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Article ; Online: Comparison of an Emoji-Based Visual Analog Scale With a Numeric Rating Scale for Pain Assessment.

He, Shuhan / Renne, Angela / Argandykov, Dias / Convissar, David / Lee, Jarone

2022 Volume 328, Issue 2, Page(s) 208–209

MeSH term(s)	Art ; Correspondence as Topic ; Humans ; Pain/diagnosis ; Pain Measurement/methods ; Symbolism ; Visual Analog Scale
Language	English
Publishing date	2022-08-22
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2022.7489
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Biplane Imaging Using Portable Ultrasound Devices for Vascular Access.

Convissar, David / Bittner, Edward A / Chang, Marvin G

Cureus

2021 Volume 13, Issue 1, Page(s) e12561

Abstract: The use of ultrasound guidance for the placement of difficult IVs, arterial lines, and central venous access has become the standard of care. While imaging quality has improved over the last two decades, the lack of affordability, availability, and ... ...

Abstract	The use of ultrasound guidance for the placement of difficult IVs, arterial lines, and central venous access has become the standard of care. While imaging quality has improved over the last two decades, the lack of affordability, availability, and training have been major limitations in its routine clinical use. We detail the first reported use of biplane imaging using a portable ultrasound probe for difficult vascular access to increase first past success, efficiency, safety, and sterility during the coronavirus disease 2019 (COVID-19) pandemic.
Language	English
Publishing date	2021-01-07
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.12561
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Image Acquisition Method for the Sonographic Assessment of the Inferior Vena Cava.

Hoffman, Maximilian / Convissar, David L / Meng, Marie-Louise / Montgomery, Sean / Bronshteyn, Yuriy S

Journal of visualized experiments : JoVE

2023 , Issue 191

Abstract: Over the past several decades, clinicians have incorporated several applications of diagnostic point-of-care ultrasound (POCUS) into medical decision-making. Among the applications of POCUS, imaging the inferior vena cava (IVC) is practiced by a wide ... ...

Abstract	Over the past several decades, clinicians have incorporated several applications of diagnostic point-of-care ultrasound (POCUS) into medical decision-making. Among the applications of POCUS, imaging the inferior vena cava (IVC) is practiced by a wide variety of specialties, such as nephrology, emergency medicine, internal medicine, critical care, anesthesiology, pulmonology, and cardiology. Although each specialty uses IVC data in slightly different ways, most medical specialties, at minimum, attempt to use IVC data to make predictions about intravascular volume status. While the relationship between IVC sonographic data and intravascular volume status is complex and highly context-dependent, all clinicians should collect the sonographic data in standardized ways to ensure repeatability. This paper describes standardized IVC image acquisition including patient positioning, transducer selection, probe placement, image optimization, and the pitfalls and limitations of IVC sonographic imaging. This paper also describes the commonly performed anterior IVC long-axis view and three other views of the IVC that can each provide helpful diagnostic information when the anterior long-axis view is difficult to obtain or interpret.
MeSH term(s)	Humans ; Vena Cava, Inferior/diagnostic imaging ; Ultrasonography/methods ; Critical Care ; Point-of-Care Testing
Language	English
Publishing date	2023-01-13
Publishing country	United States
Document type	Journal Article ; Video-Audio Media
ZDB-ID	2259946-0
ISSN	1940-087X ; 1940-087X
ISSN (online)	1940-087X
ISSN	1940-087X
DOI	10.3791/64790
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Biplane Imaging Versus Standard Transverse Single-Plane Imaging for Ultrasound-Guided Peripheral Intravenous Access: A Prospective Controlled Crossover Trial.

Convissar, David / Bittner, Edward A / Chang, Marvin G

Critical care explorations

2021 Volume 3, Issue 10, Page(s) e545

Abstract: Obtaining peripheral IV access in critically ill patients is often challenging especially for novice providers. The availability of biplane imaging for ultrasound guided peripheral access has the potential to improve successful venous cannulation ... ...

