Name: image acquisition using portable sonography for emergency airway management
Uploaded: 2022-09-28T14:40:00
Description: Watch this Scientific Journal Video about Image Acquisition using Portable Sonography for Emergency Airway Management at JoVE.com

None. No funding was received for this project.

These studies were approved by the George Washington University Institutional Review Board (IRB # NCR203147). The study subject for all procedures described below (and pictured in figures) was a 32-year-old male who gave full informed consent to the study and publication of de-identified images. Inclusion criteria include any patient undergoing airway management or anesthetic care (especially those who have characteristics of a difficult airway) and exclusion criteria would include any patient who does not consent to thi...

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	<li>Krishnan, S., Bronshteyn, Y. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Role+of+diagnostic+point-of-care+ultrasound+in+preoperative+optimization:+a+narrative+review.">Role of diagnostic point-of-care ultrasound in preoperative optimization: a narrative review.</a> International Anesthesiology Clinics. 60 (1), 64-68 (2022).</li><li>Pulton, D., Feinman, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hocus+POCUS:+Making+barriers+to+perioperative+point-of-care+ultrasound+disappear.">Hocus POCUS: Making barriers to perioperative point-of-care ultrasound disappear.</a> Journal of Cardiothoracic and Vascular Anesthesia. 33 (9), 2419-2420 (2019).</li><li>Ford, R. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Confirming+tracheal+intubation+-+a+simple+manoeuvre.">Confirming tracheal intubation - a simple manoeuvre.</a> Canadian Anaesthetists Society Journal. 30 (2), 191-193 (1983).</li><li>Howells, T. H., Riethmuller, R. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Signs+of+endotracheal+intubation.">Signs of endotracheal intubation.</a> Anaesthesia. 35 (10), 984-986 (1980).</li><li>Honardar, M. R., Posner, K. L., Domino, K. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Delayed+detection+of+esophageal+intubation+in+anesthesia+malpractice+claims:+Brief+report+of+a+case+series.">Delayed detection of esophageal intubation in anesthesia malpractice claims: Brief report of a case series.</a> Anesthesia &amp; Analgesia. 125 (6), 1948-1951 (2017).</li><li>Farrokhi, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Screening+performance+characteristics+of+ultrasonography+in+confirmation+of+endotracheal+intubation;+a+systematic+review+and+meta-analysis.">Screening performance characteristics of ultrasonography in confirmation of endotracheal intubation; a systematic review and meta-analysis.</a> Archives of Academic Emergency Medicine. 9 (1), 68 (2021).</li><li>Apfelbaum, J. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=American+Society+of+Anesthesiologists+practice+guidelines+for+management+of+the+difficult+airway.">American Society of Anesthesiologists practice guidelines for management of the difficult airway.</a> Anesthesiology. 136 (1), 31-81 (2022).</li><li>Kristensen, M. S., Teoh, W. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasound+identification+of+the+cricothyroid+membrane:+the+new+standard+in+preparing+for+front-of-neck+airway+access.">Ultrasound identification of the cricothyroid membrane: the new standard in preparing for front-of-neck airway access.</a> British Journal of Anaesthesia. 126 (1), 22-27 (2021).</li><li>Oliveira, K. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Determining+the+amount+of+training+needed+for+competency+of+anesthesia+trainees+in+ultrasonographic+identification+of+the+cricothyroid+membrane.">Determining the amount of training needed for competency of anesthesia trainees in ultrasonographic identification of the cricothyroid membrane.</a> BMC Anesthesiology. 17 (1), 74 (2017).</li><li>Roth, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Bedside+tests+for+predicting+difficult+airways:+an+abridged+Cochrane+diagnostic+test+accuracy+systematic+review.">Bedside tests for predicting difficult airways: an abridged Cochrane diagnostic test accuracy systematic review.</a> Anaesthesia. 74 (7), 915-928 (2019).