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Article ; Online: Beyond the Numbers: Assessing Competency in Point-of-Care Ultrasound.

Gottlieb, Michael / Duanmu, Youyou

2023 Volume 81, Issue 4, Page(s) 427–428

MeSH term(s)	Humans ; Point-of-Care Systems ; Ultrasonography ; Point-of-Care Testing ; Clinical Competence
Language	English
Publishing date	2023-02-17
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	603080-4
ISSN	1097-6760 ; 0196-0644
ISSN (online)	1097-6760
ISSN	0196-0644
DOI	10.1016/j.annemergmed.2023.01.020
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Evolving Paralysis after Motor Vehicle Collision.

Prendergast, Nicole / Duanmu, Youyou

Clinical practice and cases in emergency medicine

2022 Volume 6, Issue 3, Page(s) 254–255

Abstract: Case presentation: An 85-year-old male who had been prescribed prasugrel presented to the emergency department (ED) after a motor vehicle collision and developed progressive neurological deficits. Computed tomography imaging demonstrated epidural ... ...

Abstract	Case presentation: An 85-year-old male who had been prescribed prasugrel presented to the emergency department (ED) after a motor vehicle collision and developed progressive neurological deficits. Computed tomography imaging demonstrated epidural thickening from the second through seventh cervical vertebrae, and magnetic resonance imaging was notable for a cervicothoracic epidural hematoma. The patient underwent emergent decompression with a favorable outcome. Discussion: Cases of traumatic spinal epidural hematomas are rarely seen in the ED. These are part of a small subset of operative neurological emergencies that benefit from urgent surgical intervention.
Language	English
Publishing date	2022-09-01
Publishing country	United States
Document type	Journal Article
ISSN	2474-252X
ISSN (online)	2474-252X
DOI	10.5811/cpcem2022.3.51179
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Less is more: Recommendations for achieving best practices in antibiotic use for acute upper respiratory infections.

Sills, Joe / Boccio, Eric / Govindarajan, Prasanthi / Duanmu, Youyou

Journal of the American College of Emergency Physicians open

2022 Volume 3, Issue 3, Page(s) e12767

Language	English
Publishing date	2022-06-19
Publishing country	United States
Document type	Editorial
ISSN	2688-1152
ISSN (online)	2688-1152
DOI	10.1002/emp2.12767
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: AI-ENABLED ASSESSMENT OF CARDIAC FUNCTION AND VIDEO QUALITY IN EMERGENCY DEPARTMENT POINT-OF-CARE ECHOCARDIOGRAMS.

He, Bryan / Dash, Dev / Duanmu, Youyou / Tan, Ting Xu / Ouyang, David / Zou, James

The Journal of emergency medicine

2023 Volume 66, Issue 2, Page(s) 184–191

Abstract: Background: The adoption of point-of-care ultrasound (POCUS) has greatly improved the ability to rapidly evaluate unstable emergency department (ED) patients at the bedside. One major use of POCUS is to obtain echocardiograms to assess cardiac function.! ...

Abstract	Background: The adoption of point-of-care ultrasound (POCUS) has greatly improved the ability to rapidly evaluate unstable emergency department (ED) patients at the bedside. One major use of POCUS is to obtain echocardiograms to assess cardiac function. Objectives: We developed EchoNet-POCUS, a novel deep learning system, to aid emergency physicians (EPs) in interpreting POCUS echocardiograms and to reduce operator-to-operator variability. Methods: We collected a new dataset of POCUS echocardiogram videos obtained in the ED by EPs and annotated the cardiac function and quality of each video. Using this dataset, we train EchoNet-POCUS to evaluate both cardiac function and video quality in POCUS echocardiograms. Results: EchoNet-POCUS achieves an area under the receiver operating characteristic curve (AUROC) of 0.92 (0.89-0.94) for predicting whether cardiac function is abnormal and an AUROC of 0.81 (0.78-0.85) for predicting video quality. Conclusions: EchoNet-POCUS can be applied to bedside echocardiogram videos in real time using commodity hardware, as we demonstrate in a prospective pilot study.
MeSH term(s)	Humans ; Point-of-Care Systems ; Prospective Studies ; Pilot Projects ; Echocardiography ; Ultrasonography ; Emergency Service, Hospital
Language	English
Publishing date	2023-03-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	605559-x
ISSN	0736-4679
ISSN	0736-4679
DOI	10.1016/j.jemermed.2023.02.005
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Development of a Three-Dimensionally Printed Ultrasound-Guided Peripheral Intravenous Catheter Phantom.