Abstract	Obtaining peripheral IV access in critically ill patients is often challenging especially for novice providers. The availability of biplane imaging for ultrasound guided peripheral access has the potential to improve successful venous cannulation compared with standard plane imaging. Design: Single-center quasi-randomized (alternate allocation) crossover trial. Setting: Surgical ICU at the Massachusetts General Hospital. Subjects: Twenty surgical ICU nurses with no prior experience using ultrasound for peripheral IV were enrolled. Interventions: All participants viewed instructional videos on single-plane and biplane imaging for peripheral IV insertion. The participants were then quasi-randomly assigned to use either single-plane or biplane imaging for peripheral IV insertion using a phantom model. The time to catheter completion, successful lumen cannulation, and attempts in which the needle was observed to go through the back wall of the vessel were recorded for each of the three attempts. The following day the participants repeated the peripheral IV insertion with the alternate imaging modality. Measurements and main results: Biplane imaging compared with single-plane imaging was associated with a significantly greater overall success rate (78.3% ± 22.4% vs 41.7% ± 26%; Conclusions: This proof-of-principle study demonstrates that the biplane ultrasound imaging approach for vessel cannulation resulted in an overall faster, more successful, and safer peripheral IV access than the standard single-plane transverse approach when performed by novice ultrasound users.
Language	English
Publishing date	2021-10-08
Publishing country	United States
Document type	Journal Article
ISSN	2639-8028
ISSN (online)	2639-8028
DOI	10.1097/CCE.0000000000000545
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Reduced Effective Oxygen Delivery and Ventilation with a Surgical Facemask Placed under Compared to over an Oxygen Mask: A Comparative Study.

Chang, Marvin G / Sakano, Takashi / Levin, Benjamin S / Convissar, David / Bittner, Edward A

Anesthesiology research and practice

2022 Volume 2022, Page(s) 4798993

Abstract: Objectives: Consensus guidelines for perioperative anesthesia management during the COVID-19 pandemic recommend that patients wear a facemask in addition to their oxygen mask or nasal cannulae following tracheal extubation, where this is practical. The ... ...

Abstract	Objectives: Consensus guidelines for perioperative anesthesia management during the COVID-19 pandemic recommend that patients wear a facemask in addition to their oxygen mask or nasal cannulae following tracheal extubation, where this is practical. The effects on effective oxygen delivery and ventilation of a surgical facemask under compared to over an oxygen (O Design: Single-center, comparative pilot study. Subjects: Five healthy anesthesiologists. Conclusions: Effective oxygen delivery and ventilation was reduced (lower FeO
Language	English
Publishing date	2022-01-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2397574-X
ISSN	1687-6970 ; 1687-6962
ISSN (online)	1687-6970
ISSN	1687-6962
DOI	10.1155/2022/4798993
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Focused Assessment with Sonography for Trauma (FAST) Exam: Image Acquisition.

Ritchie, John D / Trujillo, Charles N / Convissar, David L / Lao, William Shihao / Montgomery, Sean / Bronshteyn, Yuriy S

Journal of visualized experiments : JoVE

2023 , Issue 199

Abstract: Over the past twenty years, the Focused Assessment with Sonography for Trauma (FAST) exam has transformed the care of patients presenting with a combination of trauma (blunt or penetrating) and hypotension. In these hemodynamically unstable trauma ... ...

Abstract	Over the past twenty years, the Focused Assessment with Sonography for Trauma (FAST) exam has transformed the care of patients presenting with a combination of trauma (blunt or penetrating) and hypotension. In these hemodynamically unstable trauma patients, the FAST exam permits rapid and noninvasive screening for free pericardial or peritoneal fluid, the latter of which implicates intra-abdominal injury as a likely contributor to the hypotension and justifies emergent abdominal surgical exploration. Further, the abdominal portion of the FAST exam can also be used outside of the trauma setting to screen for free peritoneal fluid in patients who become hemodynamically unstable in any context, including after procedures that may inadvertently injure abdominal organs. These "non-trauma" situations of hemodynamic instability are often triaged by providers from specialties other than emergency medicine or trauma surgery who are not familiar with the FAST exam. Therefore, there is a need to promulgate knowledge about the FAST exam to all clinicians caring for critically ill patients. Toward this end, this article describes FAST exam image acquisition: patient positioning, transducer selection, image optimization, and exam limitations. Since the free fluid is likely to be found in specific anatomic locations that are unique for each canonical FAST exam view, this work centers on the unique image acquisition considerations for each window: subcostal, right upper quadrant, left upper quadrant, and pelvis.
MeSH term(s)	Humans ; Focused Assessment with Sonography for Trauma ; Wounds, Nonpenetrating/diagnosis ; Ultrasonography ; Abdominal Injuries ; Hypotension
Language	English
Publishing date	2023-09-22
Publishing country	United States
Document type	Journal Article ; Video-Audio Media
ZDB-ID	2259946-0
ISSN	1940-087X ; 1940-087X
ISSN (online)	1940-087X
ISSN	1940-087X
DOI	10.3791/65066
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Point-of-Care Lung Ultrasound in Adults: Image Acquisition.

