The Importance of Bedside Ultrasonography in Confirming the Location of Endotracheal Tube

Objective. Endotracheal intubation may be associated with lethal complications when not applied in appropriate manner. In this study, we aimed to examine the efficiency of transcricoid and pulmonary ultrasonography in confirming the position of the tube in comparison with classical methods. Methods. This study was carried out between 2016 and 2017 in Turkey and was registered in Clinical Trials under number NCT03081221. The location of the tube was confirmed using methods such as monitoring the vocal cords during direct laryngoscopy, condensation on endotracheal tube during respiration, epigastric-pulmonary auscultation, radiography and capnometry. After that, the transcricoid and pulmonary ultrasonography were implemented by the blinded pediatric emergency care specialist. Results. 64 cases who needed advanced airway requirements were involved in this study. The double-line appearance could not be obtained from one patient only when using transcricoid ultrasonography, but the bilateral pleural shift movement was observed among all the cases by using pulmonary ultrasonography (sensitive: 98%-100%). Conclusion. The determination of endoesophageal, endotracheal and endobronchial intubations can be easily made by using transcricoid and pulmonary ultrasonography. The use of ultrasonography may significantly contribute to critical airway management as fast, accurate and on time

Intracranial Saccular Aneurysm in a Child With Only Persistent Headache

WOS: 000354546700013PubMed ID: 25156664Headache is one of the common symptoms of intracranial aneursym. A 5-year-old child lately presented to our pediatric emergency department with persistent headache. Brain magnetic resonance imaging revealed a 7x8 mm rounded lesion with slowly heterogeneous low signal in T2 sequence consistent with a partial occluded aneurysm, in the right medial frontal lobe that close to anterior cerebral artery. Intracranial aneurysms are rare in children and they are noncommon without complications as our case

Ultrasound-Assisted Lumbar Puncture in Pediatric Emergency Department

WOS: 000407233100003PubMed ID: 26425932Background: Lumbar puncture (LP) is one of the essential diagnostic tools in pediatric emergency services. Recently, ultrasound-assisted LP was reported to be beneficial in the emergency service by facilitating the procedure and improving the successful procedure rates. In addition, this method may be effective in reducing patient and parent anxiety due to the LP procedure. Objectives: The aim of this study was to investigate the effect of ultrasound-assisted LP on the outcomes of puncture procedures and traumatic LP. Methods: The study included patients younger than 18 years, who were admitted to the pediatric emergency service and underwent LP because of suspected central nervous system infection. The patients requiring LP were randomly divided into 2 groups designated as odd and even. One group received LP using the conventional method, whereas the other group had LP after spinal space measurement by ultrasound. The patients who did and who did not undergo ultrasound-assisted LP were compared for demographics, number of puncture attempts, and traumatic LP. Statistical analysis was performed using the Mann-Whitney U test and the Student t test. The chi(2) test was used when nominal data were compared between the 2 groups. Results: Ultrasound-assisted LP was performed in 56 patients, and LP by using conventional method was performed in 55 patients. There was traumatic LP in 5 (8.9%) of the patients who underwent ultrasoundassisted LP and 9 (16.3%) of the patients who underwent LP using the conventional method (P > 0.05). The number of puncture attempts was 2 or more in 2 (3.5%) of the patients who underwent ultrasoundassisted LP and 5 (9%) of the patients who had LP using the conventional method (P > 0.05). Conclusions: Ultrasound-assisted LP reduced traumatic LP and the number of puncture attempts in pediatric patients; however, the resultswere not statistically significant