Entries Tagged as 'J Ultrasound Med'
Comparison of infection rates among ultrasound-guided versus traditionally placed peripheral intravenous lines.
J Ultrasound Med. 2010 May;29(5):741-7
Authors: Adhikari S, Blaivas M, Morrison D, Lander L
OBJECTIVE: The purpose of this study was to compare infection rates of peripheral intravenous (IV) lines placed under ultrasound guidance with traditionally placed IV lines. METHODS: We conducted a retrospective review of emergency department (ED) and hospital records of adult patients who had a peripheral IV line placed in the ED and were admitted to the hospital over a 1-year period. This study took place at a level I academic urban ED with an annual census of 75,000. All admitted patients with a peripheral IV placed under ultrasound guidance in the ED were identified. Control patients had a traditional landmark approach. Emergency department nurses followed standard aseptic precautions when inserting both ultrasound-guided as well as traditionally placed IV lines. Researchers reviewed all parts of the medical record, including ED and inpatient notes. Descriptive statistics and chi(2) and Fisher exact tests were used in data evaluation. RESULTS: A total of 402 patients who had peripheral IV lines placed under ultrasound guidance were compared with 402 matched control patients. In the ultrasound-guided IV group, the mean time between insertion to catheter removal was 2.6 days compared with 2.4 days in the traditional group (P = .03). There were 2 documented infections in the ultrasound group and 3 in the traditional group, yielding infection rates of 5.2 per 1000 in the ultrasound-guided IV group and 7.8 per 1000 in the traditional approach group. There was no statistically significant difference between infection rates in the two groups (P = .68). CONCLUSIONS: Both traditional and ultrasound-guided approaches had low infection rates, suggesting that there is no increased risk of infection with ultrasound guidance for peripheral IV lines.
PMID: 20427786 [PubMed - indexed for MEDLINE]
[Read more →]
Tags: J Ultrasound Med
Peripherally inserted central catheter placement with the sonic flashlight: initial clinical trial by nurses.
J Ultrasound Med. 2009 May;28(5):651-6
Authors: Wang D, Amesur N, Shukla G, Bayless A, Weiser D, Scharl A, Mockel D, Banks C, Mandella B, Klatzky R, Stetten G
OBJECTIVE: We describe a case series constituting the first clinical trial by intravenous (IV) team nurses using the sonic flashlight (SF) for ultrasound guidance of peripherally inserted central catheter (PICC) placement. METHODS: Two IV team nurses with more than 10 years of experience with placing PICCs and 3 to 6 years of experience with ultrasound attempted to place PICCs under ultrasound guidance in patients requiring long-term IV access. One of two methods of ultrasound guidance was used: conventional ultrasound (CUS; 60 patients) or a new device called the SF (44 patients). The number of needle punctures required to gain IV access was recorded for each patient. RESULTS: In both methods, 87% of the cases resulted in successful venous access on the first attempt. The average number of needle sticks per patient was 1.18 for SF-guided procedures compared with 1.20 for CUS-guided procedures. No significant difference was found in the distribution of the number of attempts between the two methods. Anecdotal comments by the nurses indicated the comparative ease of use of the SF display, although the relatively small scale of the SF image compared with the CUS image was also noted. CONCLUSIONS: We have shown that the SF is a safe and effective device for guidance of PICC placement in the hands of experienced IV team nurses. The advantage of placing the ultrasound image at its actual location must be balanced against the relatively small scale of the SF image.
PMID: 19389904 [PubMed - indexed for MEDLINE]
[Read more →]
Tags: J Ultrasound Med
Emergent right upper quadrant sonography.
J Ultrasound Med. 2009 Apr;28(4):479-96
Authors: Spence SC, Teichgraeber D, Chandrasekhar C
OBJECTIVE: The purpose of this presentation is to review the sonographic spectrum of disease entities evaluated by right upper quadrant (RUQ) sonography on an emergent basis. METHODS: Right upper quadrant sonography was performed on an emergent basis in patients who came to the emergency department with signs and symptoms suspicious for or simulating acute cholecystitis or diseases of the liver and biliary tree. RESULTS: A wide gamut of acute and chronic cholecystitis and diseases of the liver and biliary tree were visualized on RUQ sonography. Several other entities in addition to hepatic and biliary disease were also suspected on sonography and further evaluated by computed tomography. CONCLUSIONS: Right upper quadrant sonography is the first line of imaging in patients with signs and symptoms of hepatic, gallbladder, or biliary disease as well as RUQ pain. Patient triage or additional imaging may be obtained on the basis of emergent RUQ sonographic findings.
PMID: 19321676 [PubMed - indexed for MEDLINE]
[Read more →]
Tags: J Ultrasound Med
A randomized controlled trial of ultrasound-assisted lumbar puncture.
J Ultrasound Med. 2007 Oct;26(10):1341-8
Authors: Nomura JT, Leech SJ, Shenbagamurthi S, Sierzenski PR, O’Connor RE, Bollinger M, Humphrey M, Gukhool JA
OBJECTIVE: Evidence showing the systematic utility of ultrasound imaging during lumbar puncture (LP) in the emergency department is lacking. Our hypothesis was that ultrasound-assisted LP would increase the success rate and ease of performing LP with a greater benefit in obese patients. METHODS: This was an Institutional Review Board-approved, randomized, prospective, double-blind study conducted at the emergency department of a teaching institution. Patients undergoing LP from January to December 2004 were eligible for enrollment. Patients were randomized to undergo LP using palpation landmarks (PLs) or ultrasound landmarks (ULs). Data collected included age, body mass index, number of attempts, ease of performance and patient comfort on a 10-cm Visual Analog Scale, procedure time, success, and traumatic LP. Statistical analysis of data included relative risk (RR), the Mann-Whitney U test, and the Student t test. RESULTS: A total of 46 patients were enrolled, 22 randomized to PLs and 24 to ULs. There were no differences between the groups in mean age or body mass index. Six of 22 attempts failed with PLs versus 1 of 24 with ULs (RR, 1.32; 95% confidence interval, 1.01-1.72). In 12 obese patients, 4 of 7 PL attempts failed versus 0 of 5 UL attempts (RR, 2.33; 95% confidence interval, 0.99-5.49). The ease of the procedure was better with ULs versus PLs. There were no statistical differences in the number of attempts, traumatic LPs, patient comfort, or procedure length. CONCLUSIONS: The use of ultrasound for LP significantly reduced the number of failures in all patients and improved the ease of the procedure in obese patients.
PMID: 17901137 [PubMed - indexed for MEDLINE]
[Read more →]
Tags: J Ultrasound Med