</li><li>Andruszkiewicz, P., Wojtczak, J., Sobczyk, D., Stach, O., Kowalik, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effectiveness+and+validity+of+sonographic+upper+airway+evaluation+to+predict+difficult+laryngoscopy.">Effectiveness and validity of sonographic upper airway evaluation to predict difficult laryngoscopy.</a> Journal of Ultrasound Medicine. 35 (10), 2243-2252 (2016).</li><li>Kristensen, M. S., Teoh, W. H., Graumann, O., Laursen, C. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasonography+for+clinical+decision-making+and+intervention+in+airway+management:+from+the+mouth+to+the+lungs+and+pleurae.">Ultrasonography for clinical decision-making and intervention in airway management: from the mouth to the lungs and pleurae.</a> Insights Imaging. 5 (2), 253-279 (2014).</li><li>Carsetti, A., Sorbello, M., Adrario, E., Donati, A., Falcetta, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Airway+ultrasound+as+predictor+of+difficult+direct+laryngoscopy:+A+systematic+review+and+meta-analysis.">Airway ultrasound as predictor of difficult direct laryngoscopy: A systematic review and meta-analysis.</a> Anesthesia &amp; Analgesia. 134 (4), 740-750 (2022).</li><li>Mart&#237;nez-Garc&#237;a, A., Guerrero-Orriach, J. L., Pino-G&#225;lvez, M. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasonography+for+predicting+a+difficult+laryngoscopy.+Getting+closer.">Ultrasonography for predicting a difficult laryngoscopy. Getting closer.</a> Journal of Clinical Monitoring and Computing. 35 (2), 269-277 (2021).</li><li>Chen, H. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Parapharyngeal+fat+pad+area+at+the+subglosso-supraglottic+level+is+associated+with+corresponding+lateral+wall+collapse+and+apnea-hypopnea+index+in+patients+with+obstructive+sleep+apnea:+a+pilot+study.">Parapharyngeal fat pad area at the subglosso-supraglottic level is associated with corresponding lateral wall collapse and apnea-hypopnea index in patients with obstructive sleep apnea: a pilot study.</a> Scientific Reports. 9 (1), 17722 (2019).</li><li>Mehta, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Usefulness+of+preoperative+point-of-care+ultrasound+measurement+of+the+lateral+parapharyngeal+wall+to+predict+difficulty+in+mask+ventilation.">Usefulness of preoperative point-of-care ultrasound measurement of the lateral parapharyngeal wall to predict difficulty in mask ventilation.</a> Baylor University Medical Center Proceedings. 35 (5), 604-607 (2022).</li><li>Chou, H. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Real-time+tracheal+ultrasonography+for+confirmation+of+endotracheal+tube+placement+during+cardiopulmonary+resuscitation.">Real-time tracheal ultrasonography for confirmation of endotracheal tube placement during cardiopulmonary resuscitation.</a> Resuscitation. 84 (12), 1708-1712 (2013).</li><li>Singh, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+sonography+for+airway+assessment:+an+observational+study.">Use of sonography for airway assessment: an observational study.</a> Journal of Ultrasound Medicine. 29 (1), 79-85 (2010).</li><li>Kristensen, M. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+randomised+cross-over+comparison+of+the+transverse+and+longitudinal+techniques+for+ultrasound-guided+identification+of+the+cricothyroid+membrane+in+morbidly+obese+subjects.">A randomised cross-over comparison of the transverse and longitudinal techniques for ultrasound-guided identification of the cricothyroid membrane in morbidly obese subjects.</a> Anaesthesia. 71 (6), 675-683 (2016).</li><li>Werner, S. L., Jones, R. A., Emerman, C. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sonographic+assessment+of+the+epiglottis.">Sonographic assessment of the epiglottis.</a> Academic Emergency Medicine. 11 (12), 1358-1360 (2004).</li><li>Fernandez-Vaquero, M. A., Charco-Mora, P., Garcia-Aroca, M. A., Greif, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preoperative+airway+ultrasound+assessment+in+the+sniffing+position:+a+prospective+observational+study.">Preoperative airway ultrasound assessment in the sniffing position: a prospective observational study.</a> Brazilian Journal of Anesthesiology. , (2022).</li><li>Bilici, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Submental+ultrasonographic+parameters+among+patients+with+obstructive+sleep+apnea.">Submental ultrasonographic parameters among patients with obstructive sleep apnea.