Tan, Ting Xu / Wu, Ying Ying / Riley, Ian / Duanmu, Youyou / Rylowicz, Samuel / Shimada, Kenji

Cureus

2021 Volume 13, Issue 8, Page(s) e17139

Abstract: Introduction Ultrasound-guided peripheral intravenous catheter (US-PIVC) placement is an effective technique to establish PIV access when the traditional approach fails. Many training programs utilize commercial or homemade phantoms for procedural ... ...

Abstract	Introduction Ultrasound-guided peripheral intravenous catheter (US-PIVC) placement is an effective technique to establish PIV access when the traditional approach fails. Many training programs utilize commercial or homemade phantoms for procedural training. However, commercial products tend to be expensive and lack realism, while homemade blocks tend to be single-use and degrade easily. Thanks to the increasing availability of three-dimensional (3D) printers in academic settings, we sought to design and develop a reusable 3D-printed US-PIVC phantom and to evaluate its utility in terms of time needed to achieve IV placement and perceived realism compared to a commercial model among a group of emergency medicine (EM) physicians. Methods The upper extremity vascular phantom was constructed using 3D printing and casting techniques. A convenience sampling of EM physicians was timed by placing a US-PIVC in the 3D-printed and commercial models. Participants were also surveyed to assess their impression of the realism of the models. The primary outcome was the time required for US-PIVC placement in the 3D-printed model compared to the commercial model. Secondary outcomes were the assessment of differences in perceived realism and total cost between the two models. Results Twenty-one EM physicians completed the study. There were no significant differences in the mean time (seconds) for US-PIVC placement in the 3D-printed model (31, SD: 21) compared to the commercial model (30, SD: 18), p=0.77. Mean realism score trended higher for the 3D-printed model (3.6, SD: 0.9) compared to the commercial model (3.1, SD: 1.0), p=0.10. The total cost for the 3D-printed model was $120, with the interchangeable replacement part costing $21, which was much cheaper compared to the commercial phantom, which cost $549. Conclusion We developed a 3D-printed reusable US-PIVC phantom, and it proved to be more economical without sacrificing the realism and time required for US-PIVC placement when compared to a commercial phantom.
Language	English
Publishing date	2021-08-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.17139
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Utilization of Point-of-care Echocardiography in Cardiac Arrest: A Cross-sectional Pilot Study.

Wolfe, Yanika / Duanmu, YouYou / Lobo, Viveta / Kohn, Michael A / Anderson, Kenton L

The western journal of emergency medicine

2021 Volume 22, Issue 4, Page(s) 803–809

Abstract: Introduction: Point-of-care (POC) echocardiography (echo) is a useful adjunct in the management of cardiac arrest. However, the practice pattern of POC echo utilization during management of cardiac arrest cases among emergency physicians (EP) is unclear. ...

Abstract	Introduction: Point-of-care (POC) echocardiography (echo) is a useful adjunct in the management of cardiac arrest. However, the practice pattern of POC echo utilization during management of cardiac arrest cases among emergency physicians (EP) is unclear. In this pilot study we aimed to characterize the utilization of POC echo and the potential barriers to its use in the management of cardiac arrest among EPs. Methods: This was a cross-sectional survey of attending EPs who completed an electronic questionnaire composed of demographic variables (age, gender, year of residency graduation, practice setting, and ultrasound training) and POC echo utilization questions. The first question queried participants regarding frequency of POC echo use during the management of cardiac arrest. Branching logic then presented participants with a series of subsequent questions regarding utilization and barriers to use based on their responses. Results: A total of 155 EPs participated in the survey, with a median age of 39 years (interquartile range 31-67). Regarding POC echo utilization, participants responded that they always (66%), sometimes (30%), or never (4.5%) use POC echo during cardiac arrest cases. Among participants who never use POC echo, 86% reported a lack of training, competency, or credentialing as a barrier to use. Among participants who either never or sometimes use POC echo, the leading barrier to use (58%) reported was a need for improved competency. Utilization was not different among participants of different age groups (P = 0.229) or different residency graduation dates (P = 0.229). POC echo utilization was higher among participants who received ultrasound training during residency (P = 0.006) or had completed ultrasound fellowship training (P <0.001) but did not differ by gender (P = 0.232), or practice setting (0.231). Conclusion: Only a small minority of EPs never use point-of-care echocardiography during the management of cardiac arrest. Lack of training, competency, or credentialing is reported as the leading barrier to use among those who do not use POC echo during cardiac arrest cases. Participants who do not always use ultrasound are less likely to have received ultrasound training during residency.
MeSH term(s)	Adult ; Cross-Sectional Studies ; Echocardiography ; Heart Arrest/diagnostic imaging ; Heart Arrest/therapy ; Humans ; Pilot Projects ; Point-of-Care Systems
Language	English
Publishing date	2021-07-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2375700-0
ISSN	1936-9018 ; 1936-9018
ISSN (online)	1936-9018
ISSN	1936-9018
DOI	10.5811/westjem.2021.4.50205
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Patiromer utility as an adjunct treatment in patients needing urgent hyperkalaemia management (PLATINUM): design of a multicentre, randomised, double-blind, placebo-controlled, parallel-group study.

