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D Mandavia

Publications and source records attributed to D Mandavia.

8 recordsLinked to original sources
PubMed2001

The UHP ultrasound protocol: a novel ultrasound approach to the empiric evaluation of the undifferentiated hypotensive patient.

This report describes a novel sonographic protocol for the evaluation of the undifferentiated hypotensive patient. This protocol combines components of 3 sonographic applications: free fluid, cardiac, and abdominal aorta into a single protocol. We believe this protocol and its underlying principles should be a routine part of the empiric evaluation of the patient with undifferentiated hypotension or pulseless electrical activity.

Adult↗
PubMed2000

Serial abdominal ultrasound in the setting of trauma.

Ultrasound is gaining wide acceptance in Emergency Medicine as an inexpensive and accurate examination modality. One of the leading uses of this technology is in the initial assessment of the trauma patient, where the ultrasound examination is often used to determine the need for immediate laparotomy or further diagnostic study. We present a series of four patients, all of whom sustained blunt or penetrating abdominal trauma. In each case, the initial screening abdominal ultrasound was negative for free intraperitoneal (i.p.) fluid but, when repeated by the same practitioner, became positive. These cases demonstrate the need for serial ultrasounds in evaluating the patient with abdominal trauma. Future studies of trauma ultrasound should investigate the utility of serial sonographic examinations.

Abdominal Injuries↗
PubMed2000

The comparative accuracy of radiolucent foreign body detection using ultrasonography.

The purpose of this prospective study was to determine the accuracy of ultrasonography in detecting radiolucent foreign bodies and to compare the performance of three newly trained emergency physicians with two experienced ultrasound technologists and one radiologist. One hundred-four chicken thighs were penetrated with a needle-driver, half of them embedded with a 1.5 cm toothpick. An 8.0 MHZ linear array ultrasound probe was used to detect the presence or absence of the foreign body. The overall accuracy (95% confidence interval [CI]) was 82% (79, 85); sensitivity 79% (74, 83), specificity 86% (82, 90), positive predicative value (PPV) 85% (81, 89), and negative predicative value (NPV) 80% (76, 84). The accuracy (95% CI) of the radiologist was 83% (75, 90); of the ultrasound technologists was 85% (80, 90); and of the emergency physicians was 0% (76, 85). The difference in accuracy among the three types of personnel was not statistically significant. Ultrasonography is an accurate modality in detecting radiolucent foreign bodies. Emergency physicians can be trained to provide a degree of accuracy comparable with more experienced ultrasonographers.

Allied Health Personnel↗
PubMed1999

The first Australian workshop on bedside ultrasound in the Emergency Department.

AIMS: Bedside ultrasound is not widely practised by emergency physicians in Australasia despite its use in Europe, Asia and North America, and an extensive medical literature on the subject. A workshop was organised at Auckland Hospital, aiming to introduce emergency physicians to the basics of emergency ultrasound. This article summarises the content of the programme, the responses from the participants and the principles that emerged at this workshop. METHODS: A standardised, 16-hour, emergency ultrasound curriculum was offered to 23 participants. Lectures with syllabus material were used to cover the following topics: basic ultrasound physics, pelvis, right upper quadrant, renal, aorta, trauma and echocardiography. Each participant received eight hours of hands-on ultrasound instruction. On completion of the course participants responded anonymously to a course appraisal questionnaire. RESULTS: Twenty-one participants responded to the questionnaire (91% response rate). Delegates found the course informative and the material was considered relevant. Workshop objectives were met and the venue was appropriate. Most participants thought the practical sessions could be improved by decreasing the ratio of delegates to human models. CONCLUSIONS: The first Australasian workshop on bedside ultrasound in the Emergency Department held in Auckland (February 1998) was successful in achieving its objectives. Focused emergency ultrasound can be taught to detect free intraperitoneal or pericardial fluid in trauma patients. There is a need for appropriate quality assurance and credentialling guidelines as more Australasian emergency departments consider the application of focused ultrasound.

Attitude of Health Personnel↗
PubMed1998

Geriatric trauma.

This article reviews the salient aspects of geriatric trauma, including common injury mechanisms, physiologic differences in elderly patients, and their prehospital and emergency department evaluation. Specific organ injuries and associated mortality are also discussed.

Aged↗