</a> Otolaryngology-Head and Neck Surgery. 156 (3), 559-566 (2017).</li><li>Mahmood, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Perioperative+ultrasound+training+in+anesthesiology:+A+call+to+action.">Perioperative ultrasound training in anesthesiology: A call to action.</a> Anesthesia and Analgesia. 122 (6), 1794-1804 (2016).</li><li>Ramsingh, D., Bronshteyn, Y. S., Haskins, S., Zimmerman, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Perioperative+point-of-care+ultrasound:+From+concept+to+application.">Perioperative point-of-care ultrasound: From concept to application.</a> Anesthesiology. 132 (4), 908-916 (2020).</li><li>Mishra, P. R., Bhoi, S., Sinha, T. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Integration+of+point-of-care+ultrasound+during+rapid+sequence+intubation+in+trauma+resuscitation.">Integration of point-of-care ultrasound during rapid sequence intubation in trauma resuscitation.</a> Journal of Emergencies, Trauma, and Shock. 11 (2), 92-97 (2018).</li><li>Bhoi, S., Mishra, P. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Integration+of+point-of-care+sonography+during+rapid+sequence+intubation+in+trauma+resuscitation:+will+it+make+a+difference.">Integration of point-of-care sonography during rapid sequence intubation in trauma resuscitation: will it make a difference.</a> The American Journal of Emergency Medicine. 34 (2), 330 (2016).</li><li>Thomas, V. K., Paul, C., Rajeev, P. C., Palatty, B. U. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reliability+of+ultrasonography+in+confirming+endotracheal+tube+placement+in+an+emergency+setting.">Reliability of ultrasonography in confirming endotracheal tube placement in an emergency setting.</a> Indian Journal of Critical Care Medicine. 21 (5), 257-261 (2017).</li><li>Fiadjoe, J. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasound-guided+tracheal+intubation:+a+novel+intubation+technique.">Ultrasound-guided tracheal intubation: a novel intubation technique.</a> Anesthesiology. 117 (6), 1389-1391 (2012).</li><li>Hung, K. C., Chen, I. W., Lin, C. M., Sun, C. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+between+ultrasound-guided+and+digital+palpation+techniques+for+identification+of+the+cricothyroid+membrane:+a+meta-analysis.">Comparison between ultrasound-guided and digital palpation techniques for identification of the cricothyroid membrane: a meta-analysis.</a> British Journal of Anaesthesia. 126 (1), 9-11 (2021).</li><li>Siddiqui, N., Yu, E., Boulis, S., You-Ten, K. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasound+is+superior+to+palpation+in+identifying+thecricothyroid+membrane+in+subjects+with+poorly+defined+neck+landmarks:+A+randomized+clinical+trial.">Ultrasound is superior to palpation in identifying thecricothyroid membrane in subjects with poorly defined neck landmarks: A randomized clinical trial.</a> Anesthesiology. 129 (6), 1132-1139 (2018).</li><li>Lavelle, A., Drew, T., Fennessy, P., McCaul, C., Shannon, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Accuracy+of+cricothyroid+membrane+identification+using+ultrasound+and+palpation+techniques+in+obese+obstetric+patients:+an+observational+study.">Accuracy of cricothyroid membrane identification using ultrasound and palpation techniques in obese obstetric patients: an observational study.</a> International Journal of Obstetric Anesthesia. 48, 103205 (2021).</li><li>Altun, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Role+of+ultrasonography+in+determining+the+cricothyroid+membrane+localization+in+the+predicted+difficult+airway.">Role of ultrasonography in determining the cricothyroid membrane localization in the predicted difficult airway.</a> Ulus Travma Acil Cerrahi Derg. 25 (4), 355-360 (2019).</li><li>Cho, S. 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In 2018, a call to action was made by the leadership of the Society of Cardiovascular Anesthesiologists for "Perioperative ultrasound training in anesthesiology"23. Notably, these leaders highlighted that POCUS education should become an essential component of anesthesiology training programs. More recently, experts in anesthesiology further explained the utility and necessity of POCUS in all aspects of perioperative patient care, including airway management24. Experts emph...

