic resonance imaging (MRI) to detect acute medial meniscus tears in knee. Methods The prospective study was conducted on patients with suspected medial meniscus tears in knee. in the emergency department. In the absence of a knee fracture on x-ray, POCUS on the knee was performed. All patients underwent POCUS and MRI of the knee followed by arthroscopy. POCUS findings were then compared to MRI findings to diagnose medial meniscus tears. Results A final total of 157 patients with a mean age of 25.04±7.41 years was included. Out of 157 patients, 94 (59.9%) were male. Medial meniscus tears were detected in 89 patients (56.7%) using arthroscopy as the gold standard. The sensitivity, specificity, positive and negative predictive values, and accuracy of POCUS to detect medial meniscus tears were 88.8% (95% confidence interval [CI], 80.3%–94.5%), 89.7% (95% CI, 79.9%–95.8%), 91.9% (95% CI, 84.8%–95.8%), 85.9% (95% CI, 77.2%–91.7%), and 89.2% (95% CI, 83.3%–93.6%), respectively. The diagnostic accuracy of MRI to detect medial meniscus injury was 93.0% (95% CI, 87.8%– 96.4%). Conclusion The present study demonstrated that POCUS is an accurate and reliable diagnostic tool alternative to MRI in detecting medial meniscal tears. POCUS had acceptable sensitivity, specificity, and accuracy in detecting meniscal injuries and could be performed as an effective immediate investigation to guide further modalities in patients with acute knee trauma

Citations

Citations to this article as recorded by  Crossref logo
  • Diagnostic accuracy of ultrasonography for meniscal tears: a systematic review and meta-analysis
    Rifat Hassan, Daryl Poku, Otto Chan, Nicola Maffulli
    Skeletal Radiology.2026; 55(8): 1777.     CrossRef
  • Diagnostic accuracy of ultrasound in assessing medial collateral ligament and medial meniscus injuries? A systematic review and meta-analysis.
    Melanie Potter, Anthony Smith
    The Ultrasound Journal.2026; 18(1): 18171.     CrossRef
  • Point-of-care ultrasound in trauma: a systematic review of recent literature
    Azizul Fadzli Jusoh, Rosliza Yahaya, Mohd Hashairi Fauzi, Shaik Farid Abdull Wahab
    Journal of Ultrasonography.2026;[Epub]     CrossRef
  • Ultrasonographic Assessment of Meniscus Damage in the Context of Clinical Manifestations
    Tomasz Poboży, Wojciech Konarski, Kacper Janowski, Klaudia Michalak, Kamil Poboży, Julia Domańska-Poboża
    Medicina.2025; 61(8): 1339.     CrossRef
  • A Retrospective Audit of the Timescales Involved in the Diagnosis and Management of Soft Tissue Knee Injuries at a Single National Health Service Trust: A Quality Service Improvement and Redesign Project
    Ashmitha Vindya, Siddesh Bhushan Gangadharaswamy Nagabhushan
    Cureus.2025;[Epub]     CrossRef
  • The Utility of a Community-Based Knee Ultrasound in Detecting Meniscal Tears: A Retrospective Analysis in Comparison with MRI
    Fatima Awan, Prosanta Mondal, Johannes M. van der Merwe, Nicholas Vassos, Haron Obaid
    Healthcare.2024; 12(20): 2051.     CrossRef
  • 9,235 View
  • 149 Download
  • 5 Web of Science
  • 6 Crossref

Case Report

Point-of-care ultrasound by emergency physicians for direct ureteral stone detection: a case series and review of the literature
Nadav Granat, Evan Avraham Alpert
Clin Exp Emerg Med 2024;11(2):218-223.   Published online January 29, 2024
DOI: https://doi.org/10.15441/ceem.23.096

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Point-of-care ultrasound by emergency physicians for direct ureteral stone detection: a case series and review of the literature
Clin Exp Emerg Med. 2024;11(2):218-223.   Published online January 29, 2024
DOI: https://doi.org/10.15441/ceem.23.096
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Point-of-care ultrasound by emergency physicians for direct ureteral stone detection: a case series and review of the literature
Clin Exp Emerg Med. 2024;11(2):218-223.   Published online January 29, 2024
DOI: https://doi.org/10.15441/ceem.23.096
Close
Symptomatic urolithiasis is a common cause of emergency department visits, with noncontrast computed tomography considered the imaging gold standard. According to the current guidelines, point-of-care ultrasound (POCUS) is limited to evaluating hydronephrosis as a secondary sign of acute ureteral stones. However, the use of POCUS to detect ureteral stones may lead to decreased radiation to the patient and a more rapid diagnosis. This case series describes 10 patients with suspected symptomatic urolithiasis who were diagnosed accurately by emergency physicians using POCUS to detect obstructive ureteral stones. In three of the cases, POCUS significantly changed the patient’s management. This article also describes the proper techniques for the emergency physician to learn to master POCUS for ureteral stone detection.