Rafique, Zubaid / Budden, Jeffrey / Quinn, Carol Moreno / Duanmu, Youyou / Safdar, Basmah / Bischof, Jason J / Driver, Brian E / Herzog, Charles A / Weir, Matthew R / Singer, Adam J / Boone, Stephen / Soto-Ruiz, Karina M / Peacock, W Frank

BMJ open

2023 Volume 13, Issue 6, Page(s) e071311

Abstract: Introduction: Hyperkalaemia is common, life-threatening and often requires emergency department (ED) management; however, no standardised ED treatment protocol exists. Common treatments transiently reducing serum potassium (K: Methods and analysis: ... ...

Abstract	Introduction: Hyperkalaemia is common, life-threatening and often requires emergency department (ED) management; however, no standardised ED treatment protocol exists. Common treatments transiently reducing serum potassium (K Methods and analysis: PLATINUM is a Phase 4, multicentre, randomised, double-blind, placebo-controlled study in participants who present to the ED at approximately 30 US sites. Approximately 300 adult participants with hyperkalaemia (K Ethics and dissemination: A central Institutional Review Board (IRB) and Ethics Committee provided protocol approval (#20201569), with subsequent approval by local IRBs at each site, and participants will provide written consent. Primary results will be published in peer-reviewed manuscripts promptly following study completion. Trial registration number: NCT04443608.
MeSH term(s)	Adult ; Humans ; Albuterol ; Ethics Committees, Research ; Glucose ; Hyperkalemia ; Insulin ; Clinical Trials, Phase IV as Topic ; Randomized Controlled Trials as Topic ; Multicenter Studies as Topic
Chemical Substances	Albuterol (QF8SVZ843E) ; Glucose (IY9XDZ35W2) ; Insulin ; patiromer (1FQ2RY5YHH)
Language	English
Publishing date	2023-06-12
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2022-071311
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Utilization of Point-of-care Echocardiography in Cardiac Arrest

Yanika Wolfe / YouYou Duanmu / Viveta Lobo / Michael A. Kohn / Kenton L. Anderson

Western Journal of Emergency Medicine, Vol 22, Iss

A Cross-sectional Pilot Study

2021 Volume 4

Abstract	Introduction: Point-of-care (POC) echocardiography (echo) is a useful adjunct in the management of cardiac arrest. However, the practice pattern of POC echo utilization during management of cardiac arrest cases among emergency physicians (EP) is unclear. In this pilot study we aimed to characterize the utilization of POC echo and the potential barriers to its use in the management of cardiac arrest among EPs. Methods: This was a cross-sectional survey of attending EPs who completed an electronic questionnaire composed of demographic variables (age, gender, year of residency graduation, practice setting, and ultrasound training) and POC echo utilization questions. The first question queried participants regarding frequency of POC echo use during the management of cardiac arrest. Branching logic then presented participants with a series of subsequent questions regarding utilization and barriers to use based on their responses. Results: A total of 155 EPs participated in the survey, with a median age of 39 years (interquartile range 31–67). Regarding POC echo utilization, participants responded that they always (66%), sometimes (30%), or never (4.5%) use POC echo during cardiac arrest cases. Among participants who never use POC echo, 86% reported a lack of training, competency, or credentialing as a barrier to use. Among participants who either never or sometimes use POC echo, the leading barrier to use (58%) reported was a need for improved competency. Utilization was not different among participants of different age groups (P = 0.229) or different residency graduation dates (P = 0.229). POC echo utilization was higher among participants who received ultrasound training during residency (P = 0.006) or had completed ultrasound fellowship training (P <0.001) but did not differ by gender (P = 0.232), or practice setting (0.231). Conclusion: Only a small minority of EPs never use point-of-care echocardiography during the management of cardiac arrest. Lack of training, competency, or credentialing is reported as the ...
Keywords	Medicine ; R ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9
Subject code	300
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	eScholarship Publishing, University of California
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Young Woman With Abdominal Pain and Distention.