Pereira, Rodrigo O L / Convissar, David L / Montgomery, Sean / Herbert, James T / Reed, Christopher R / Tang, Hoang J / Bronshteyn, Yuriy S

Journal of visualized experiments : JoVE

2023 , Issue 193

Abstract: Consultative ultrasound performed by radiologists has traditionally not been used for imaging the lungs, as the lungs' air-filled nature normally prevents direct visualization of the lung parenchyma. When showing the lung parenchyma, ultrasound typically ...

Abstract	Consultative ultrasound performed by radiologists has traditionally not been used for imaging the lungs, as the lungs' air-filled nature normally prevents direct visualization of the lung parenchyma. When showing the lung parenchyma, ultrasound typically generates a number of non-anatomic artifacts. However, over the past several decades, these artifacts have been studied by diagnostic point-of-care ultrasound (POCUS) practitioners, who have identified findings that have value in narrowing the differential diagnoses of cardiopulmonary dysfunction. For instance, in patients presenting with dyspnea, lung POCUS is superior to chest radiography (CXR) for the diagnosis of pneumothorax, pulmonary edema, lung consolidations, and pleural effusions. Despite its known diagnostic value, the utilization of lung POCUS in clinical medicine remains variable, in part because training in this modality across hospitals remains inconsistent. To address this educational gap, this narrative review describes lung POCUS image acquisition in adults, including patient positioning, transducer selection, probe placement, acquisition sequence, and image optimization.
MeSH term(s)	Humans ; Adult ; Point-of-Care Systems ; Lung/diagnostic imaging ; Lung Diseases/diagnostic imaging ; Point-of-Care Testing ; Pneumothorax ; Ultrasonography/methods
Language	English
Publishing date	2023-03-03
Publishing country	United States
Document type	Review ; Journal Article ; Video-Audio Media
ZDB-ID	2259946-0
ISSN	1940-087X ; 1940-087X
ISSN (online)	1940-087X
ISSN	1940-087X
DOI	10.3791/64722
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis.

Theophanous, Rebecca G / Chow, Vinca W / Convissar, David L / Haskins, Stephen C / Jones, Robert A / P Kalagara, Hari K / Bronshteyn, Yuriy S

Journal of visualized experiments : JoVE

2023 , Issue 192

Abstract: Acute lower extremity deep venous thrombosis (DVT) is a serious vascular disorder that requires accurate and early diagnosis to prevent life-threatening sequelae. While whole leg compression ultrasound with color and spectral Doppler is commonly ... ...

Abstract	Acute lower extremity deep venous thrombosis (DVT) is a serious vascular disorder that requires accurate and early diagnosis to prevent life-threatening sequelae. While whole leg compression ultrasound with color and spectral Doppler is commonly performed in radiology and vascular labs, point-of-care ultrasound (POCUS) is becoming more common in the acute care setting. Providers appropriately trained in focused POCUS can perform a rapid bedside examination with high sensitivity and specificity in critically ill patients. This paper describes a simplified yet validated approach to POCUS by describing a three-zone protocol for lower extremity DVT POCUS image acquisition. The protocol explains the steps in obtaining vascular images at six compression points in the lower extremity. Beginning at the level of the proximal thigh and moving distally to the popliteal space, the protocol guides the user through each of the compression points in a stepwise manner: from the common femoral vein to the femoral and deep femoral vein bifurcation, and, finally, to the popliteal vein. Further, a visual aid is provided that may assist providers during real-time image acquisition. The goal in presenting this protocol is to help make proximal lower extremity DVT exams more accessible and efficient for POCUS users at the patient's bedside.
MeSH term(s)	Humans ; Point-of-Care Systems ; Venous Thrombosis/diagnostic imaging ; Femoral Vein ; Popliteal Vein/diagnostic imaging ; Lower Extremity/diagnostic imaging ; Ultrasonography/methods
Language	English
Publishing date	2023-02-10
Publishing country	United States
Document type	Journal Article ; Video-Audio Media
ZDB-ID	2259946-0
ISSN	1940-087X ; 1940-087X
ISSN (online)	1940-087X
ISSN	1940-087X
DOI	10.3791/64601
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Personal Protective Equipment N95 Facemask Shortage Quick Fix: The Modified Airway From VEntilatoR Circuit (MAVerIC).