Citations

Citations to this article as recorded by  Crossref logo
  • Correlation between expulsion rate of distal ureteric calculus up to 8mm in size with CRP level, WBC count and Neutrophil percentage
    Dr. Amit Singh, Dr. Ashok Yadav, Dr. Anish Ahemad
    Dinkum Journal of Medical Innovations.2024; 3(5): 358.     CrossRef
  • 6,325 View
  • 101 Download
  • 1 Web of Science
  • 1 Crossref

Review Article

Point-of-care ultrasound for airway management in the emergency and critical care setting
Michael Gottlieb, James R. O’Brien, Nicholas Ferrigno, Tina Sundaram
Clin Exp Emerg Med 2024;11(1):22-32.   Published online November 25, 2023
DOI: https://doi.org/10.15441/ceem.23.094

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Point-of-care ultrasound for airway management in the emergency and critical care setting
Clin Exp Emerg Med. 2024;11(1):22-32.   Published online November 25, 2023
DOI: https://doi.org/10.15441/ceem.23.094
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Point-of-care ultrasound for airway management in the emergency and critical care setting
Clin Exp Emerg Med. 2024;11(1):22-32.   Published online November 25, 2023
DOI: https://doi.org/10.15441/ceem.23.094
Close
Airway management is a common procedure within emergency and critical care medicine. Traditional techniques for predicting and managing a difficult airway each have important limitations. As the field has evolved, point-of-care ultrasound has been increasingly utilized for this application. Several measures can be used to sonographically predict a difficult airway, including skin to epiglottis, hyomental distance, and tongue thickness. Ultrasound can also be used to confirm endotracheal tube intubation and assess endotracheal tube depth. Ultrasound is superior to the landmark-based approach for locating the cricothyroid membrane, particularly in patients with difficult anatomy. Finally, we provide an algorithm for using ultrasound to manage the crashing patient on mechanical ventilation. After reading this article, readers will have an enhanced understanding of the role of ultrasound in airway management.