Jansson, Paul S / Bortoletto, Pietro / Duanmu, Youyou / Rempell, Joshua S

Annals of emergency medicine

2017 Volume 70, Issue 1, Page(s) e5–e6

Language	English
Publishing date	2017-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	603080-4
ISSN	1097-6760 ; 0196-0644
ISSN (online)	1097-6760
ISSN	0196-0644
DOI	10.1016/j.annemergmed.2017.01.039
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Article ; Online: Visual Estimation of Tricuspid Annular Plane Systolic Excursion by Emergency Medicine Clinicians.

Duanmu, Youyou / Goldsmith, Andrew J / Henwood, Patricia C / Platz, Elke / Hoyler, Janet E / Kimberly, Heidi H

The western journal of emergency medicine

2020 Volume 21, Issue 4, Page(s) 1022–1028

Abstract: Introduction: Tricuspid annular plane systolic excursion (TAPSE) is an established echocardiographic marker of right ventricular (RV) systolic function. The objective of this study was to evaluate whether emergency clinicians can visually estimate RV ... ...

Abstract	Introduction: Tricuspid annular plane systolic excursion (TAPSE) is an established echocardiographic marker of right ventricular (RV) systolic function. The objective of this study was to evaluate whether emergency clinicians can visually estimate RV function using TAPSE in a set of video clips compared to a reference standard M-mode measurement. Methods: Emergency clinicians were shown a five-minute educational video on TAPSE. Participants then viewed 20 apical four-chamber point-of-care ultrasound (POCUS) echocardiography clips and recorded their estimate of TAPSE distance in centimeters (cm), as well as whether TAPSE was normal (>1.9 cm), borderline (1.5-1.9 cm), or abnormal (<1.5 cm). We calculated sensitivity, specificity, and overall accuracy of visual TAPSE categorization using M-mode measurement as the criterion standard. Participants also reported their comfort with assessing TAPSE on a five-point Likert scale before and after participation in the study. Results: Among 70 emergency clinicians, including 20 postgraduate year 1-4 residents, 22 attending physicians, and 28 physician assistants (PA), the pooled sensitivity and specificity for visual assessment of TAPSE was 88.6% (95% confidence interval, 85.4-91.7%) and 81.6% (95% CI, 78.2-84.4%), respectively. The sensitivity and specificity for the clips in which the measured TAPSE was <1.5 cm or >1.9 cm was 91.4% (95% CI, 88.4-94.3%) and 90.8% (95% CI, 87.7-93.9%), respectively. There was no significant difference in sensitivity (p = 0.27) or specificity (p = 0.55) between resident and attending physicians or between physicians and PAs (p = 0.17 and p = 0.81). Median self-reported comfort with TAPSE assessment increased from 1 (interquartile range [IQR] 1-2) to 3 (IQR 3-4) points after participation in the study. Conclusion: A wide range of emergency clinicians demonstrated fair accuracy for visual estimation of TAPSE on previously recorded POCUS echocardiography video clips. These findings should be considered hypothesis generating and warrant validation in larger, prospective studies.
MeSH term(s)	Echocardiography/methods ; Echocardiography/standards ; Emergency Medical Services/methods ; Emergency Medical Services/standards ; Humans ; Point-of-Care Testing ; Prospective Studies ; Sensitivity and Specificity ; Tricuspid Valve/diagnostic imaging ; Tricuspid Valve/physiopathology ; Ventricular Dysfunction, Right/diagnosis ; Ventricular Dysfunction, Right/physiopathology ; Ventricular Function, Right/physiology
Language	English
Publishing date	2020-07-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2375700-0
ISSN	1936-9018 ; 1936-900X
ISSN (online)	1936-9018
ISSN	1936-900X
DOI	10.5811/westjem.2020.5.46714
Database	MEDical Literature Analysis and Retrieval System OnLINE

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