Rant: ultrasound visualization of pills in the stomach will never make sense
Konstantin Shevtsov/shutterstock.com 2 out of 5 stars Accuracy of Trans-Abdominal Ultrasound in a Simulated Massive Acute Overdose. Sullivan S et al. Am J Emerg Med 2016 Apr 23 [Epub ahead of print] Abstract As soon as emergency portable bedside ultrasound became feasible approximately three decades ago, toxicologists wondered if it would be a useful modality for visualizing pills in the stomach of overdose patients. The answer, clearly, is no it would not. This misguided paper illustrates why. This randomized study had a study group (N=10) and a control group (N=10) ingest 50 enteric-coated placebo capsules plus 1 L fluid, or or 1 L fluid only. Ultrasound imaging of the stomach was performed and interpreted by 3 emergency ultrasound-trained sonographers attires 0, 60, and 90 minutes after ingestion. All subjects fasted for at least 6 hours before the study. Without going into the weeds with precise numbers (consult the abstract if you’re really interested,) we can say that even under these ideal conditions, the sensitivity and specificity of the test were lousy. This is consistent both with the results of a previous pilot study and with common sense. Furthermore, the authors’ premise is ill-considered: In many cases, traditional ED decontamination therapy with activated charcoal, whole bowel irrigation with polyethylene glycol, and gastric lavage are limited to the first hour post-ingestion. . . .If effective, ultrasound would allow visualization of ingested c...
Source: The Poison Review - Category: Toxicology Authors: Leon Gussow Tags: Medical activated charcoal acute ingestion gastric lavage sonography ultrasound whole bowel irrigation Source Type: news
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