Citations

Citations to this article as recorded by  Crossref logo
  • Point-of-care Ultrasonography for Endotracheal Tube Confirmation: An Essential Adjunct in Airway Management
    Neeraj Kumar
    Indian Journal of Critical Care Medicine.2026; 30(2): 92.     CrossRef
  • A Prospective Observational Study to Identify the Predictors of First Pass Success with Video-Laryngoscope-Guided Nasal Intubation in Patients with Restricted Mouth Opening in Oral Cavity Tumours
    Aishwarya Ramkrishnan, P R Pravin Sankar
    Airway.2026; 9(1): 33.     CrossRef
  • Training for pediatric cannot intubate cannot oxygenate: surgical airway should replace needle cricothyrotomy
    Allison M. B. Lehman, Paul Amstutz, Jackson E. Moore, Matthew Johnson, Christopher Obersteadt, Dominique Williams, Mary J. Waxman, Morgan Blubaugh, Anaya Parikh, Timothy R. Walsh, Daniel E. Bruegger, Shawn B. Sood, Adrienne N. Malik, Andrew Pirotte
    Frontiers in Disaster and Emergency Medicine.2026;[Epub]     CrossRef
  • Airway management of adults in the acute care setting
    Michael Gottlieb, Stephanie C DeMasi, Jonathan D Casey, Matthew W Semler, Kevin G Buell
    BMJ.2026; 393: e086612.     CrossRef
  • Diagnostic Accuracy of Point-of-care Ultrasonography for Endotracheal Tube Confirmation: Interpreting Evidence beyond Pooled Estimates
    Jay Prakash, Khushboo Saran, Kalavathy Swarna, Bodhisatwa Choudhuri, Bikram K Gupta
    Indian Journal of Critical Care Medicine.2026; 30(4): 357.     CrossRef
  • Seeing is believing: Point-of-care ultrasound for endotracheal tube confirmation
    Michael Gottlieb
    The American Journal of Emergency Medicine.2026; 108: 10.     CrossRef
  • Point-of-Care Ultrasound—A Paradigm Shift in Clinical Practice and Medical Education: A Narrative Review
    Sulafa Ali, Mohammed A. Alhassan, Hayat A. Ahmed, Ammar Elgadi
    Sudan Journal of Medical Sciences.2026; 21(2): 169.     CrossRef
  • In-depth tube assessment by ultrasound: double twist sign to evaluate endotracheal tube depth—results of a cadaver diagnostic accuracy study
    Jorge Ernesto Lopez Matta, Marissa Ginette Vive, Carlos Vsevolod Elzo Kraemer, Jeroen Alphons Janson, Marco Cornelis de Ruiter, Pieter Roel Tuinman, Robbert Godfried Notenboom, David Johannes van Westerloo
    Intensive Care Medicine Experimental.2026;[Epub]     CrossRef
  • Point-of-care ultrasound (POCUS) in emergency airway management: emerging evidence for assessment, prediction, and confirmation
    Fahad Abuguyan
    Internal and Emergency Medicine.2026;[Epub]     CrossRef
  • Evolution of Emergency Airway Management From Anatomical Prediction to a Systems-Based Resuscitative Approach in the Emergency Department: A Narrative Review
    Anagani Hrushikesh, Chinnam Vishnupriya, Chetla Rakesh, Anusree K, Dhanasekaran B S, Gireesh Kumar
    Cureus.2026;[Epub]     CrossRef
  • Transtracheal ultrasound for identifying endotracheal intubation in adults
    Michael Gottlieb, Daniel J Kim, Gary D Peksa, Jennifer Westrick, Amy Marks
    Cochrane Database of Systematic Reviews.2025;[Epub]     CrossRef
  • Emergency medicine updates: Managing the patient with return of spontaneous circulation
    Brit Long, Michael Gottlieb
    The American Journal of Emergency Medicine.2025; 93: 26.     CrossRef
  • Comparison of Airway Ultrasound and Conventional Methods in Airway Management: Effectiveness and Temporal Efficiency in Traumatic Patients in Emergency Department
    Vijay Kumar SS, Pranup Roshan Quadras, Sofiya Crastha, Anila Jose
    National Journal of Medical Research.2025; 15(02): 109.     CrossRef
  • Emergency medicine updates: Cardiac arrest airway management
    Brit Long, Michael Gottlieb
    The American Journal of Emergency Medicine.2025; 94: 158.     CrossRef
  • Ultrasonography – A New Method for Airway Assessment: A Review of the Literature
    B. Dimitrova, M. Gaydarova, G. Nikolova, T. Ilchev, Z. Jeleva, M. Mladenova
    Acta Medica Bulgarica.2025; 52(3): 89.     CrossRef
  • PeRLS for procedural sedation: A specialized resuscitation framework enhanced by EASy-ALS ultrasound integration
    Nibras F. Bughrara, Rosie Gaylor, William Hsu, Chelsey Santino, Mohamed Shembesh, Aliaksei Pustavoitau
    Best Practice & Research Clinical Anaesthesiology.2025; 39(3): 255.     CrossRef
  • VIA AÉREA DIFÍCIL EM CENÁRIOS CRÍTICOS: UMA REVISÃO SISTEMÁTICA SOBRE AVALIAÇÃO, TECNOLOGIAS E SEGURANÇA DO PACIENTE
    Eduardo Vilela Rodrigues, José Matos De Oliveira Neto, Julia Yurie Nakao Ravazzi, Laura Favero Janini Abboud, Maria Eduarda Colmanetti Rezende, Ana Laura Fugita Santos, Amanda Freire Candido
    LUMEN ET VIRTUS.2025; 16(55): e10788.     CrossRef
  • Diagnostic accuracy of point-of-care ultrasound for confirming endotracheal tube placement in pediatric acute care settings: a systematic review and meta-analysis
    Mohammed Alsabri, Khaled Abouelmagd, Ahmed Bostamy Elsnhory, Mohammed Tarek Hasan, Shree Rath, Mohamed Ismaeil Elnady, Yisha Cheng, Eslam Abady, Abdelrahman M. Tawfik, Mohamed Nasser ELshabrawi, Patrick Yoo, Aysha Hasan, Mohammed Hamzah
    BMC Emergency Medicine.2025;[Epub]     CrossRef
  • SONO case series: point-of-care ultrasound for intubation confirmation
    Michael Gottlieb, James R O'Brien, Daven Patel
    Emergency Medicine Journal.2024; 41(6): 379.     CrossRef
  • Airway and Thoracic Ultrasound
    Martin Demant, Paul Koscumb, Elaine Situ-LaCasse
    Emergency Medicine Clinics of North America.2024; 42(4): 755.     CrossRef
  • Point-of-Care Ultrasound: A Vital Tool for Anesthesiologists in the Perioperative and Critical Care Settings
    Ankita Dhir, Dinkar Bhasin, Bhavna Bhasin-Chhabra, Abhilash Koratala
    Cureus.2024;[Epub]     CrossRef
  • Emergency medicine updates: Endotracheal intubation
    Brit Long, Michael Gottlieb
    The American Journal of Emergency Medicine.2024; 85: 108.     CrossRef
  • Current trends in emergency airway management: a clinical review
    Sangun Nah, Yonghee Lee, Sol Ji Choi, Jeongwoo Lee, Soyun Hwang, Seongmi Lim, Inhye Lee, Young Soon Cho, Hyun Soo Chung
    Clinical and Experimental Emergency Medicine.2024; 11(3): 243.     CrossRef
  • Difficult Airway: Is this the Time to Focus on Point-of-care Ultrasonography?
    Sunil Karanth, Mahesha Padyana
    Indian Journal of Critical Care Medicine.2024; 29(1): 1.     CrossRef
  • 23,086 View
  • 887 Download
  • 20 Web of Science
  • 24 Crossref

