User talk:Dmresop

Welcome to Wikipedia!
Hello, I am a member of Wikiproject Medicine and I just want to personally welcome you to Wikipedia. I saw that you were interested in expanding the emergency untrasound article. If you are interested I would be very happy to help guide you through the process of editing medical articles for the first time. If you are, just reply here. Peter.C •  talk  •  contribs  21:06, 26 September 2012 (UTC)

Emergency Ultrasound
Hello,

I first want to compliment you on your work on emergency ultrasound, however, due to some problems I reverted it. Honest to god, it was a great contribution in many ways to the article, but, it had many problems as it did not follow the Medical Manual of Style, so much so, that it read as unencyclopedic and more like a research article. Typically I would just rewrite it myself but I have been extremely busy as of yet. I want to highly encourage you to read the manual of style and make corrections and resubmit the article. I truly do not wish I had to do this and I would be more than welcome to answer any questions you have. Peter.C •  talk  •  contribs  18:30, 3 October 2012 (UTC)

'''Thanks. And Whoops.''' Sorry I apparently went about this the wrong way. I was working with another emergency physician and we put together the content over the last two months. I will look at the Medical Manual of Style and try to get it back up. If you do not feel strongly about the original content, I will edit both together so it "flows" - Not sure what questions I'll have as I haven't looked at the manual yet. Dmresop (talk) 09:53, 4 October 2012 (UTC)

Me again!
Try this on for size... I'd really like to keep the more detailed content...I can always divide it out later into more detailed pages... but I am working on simplifying it and using more internal links, fewer definitions. I hate to ask to do this, but I'd like to know if I'm on the wrong track. Can you skim this and tell me if it's okay? I still have to complete the editing, but I really want to know if I'm on the right track...Or if I still need to make major changes, what they are? Still too much info? I can scale it down a lot by removing most of the info...whatever we need to do to improve the page to make it more accurate. There's a bit of a time crunch as there is a national emergency ultrasound meeting next week and I'd really like to get it up by this weekend so I can get feedback from colleagues at the meeting. Thanks!Dmresop (talk) 15:07, 5 October 2012 (UTC)

RE-EDIT: Emergency ultrasound is the application of ultrasound at the point of care to make immediate patient-care decisions. It is performed by the health care professional caring for the patient. This point-of-care use of ultrasound is often to evaluate an emergent medical condition, in settings such as an emergency department, critical care unit, ambulance, or combat zone.

Emergency and point-of-care ultrasound is focused on a limited set of Emergency ultrasound is used to quickly diagnose a limited set of injuries or pathologic conditions, specifically those where conventional diagnostic methods would either take too long or would introduce greater risk to the patient (either by transporting the patient away from the most closely monitored setting, or exposing them to ionizing radiation and/or intravenous contrast agents).

Point of care ultrasound has been used in a wide variety of specialties and has increased in use in the last decade as ultrasound machines have become more compact and portable. It is now used for a variety of exams in various clinical settings at the patient's bedside. In the emergency setting, it is used to guide resuscitation and monitor critically ill patients, provide procedural guidance for improved patient safety and confirm clinical diagnosis.

Scope
Emergency ultrasound can help direct resuscitation, monitor therapy, guide procedures or indicate diagnosis.

RESUSCITATION of the critically ill
Point of care ultrasound is sometimes the only option in the evaluation of patients who are too ill for transport to other imaging modalities (ie computed tomography, or CT scan) or whose illness is so acute that medical decisions in their care need to be made in seconds to minutes. It is also increasingly used to guide and triage care in resource-limited situations, in rural or medically-underserved areas.

In patients who present with a traumatic injury, The Focused assessment with sonography for trauma or FAST exam is used to assess hypotensive patients for occult bleeding. Traditionally used by emergency physicians and surgeons treating trauma patients, it has also been used by paramedics in combat zones, and for non-traumatic problems such as ruptured ectopic pregnancy. Similarly, emergency ultrasound can also evaluate the lungs for hemothorax, or bleeding in the chest, and pneumothorax, a puncture resulting in air trapped in the chest and lung collapse.

For patients presenting with hypotension of unknown cause, ultrasound has been utilized to determine the cause of shock. Evaluation of the heart and inferior vena cava (IVC) can help the clinician at the bedside choose important treatments and monitor the response to the interventions.

A patient who has hypotension and a bedside ultrasound showing hyperdynamic left heart with a flat, collapsible IVC indicates low blood volume. If the patient has a fever, the clinician may deduce sepsis, or severe infection is causing the problem. If that same patient has back pain instead of a fever, the clinician may see an abdominal aortic aneurysm that is leaking or ruptured. Conversely, weak heart activity and a very full, non-collapsible IVC would indicate a cardiac cause for low blood pressure.

For patients presenting with acute shortness of breath, ultrasound assessment of the lung, heart, and IVC can evaluate for potentially life threatening diseases including pneumothorax, significant pleural effusions, congestive heart failure, pulmonary edema, pericardial effusion, and some large pulmonary emboli.

With its increased availability, ultrasound is now frequently used more in code situations, in which patients have lost most or all signs of life. Practitioners may use the ultrasound to see if the heart is moving, beating in organized fashion or if it has a pericardial effusion or fluid around it. Pericardiocentesis, a procedure in which a needle is used to drain the effusion, can utilize ultrasound guidance of a needle to decrease the risk of hitting lungs, heart or other vital organs

MONITORING THERAPY
Emergency ultrasound can not only diagnose, but also monitor a patient’s response to therapeutic interventions. Ultrasound can be utilized to assess a patient’s intravascular volume status and response to intravenous fluid therapy by measuring the size and respiratory change in the diameter of the IVC. Ultrasound of the lungs may demonstrate resolution of pulmonary edema from congestive heart failure.

PROCEDURAL GUIDANCE
Using ultrasound to guide needles during procedures may improve success and decrease complications in procedures performed by multiple specialties, including central and venous access, thoracentesis, paracentesis, pericardiocentesis , arthrocentesis, regional anesthesia, incision and drainage of abscesses  , localization and removal of foreign bodies, lumbar puncture, biopsies, and other procedures.

DIAGNOSTIC
to be continued...