Portable ultrasonography has evident utility in the perioperative care of patients. Its accessibility and lack of invasiveness are benefits that have led to the rapid incorporation of point of care ultrasound (POCUS) to the clinical care of surgical patients1,2. As POCUS continues to find new indications in the perioperative arena, there are several established indications that have clear benefits over traditional clinical exams. In this methods paper, we review the recent findings and demonstrate how to integrate POCUS into clinical practice or airway management.
Undetected esophageal intubation results in significant morbidity and mortality; therefore, it is critical to identify esophageal intubation immediately and place the tube in an endotracheal location to avoid disastrous respiratory compromise. Traditional confirmation of endotracheal intubation relies on clinical examinations such as auscultation for bilateral breath sounds and chest rise3,4. Even after the American Society of Anesthesiologists (ASA) instituted end-tidal CO2 as a required monitor for identifying endotracheal intubation, there still remained cases of undetected esophageal intubation leading to significant morbidity and mortality5. One main benefit of incorporating tracheal ultrasonography into the intubation procedure is that esophageal intubation can be recognized immediately, and real-time, direct visualization of the tube can be confirmed in the trachea. In a recent meta-analysis, the pooled sensitivity and specificity of endotracheal confirmation were 98% and 94%, respectively, illustrating the superior diagnostic accuracy of this technique6. In this methods paper, a video example will be shown of the tube being placed in the esophagus erroneously, immediate recognition of this complication, and proper placement of the tube in the trachea. This highlights the real-time visual benefits that POCUS allows during an intubation procedure.
Despite advances in supraglottic airways and video laryngoscopy, surgical airway may remain a life-saving necessity in a &#34;cannot intubate, cannot oxygenate&#34; scenario. The updated ASA Difficult Airway Guidelines highlight that in the event of a life-saving invasive airway being required, the procedure must be performed as quickly as possible and by a trained specialist7. In the event a cricothyrotomy is required, the identification of proper anatomy is required to prevent further complications. Utilization of ultrasonography to visualize the anatomy of the cricothyroid membrane (CTM) is a quick and effective technique that is now being suggested preoperatively if there is any concern of a difficult airway8. This technique can be taught in a relatively quick manner, with learners gaining almost complete competency after a brief 2 hour tutorial and 20 expert guided scans9. In this methods paper, two techniques to identify the CTM with POCUS will be demonstrated in the hopes of further educating any healthcare providers who routinely perform airway management.
Preoperative assessment of the patient&#39;s airway involves traditional bedside clinical exams (e.g., Mallampati score, mouth opening, cervical range of motion, etc.). There are several problems with these assessments. The first and probably most salient is that they are not very accurate at predicting a difficult airway situation10. In addition, these tests require patient participation, which is not possible in all clinical scenarios (such as in cases of trauma or altered mental status).
Preoperative airway ultrasound measurements have shown improved accuracy in predicting difficult endotracheal tube placement11,12. Anterior neck soft tissue thickness at varying levels has been measured and analyzed as a prediction of difficult intubation. The ultrasonographic measurement of the distance between the skin to epiglottis appears to have the best diagnostic accuracy identified to date13. This measurement has also been shown to improve predictive capability considerably when added to the traditional bedside examinations14. This paper explains how to use POCUS to measure the skin-to-epiglottis distance and incorporate it into the preoperative airway examination, in order to help healthcare providers better predict a difficult airway situation.
In addition, investigators have begun to identify anatomical structures that indicate difficult mask ventilation. One such anatomical structure is the lateral pharyngeal wall, whose thickness (LPWT) has been shown to correspond to the severity of obstructive sleep apnea (OSA) and apnea-hypopnea index15. Preliminary data also suggest that measurement of the LPWT preoperatively provides evidence for the difficulty of mask ventilation16. This methods paper and the associated video will demonstrate how to acquire the LPWT with portable ultrasonography to assess the severity of OSA in a patient and potential for difficulty in mask ventilation.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>High Frequency Ultrasound Probe (HFL38xp)</td>
			<td>SonoSite (FujiFilm)</td>
			<td>P16038</td>
			<td></td>
		</tr>
		<tr>
			<td>Low Frequency Ultrasound Probe (C35xp)</td>
			<td>SonoSite (FujiFilm)</td>
			<td>P19617</td>
			<td></td>
		</tr>
		<tr>
			<td>SonoSite X-porte Ultrasound</td>
			<td>SonoSite (FujiFilm)</td>
			<td>P19220</td>
			<td></td>
		</tr>
		<tr>
			<td>Ultrasound Gel</td>
			<td>AquaSonic</td>
			<td>PLI 01-08</td>
			<td></td>
		</tr>
	</tbody>
</table>