Case Report

Resuscitation | Imaging

A case report of point-of-care ultrasound directed thrombectomy: a reversible cause of cardiac arrest managed with extracorporeal membrane oxygenation cannulation
Megan Hoffer, Salim Aziz, Keith Boniface, Jenna E. Aziz, Ali Pourmand
Clin Exp Emerg Med 2024;11(1):100-105.   Published online November 5, 2023
DOI: https://doi.org/10.15441/ceem.23.084

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A case report of point-of-care ultrasound directed thrombectomy: a reversible cause of cardiac arrest managed with extracorporeal membrane oxygenation cannulation
Clin Exp Emerg Med. 2024;11(1):100-105.   Published online November 5, 2023
DOI: https://doi.org/10.15441/ceem.23.084
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A case report of point-of-care ultrasound directed thrombectomy: a reversible cause of cardiac arrest managed with extracorporeal membrane oxygenation cannulation
Clin Exp Emerg Med. 2024;11(1):100-105.   Published online November 5, 2023
DOI: https://doi.org/10.15441/ceem.23.084
Close
Extracorporeal membrane oxygenation (ECMO) has been increasingly employed in the emergency department for patients with a potentially reversible cause of cardiac arrest. We present the case of a young female patient with an in-hospital cardiac arrest who was found to have severe right heart strain on point-of-care ultrasound (POCUS), suggesting a massive pulmonary embolism. Rapid bedside diagnosis using ultrasound expedited bedside cannulation and initiation of ECMO as a bridge to surgical thrombectomy, and ultimately the patient survived with full neurologic function. With its ready availability and increasing acceptance by consultants, POCUS should be incorporated into cardiac arrest algorithms as the standard of care to rule in thrombotic and obstructive causes of cardiac arrest.

Citations

Citations to this article as recorded by  Crossref logo
  • Artificial intelligence-based evaluation of carotid artery compressibility via point-of-care ultrasound in determining the return of spontaneous circulation during cardiopulmonary resuscitation
    Subin Park, Hee Yoon, Soo Yeon Kang, Ik Joon Jo, Sejin Heo, Hansol Chang, Jong Eun Park, Guntak Lee, Taerim Kim, Sung Yeon Hwang, Soyoung Park, Myung Jin Chung
    Resuscitation.2024; 202: 110302.     CrossRef
  • 7,577 View
  • 104 Download
  • 1 Web of Science
  • 1 Crossref