Convissar, David / Berra, Lorenzo / Chang, Marvin G / Bittner, Edward A

Cureus

2020 Volume 12, Issue 5, Page(s) e7914

Abstract: We are in a crisis where healthcare providers on the frontlines are running out of the appropriate personal protective equipment including N95 masks and power air-purifying respirators. Here, we propose a makeshift filter mask that we call the Modified ... ...

Abstract	We are in a crisis where healthcare providers on the frontlines are running out of the appropriate personal protective equipment including N95 masks and power air-purifying respirators. Here, we propose a makeshift filter mask that we call the Modified Airway from VEntilatoR Circuit (MAVerIC) that can be assembled within seconds using widely available supplies routinely utilized by anesthesia providers in the operating room to provide practitioners on the frontlines with the high standard of protection of a N95 mask during the coronavirus disease 2019 (COVID-19) pandemic, and can be easily quantitatively "fit tested" to ensure no significant leak to optimize safety and efficacy.
Keywords	covid19
Language	English
Publishing date	2020-05-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.7914
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Gastric Point of Care Ultrasound in Adults: Image Acquisition and Interpretation.

Heinz, Eric R / Al-Qudsi, Omar / Convissar, David L / David, Marianne D / Dominguez, Jennifer E / Haskins, Stephen / Jelly, Christina / Perlas, Anahi / Vincent, Anita N / Bronshteyn, Yuriy S

Journal of visualized experiments : JoVE

2023 , Issue 199

Abstract: Over the past two decades, diagnostic point-of-care ultrasound (POCUS) has emerged as a rapid and non-invasive bedside tool for addressing clinical inquiries related to gastric content. One emerging concern pertains to patients about to undergo sedation ... ...

Abstract	Over the past two decades, diagnostic point-of-care ultrasound (POCUS) has emerged as a rapid and non-invasive bedside tool for addressing clinical inquiries related to gastric content. One emerging concern pertains to patients about to undergo sedation and/or endotracheal intubation: the elevated risk of aspiration from the patient's stomach contents. Aspiration of gastric contents into the lungs poses a serious and potentially life-threatening complication. This occurs more frequently when the stomach is considered "full" and can be affected by the techniques employed for airway management, making it potentially preventable. To mitigate the risk of peri-procedural aspiration, two distinct medical specialties (anesthesiology and critical care medicine) have independently developed techniques to utilize ultrasonography for identifying patients requiring "full stomach" precautions. Due to these separate specialties, the work of each group remains relatively unfamiliar outside its respective field. This article presents descriptions of both techniques for gastric ultrasound. Furthermore, it explains how these approaches can complement each other when one of them falls short. Regarding image acquisition, the article covers the following topics: indications and contraindications, selection of the appropriate probe, patient positioning, and troubleshooting. The article also delves into image interpretation, complete with example images. Additionally, it demonstrates how one of the two techniques can be employed to estimate gastric fluid volume. Lastly, the article briefly discusses medical decision-making based on the findings of this examination.
MeSH term(s)	Humans ; Adult ; Point-of-Care Systems ; Stomach/diagnostic imaging ; Ultrasonography/methods ; Point-of-Care Testing ; Anesthesia
Language	English
Publishing date	2023-09-22
Publishing country	United States
Document type	Journal Article ; Video-Audio Media
ZDB-ID	2259946-0
ISSN	1940-087X ; 1940-087X
ISSN (online)	1940-087X
ISSN	1940-087X
DOI	10.3791/65707
Database	MEDical Literature Analysis and Retrieval System OnLINE

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