FUSIC HD. Comprehensive haemodynamic assessment with ultrasound (2021)

Type of publication:
Journal article

Author(s):
*Miller A.; Peck M.; Clark T.; Conway H.; Olusanya S.; Fletcher N.; Aron J.; Coleman N.; Parulekar P.; Kirk-Bayley J.; Wilkinson J.N.; Wong A.; Stephens J.; Rubino A.; Attwood B.; Walden A.; Breen A.; Waraich M.; Nix C.; Hayward S.

Citation:
Journal of the Intensive Care Society; 2021 [epub ahead of print]

Abstract:
FUSIC haemodynamics (HD) – the latest Focused Ultrasound in Intensive Care (FUSIC) module created by the
Intensive Care Society (ICS) – describes a complete haemodynamic assessment with ultrasound based on ten
key clinical questions: 1. Is stroke volume abnormal? 2. Is stroke volume responsive to fluid, vasopressors or
inotropes? 3. Is the aorta abnormal? 4. Is the aortic valve, mitral valve or tricuspid valve severely abnormal? 5. Is there systolic anterior motion of the mitral valve? 6. Is there a regional wall motion abnormality? 7. Are there
features of raised left atrial pressure? 8. Are there features of right ventricular impairment or raised pulmonary
artery pressure? 9. Are there features of tamponade? 10. Is there venous congestion? FUSIC HD is the first
system of its kind to interrogate major cardiac, arterial and venous structures to direct time-critical
interventions in acutely unwell patients. This article explains the rationale for this accreditation, outlines the
training pathway and summarises the ten clinical questions. Further details are included in an online
supplementary appendix.

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The role of ultrasound scanning (USS) in right iliac fossa (RIF) pain: Is USS imaging delaying emergency appendicectomies? (2015)

Type of publication:
Conference abstract

Author(s):
*Sukha A., *Luke D.

Citation:
International Journal of Surgery, November 2015, vol./is. 23/(S114)

Abstract:
Aim: This project investigates USS results from patients who had undergone appendicectomies to assess the sensitivity and specificity in detecting a histology positive acute appendicitis. We also investigated whether the decision to USS delayed an emergency procedure. Methods: Retrospective data collection between January-June 2014. Data was collected from Theatre log books, Pathology/PACS systems. Results: Between January-June 2014, 226 appendectomies were performed on the emergency-operating list. 15% (n = 34) ha d undergone pre-operative USS (74% Female, Mean age = 27 years). 76% (n = 26) of those who had a scan went onto have a diagnostic laparoscopy and appendicectomy, 24% (n = 8) had an open appendicectomy.53% (n = 18) were found to have a histology proven positive appendicitis. USS as an investigation to detect acute appendicitis demonstrated a sensitivity of 22.2% an d specificity of 68.8%, PPV of 44.4% and a NPV of 44.0%. A mean delay of 0.97 days was observed from admission to operation due to USS. Conclusion: US S result often does not change the definitive management in patients with ongoing RIF pain. Diagnostic laparoscopy can be therapeutic even in the absence of appendicitis. With USS delaying time to theatre and increasing hospital stay we conclude the USS has a limited role in investigating RIF pain in a patient presenting with the classic acute appendicitis.