Brief Research Report

Education & Simulation | Imaging

Utilization of point-of-care ultrasound among graduates of a 4-year longitudinal medical school ultrasound curriculum
Andy Phan Nguyen, Soheil Saadat, Michelle Thao Nguyen, Monica Devang Desai, Jonathan Wesley Rowland, John Christian Fox
Clin Exp Emerg Med 2023;10(2):224-229.   Published online January 30, 2023
DOI: https://doi.org/10.15441/ceem.22.357

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Utilization of point-of-care ultrasound among graduates of a 4-year longitudinal medical school ultrasound curriculum
Clin Exp Emerg Med. 2023;10(2):224-229.   Published online January 30, 2023
DOI: https://doi.org/10.15441/ceem.22.357
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Utilization of point-of-care ultrasound among graduates of a 4-year longitudinal medical school ultrasound curriculum
Clin Exp Emerg Med. 2023;10(2):224-229.   Published online January 30, 2023
DOI: https://doi.org/10.15441/ceem.22.357
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Objective
In 2011, School of Medicine, University of California, Irvine was among the first schools to implement a 4-year ultrasound curriculum. We aimed to find the point-of-care ultrasound (POCUS) utilization pattern among University of California, Irvine alumni.
Methods
We surveyed University of California, Irvine alumni from the class of 2011 and beyond. Survey questions included POCUS reliance, frequency of use, and comfort with image acquisition and interpretation compared with peers. The primary outcomes were self-reported comfort and reliance on POCUS.
Results
We received 93 responses from 624 surveyed alumni (response rate, 14.9%), of which 87 were analyzed. Although 46 respondents (52.9%) reported more reliance on POCUS, three (3.4%) relied on it less than their peers. At the same time, 72 (82.7%) and 67 (77.0%) felt more comfortable than their colleagues in obtaining and interpreting POCUS, respectively. No respondents felt less comfortable obtaining or interpreting POCUS than their peers. The frequency of POCUS use correlated directly with the frequency with which POCUS changed the responder’s case management (rho, 0.860; P<0.001). POCUS reliance also correlated with respondents’ comfort level in obtaining (rho, 0.321; P<0.001) and interpreting (rho, 0.378; P<0.001) POCUS results.
Conclusion
University of California, Irvine graduates had higher reliance on POCUS than peers in their respective specialties. Their POCUS findings frequently changed their case management.

Citations

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    Seungwan Eun, Hee Yoon, Soo Yeon Kang, Ik Joon Jo, Sejin Heo, Hansol Chang, Guntak Lee, Jong Eun Park, Taerim Kim, Se Uk Lee, Sung Yeon Hwang, Sun-Young Baek
    Diagnostics.2024; 14(2): 225.     CrossRef
  • Role of point-of-care ultrasound in critical care and emergency medicine: update and future perspective
    Wookjin Choi, Young Soon Cho, Young Rock Ha, Je Hyeok Oh, Heekyung Lee, Bo Seung Kang, Yong Won Kim, Chan Young Koh, Ji Han Lee, Euigi Jung, Youdong Sohn, Han Bit Kim, Su Jin Kim, Hohyun Kim, Dongbum Suh, Dong Hyun Lee, Ju Young Hong, Won Woong Lee
    Clinical and Experimental Emergency Medicine.2023; 10(4): 363.     CrossRef
  • 6,508 View
  • 155 Download
  • 2 Web of Science
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Case Report

Cardiovascular

Prompt diagnosis of ST-elevation myocardial infarction with papillary muscle rupture by point-of-care ultrasound in the emergency department
Koon Ho Cheung, Colin Graham Alexander
Clin Exp Emerg Med 2017;4(3):178-181.   Published online September 30, 2017
DOI: https://doi.org/10.15441/ceem.16.172
Correction in: Clin Exp Emerg Med 2017;4(4):258