image acquisition using portable sonography for emergency airway management

With its increasing popularity and accessibility, portable ultrasonography has been rapidly adapted not only to improve the perioperative care of patients, but also to address the potential benefits of employing ultrasound in airway management. The benefits of point of care ultrasound (POCUS) include its portability, the speed at which it can be utilized, and its lack of invasiveness or exposure of the patient to radiation of other imaging modalities.
Two primary indications for airway POCUS include confirmation of endotracheal intubation and identification of the cricothyroid membrane in the event a surgical airway is required. In this article, the technique of using ultrasound to confirm endotracheal intubation and the relevant anatomy is described, along with the associated ultrasonographic images. In addition, identification of the anatomy of the cricothyroid membrane and the ultrasonographic acquisition of appropriate images to perform this procedure are reviewed.
Future advances include utilizing airway POCUS to identify patient characteristics that might indicate difficult airway management. Traditional bedside clinical exams have, at best, fair predictive values. The addition of ultrasonographic airway assessment has the potential to improve this predictive accuracy. This article describes the use of POCUS for airway management, and initial evidence suggests that this has improved the diagnostic accuracy of predicting a difficult airway. Given that one of the limitations of airway POCUS is that it requires a skilled sonographer, and image analysis can be operator dependent, this paper will provide recommendations to standardize the technical aspects of airway ultrasonography and promote further research utilizing sonography in airway management. The goal of this protocol is to educate researchers and medical health professionals and to advance the research in the field of airway POCUS.

By utilizing real-time ultrasound probe visualization of the trachea, the directions in step 1 of the protocol enable the airway manager to secure the airway expeditiously and safely. The endotracheal tube is quickly recognized and removed from the esophagus by following the steps for placement in the proper endotracheal position under ultrasound visualization (Figure 1, Figure 2, and Figure 3). The advantage of thi...

Watch this Scientific Journal Video about Image Acquisition using Portable Sonography for Emergency Airway Management at JoVE.com

Image Acquisition using Portable Sonography for Emergency Airway Management

Point of care ultrasound (POCUS) is increasingly being utilized in airway management. Presented here are some clinical utilities of POCUS, including differentiating endotracheal and esophageal intubation, identification of the cricothyroid membrane in the event a surgical airway is required, and measuring anterior neck soft tissue to predict difficult airway management.

With its increasing popularity and accessibility, portable ultrasonography has been rapidly adapted not only to improve the perioperative care of ...

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Medicine

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

The Institute of Medicine has targeted patient-centeredness as an important area of quality improvement. A major dimension of patient-centeredness is ...

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management

Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often ...

Endotracheal Intubation Using a Flexible Intubation Endoscope as a Standardized Model for Safe Airway Management in Swine

Endotracheal intubation is often a basic requirement for translational research in porcine models for various interventions that require a secured airway ...

Image Acquisition Method for the Sonographic Assessment of the Inferior Vena Cava

Over the past several decades, clinicians have incorporated several applications of diagnostic point-of-care ultrasound (POCUS) into medical ...

Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis

Acute lower extremity deep venous thrombosis (DVT) is a serious vascular disorder that requires accurate and early diagnosis to prevent life-threatening ...

Troubleshooting FoCUS Image Acquisition: Patient Positioning, Transducer Manipulation, and Image Optimization

Focused cardiac ultrasound (FoCUS) is a limited, clinician-performed application of echocardiography to add real-time information to patient care. These ...

Point-of-Care Lung Ultrasound in Adults: Image Acquisition

Consultative ultrasound performed by radiologists has traditionally not been used for imaging the lungs, as the lungs&#39; air-filled nature normally ...

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

The use of routine point-of-care ultrasound (POCUS) is increasing in neonatal intensive care units (NICUs), with several centers advocating for 24 h ...

Exploring Quantitative Autofluorescence in Age-Related Macular Degeneration

A Workflow to Quantitatively Determine Age-Related Macular Degeneration Lesion-Specific Variations in Fundus Autofluorescence

Understanding Age-Related Macular Degeneration Pathophysiology with QAF Workflow (Video) | JoVE

Fundus autofluorescence (FAF) imaging allows the noninvasive mapping of intrinsic fluorophores of the ocular fundus, particularly the retinal pigment ...

Laryngeal Mask Airway (LMA) Placement in a Neonatal Patient Simulator Using a Non-Inflatable Supraglottic Airway (SGA)

Laryngeal Mask Airway LMA Placement in a Neonatal Patient Simulator Using a Non-Inflatable Supraglottic Airway SGA

The effective delivery of positive pressure ventilation (PPV) can be challenging during neonatal resuscitation. Achieving a patent airway through an ...