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Prompt diagnosis of ST-elevation myocardial infarction with papillary muscle rupture by point-of-care ultrasound in the emergency department
Clin Exp Emerg Med. 2017;4(3):178-181.   Published online September 30, 2017
DOI: https://doi.org/10.15441/ceem.16.172
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Prompt diagnosis of ST-elevation myocardial infarction with papillary muscle rupture by point-of-care ultrasound in the emergency department
Clin Exp Emerg Med. 2017;4(3):178-181.   Published online September 30, 2017
DOI: https://doi.org/10.15441/ceem.16.172
Close
A previously healthy 61-year-old man presented to the emergency department with chest pain and dyspnoea for 6 hours. Examination revealed distress with an apical pansystolic murmur. Initial electrocardiogram showed sinus tachycardia and ST elevation in leads II, III, and aVF compatible with an inferior ST-elevation myocardial infarction. Point-of-care echocardiography in the emergency department showed a flail anterior mitral leaflet and severe mitral regurgitation, leading to a provisional diagnosis of papillary muscle rupture. Emergency cardiac catheterization showed 100%, 80%, and 70% occlusion of the middle right coronary, left anterior descending, and left circumflex arteries, respectively. An emergency triple vessel coronary artery bypass grafting and mitral valve replacement was performed. Posteromedial papillary muscle rupture resulting in mitral regurgitation was confirmed intraoperatively. The patient recovered uneventfully. In the absence of primary percutaneous coronary intervention, thrombolysis decisions should be made with extreme caution if mechanical complications of ST-elevation myocardial infarction are suspected.

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  • Point-of-care ultrasound in cardiovascular imaging: current status and future prospects
    Parker J. Kim, Joseph Delly, Kevin M. Kozakowski, Paul J. Han, Keshav R. Nayak, Bruce J. Kimura
    Expert Review of Medical Devices.2026; 23(8): 925.     CrossRef
  • Emergent Diagnosis of a Flail Mitral Leaflet With Bedside Echocardiography
    Patrick Hsu, Caroline Shepherd, Keyon Shokraneh, Gabriel Cabrera, Eric J Kalivoda
    Cureus.2020;[Epub]     CrossRef
  • 12,824 View
  • 150 Download
  • 3 Web of Science
  • 2 Crossref
Original Articles

Procedures

Comparison of internal jugular vein dilation between Valsalva maneuver and proximal internal jugular vein compression
Hyeonjoo Seong, Bora Kang, Giwoon Kim
Clin Exp Emerg Med 2016;3(4):193-196.   Published online December 30, 2016
DOI: https://doi.org/10.15441/ceem.15.098

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Comparison of internal jugular vein dilation between Valsalva maneuver and proximal internal jugular vein compression
Clin Exp Emerg Med. 2016;3(4):193-196.   Published online December 30, 2016
DOI: https://doi.org/10.15441/ceem.15.098
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Comparison of internal jugular vein dilation between Valsalva maneuver and proximal internal jugular vein compression
Clin Exp Emerg Med. 2016;3(4):193-196.   Published online December 30, 2016
DOI: https://doi.org/10.15441/ceem.15.098
Close
Objective
The Valsalva maneuver is recognized as an effective method to dilate the internal jugular vein (IJV). However, this maneuver cannot be performed in many cases, such as children and unconscious patients. The aim of this study was to evaluate the effectiveness of proximal IJV compression, which can easily be performed, regardless of patient cooperation.
Methods
Healthy adult volunteers were recruited from tertiary hospital employees. Basic anatomic and physiologic data were collected. The subjects lay down as if they were undergoing IJV catheter insertion, in the supine position with their necks turned 30 degrees to the left. The main outcome was the cross-sectional area (CSA) of the distal IJV as measured by ultrasound in four stages. The first stage was sham without any maneuver. The second was Valsalva maneuver, the third was digital IJV compression, and the fourth was digital compression accompanied by simultaneous Valsalva maneuver.
Results
A total of 41 volunteers were enrolled. Twenty-six (63.41%) were male with an average age of 28.15±2.85 years. Mean height was 170.74±8.66 cm and mean neck circumference was 35.28±3.87 cm. The mean CSA-IJV was 1.06±0.36 cm2 without any maneuver. It increased to 1.34±0.45 cm2 with Valsalva maneuver (P<0.001), to 1.26±0.41 cm2 with digital compression (P<0.001), and to 1.41±0.47 cm2 with the two maneuvers combined (P=0.01).
Conclusion
Digital proximal IJV compression effectively dilates the distal IJV. When performed simultaneously with the Valsalva maneuver, the effect was enhanced.

Citations

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  • Effect of 10 cm H₂O positive end-expiratory pressure on right internal jugular vein cross-sectional area in obese patients under general anesthesia: a prospective observational study
    Xiaofan Zheng, Xiaoqiong Cao, Shiwen Shen, Dongliang Pei
    BMC Anesthesiology.2026;[Epub]     CrossRef
  • Impact of the Valsalva manoeuvre on the choroid: A systematic review with meta‐analyses
    Andreas Arnold‐Vangsted, Lars Christian Boberg‐Ans, Lasse Jørgensen Cehofski, Elon H. C. van Dijk, Jakob Grauslund, Michael Stormly Hansen, Hans Christian Kiilgaard, Oliver Niels Klefter, Marie Krogh Nielsen, Mehmet Orkun Sevik, Yousif Subhi
    Acta Ophthalmologica.2025; 103(2): 127.     CrossRef
  • The effect of passive leg raising on the cross-sectional area of the right internal jugular vein in obese patients undergoing surgery: a prospective observational study
    Shuyan Wang, Xiaoqiong Cao, Pei Zhu, Chenmin Sun, Lijun Cao, Dongliang Pei
    BMJ Open.2025; 15(5): e098031.     CrossRef
  • Ultrasound-guided supraclavicular internal jugular vein compression to increase internal jugular vein cross-sectional area in hospitalized patients: a prospective observational study in Japan
    Masataka Hiruma, Hiroyuki Honda, Shuichiro Kurita, Shunsuke Nukaga, Mitsuhiro Watanabe, Kei Nishiyama
    Acute and Critical Care.2025; 40(4): 574.     CrossRef
  • Effect of passive leg raising on the cross-sectional area of the right internal jugular vein in patients with obesity: a randomised controlled trial protocol
    Dongliang Pei, Shuyan Wang, Chenmin Sun
    BMJ Open.2024; 14(5): e085044.     CrossRef
  • Effects of Combined the Trendelenburg and Passive Leg Raising Positions on the Cross-Sectional Area of the Right Internal Jugular Vein
    B Arslan, A İdem, A Arslan
    Nigerian Journal of Clinical Practice.2021; 24(6): 892.     CrossRef
  • The effect of increased abdominal pressure on internal jugular vein catheterization under ultrasound-guidance on conscious patients: A randomised controlled trial
    Jing-Li Yang, Peng-Cheng Xie, Guo-Ping Ma, Zhan-Fang Li
    International Journal of Surgery.2020; 77: 183.     CrossRef
  • A commentary on “the effect of increased abdominal pressure on internal jugular vein catheterization under ultrasound-guidance on conscious patients: A randomised controlled trial” (International Journal of Surgery 2020; 77:183-6)
    Baoji Hu, Ying Song, Hongwei Duan
    International Journal of Surgery.2020; 83: 257.     CrossRef
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  • 131 Download
  • 10 Web of Science
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Ultrasound-guided regional anesthesia for the pain management of elderly patients with hip fractures in the emergency department
Hee Kyung Lee, Bo Seung Kang, Chang Sun Kim, Hyuk Joong Choi
Clin Exp Emerg Med 2014;1(1):49-55.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.008

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Ultrasound-guided regional anesthesia for the pain management of elderly patients with hip fractures in the emergency department
Clin Exp Emerg Med. 2014;1(1):49-55.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.008
Download Citation

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Ultrasound-guided regional anesthesia for the pain management of elderly patients with hip fractures in the emergency department
Clin Exp Emerg Med. 2014;1(1):49-55.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.008
Close
Objective

We examined the pain-relieving effect of ultrasound-guided regional anesthesia performed by emergency physicians on elderly hip fracture patients.

 Methods

This study is a prospective, non-randomized, case-control study. The subjects were patients older than 65 years who visited the emergency department with a hip fracture. After we obtained informed consent, two emergency physicians performed an ultrasound-guided three-in-one femoral block using 20 mL of 0.5% bupivacaine. The pain score was measured just before regional anesthesia, and 0.25, 0.5, 1, 2, 3, and 4 hours after the procedure. Another group of patients was given multiple doses of morphine to control the pain. We compared the change in pain score and the development of adverse reactions between the two groups.

 Results

A total of 47 patients were enrolled in this study, of which 25 were given regional anesthesia. Successful pain control (pain score<4) was significantly higher in the regional anesthesia group (96.0% vs. 40.9%; P<0.001). The decrease in pain score was significantly higher in the regional anesthesia group (7 [interquartile range, 6 to 7] vs. 4 [interquartile range, 3 to 5]; P< 0.001). The only adverse reaction observed was mild nausea in 4 patients (1 out of 25 from the regional anesthesia group and 3 out of 22 from the morphine group).

 Conclusion

Ultrasound-guided regional anesthesia administered by emergency physicians treating elderly hip fracture patients provided faster pain relief and a larger decrease in pain than conventional intravenous injections of morphine.

Citations

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    Ashley Grant, Colin Sullivan, Brandon Buchel, Charlotte Derr
    Cureus.2025;[Epub]     CrossRef
  • Complications of Ultrasound-Guided Peripheral Nerve Blocks in the Emergency Department: A Systematic Review and Meta-Analysis
    Joyce Hanyue Gu, Adrian Cotarelo, Mark Samarneh
    The Journal of Emergency Medicine.2025; 75: 256.     CrossRef
  • Precision and safety advantages of ultrasound-guided nerve blocks in geriatric anesthesia: current status and future prospects
    Xiao-yin Lin, Ya-mei Yang, Yang Liu, Qing-qing Dang, Kan Zhang
    Frontiers in Medicine.2025;[Epub]     CrossRef
  • Unique considerations in regional anesthesia for emergency department and non-or procedures
    Elizabeth A. Scholzen, John B. Silva, Kristopher M. Schroeder
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  • Serratus Anterior Plane Block Remote Learning Curriculum
    Gabriel Weingart, Di Coneybeare
    MedEdPORTAL.2024;[Epub]     CrossRef
  • Comparative study lumbar plexus block and lumbar erector spinae plane block for postoperative pain relief after proximal femoral nail for proximal femoral fractures
    Sandeep Diwan, Abhishek Lonikar, Himaunshu Dongre, Parag Sancheti, Abhijit S. Nair, Suhrud Panchawagh
    Saudi Journal of Anaesthesia.2023; 17(2): 147.     CrossRef
  • The impact of loco-regional anaesthesia on postoperative opioid use in elderly hip fracture patients: an observational study
    Gioia Häusler, Puck C. R. van der Vet, Frank J. P. Beeres, Thomas Kaufman, Jip Q. Kusen, Beate Poblete
    European Journal of Trauma and Emergency Surgery.2022; 48(4): 2943.     CrossRef
  • An integrative comparative study between ultrasound-guided regional anesthesia versus parenteral opioids alone for analgesia in emergency department patients with hip fractures: A systematic review and meta-analysis
    Hany A. Zaki, Haris Iftikhar, Nabil Shallik, Amr Elmoheen, Khalid Bashir, Eman E. Shaban, Aftab Mohammad Azad
    Heliyon.2022; 8(12): e12413.     CrossRef
  • Sustained Release of Levobupivacaine, Lidocaine, and Acemetacin from Electrosprayed Microparticles: In Vitro and In Vivo Studies
    Jian-Ming Chen, Kuan-Chieh Liu, Wen-Ling Yeh, Jin-Chung Chen, Shih-Jung Liu
    International Journal of Molecular Sciences.2020; 21(3): 1093.     CrossRef
  • Preoperative Pain Management of Patients with Hip Fractures: Blind Fascia Iliaca Compartment Block Compared to Ultrasound Guided Femoral Nerve Block—A Randomized Controlled Trial
    Johanne Bangshoej, Thomas Thougaard, Hans Fjeldsøe-Nielsen, Sandra Viggers
    Open Journal of Anesthesiology.2020; 10(11): 371.     CrossRef
  • A Feasibility Study of Smartphone-Based Telesonography for Evaluating Cardiac Dynamic Function and Diagnosing Acute Appendicitis with Control of the Image Quality of the Transmitted Videos
    Changsun Kim, Hyunmin Cha, Bo Seung Kang, Hyuk Joong Choi, Tae Ho Lim, Jaehoon Oh
    Journal of Digital Imaging.2016; 29(3): 347.     CrossRef
  • Identification of teaching priorities for ultrasound-guided regional anesthesia as first-line pain management in a swiss university emergency department
    Eckehart Schöll, Dieter Kolleth, Gilbert Krähenbühl, Christian H Nickel, Roland Bingisser
    Emergency Medicine and Health Care.2016; 4(1): 2.     CrossRef
  • The Use of Clinician-Performed Ultrasonography to Determine the Treatment Method for Suspected Paediatric Appendicitis
    C Kim, B Kang, Jb Park, Yr Ha
    Hong Kong Journal of Emergency Medicine.2015; 22(1): 31.     CrossRef
  • 16,337 View
  • 154 Download
  • 10 Web of Science
  • 13 Crossref
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CEEM : Clinical and Experimental Emergency Medicine