Lindsay Taylor - Academia.edu (original) (raw)
Papers by Lindsay Taylor
Clinical Practice and Cases in Emergency Medicine, Apr 20, 2018
The western journal of emergency medicine, 2017
Transesophageal echocardiography (TEE) is a well-established method of evaluating cardiac patholo... more Transesophageal echocardiography (TEE) is a well-established method of evaluating cardiac pathology. It has many advantages over transthoracic echocardiography (TTE), including the ability to image the heart during active cardiopulmonary resuscitation. This prospective simulation study aims to evaluate the ability of emergency medicine (EM) residents to learn TEE image acquisition techniques and demonstrate those techniques to identify common pathologic causes of cardiac arrest. This was a prospective educational cohort study with 40 EM residents from two participating academic medical centers who underwent an educational model and testing protocol. All participants were tested across six cases, including two normals, pericardial tamponade, acute myocardial infarction (MI), ventricular fibrillation (VF), and asystole presented in random order. Primary endpoints were correct identification of the cardiac pathology, if any, and time to sonographic diagnosis. Calculated endpoints inclu...
The Ultrasound Journal, 2021
Background In 2008 the Council of Emergency Medicine Residency Directors delineated consensus rec... more Background In 2008 the Council of Emergency Medicine Residency Directors delineated consensus recommendations for training in biliary ultrasound for the “detection of biliary pathology”. Objectives While studies have looked at the accuracy of emergency provider performed clinical ultrasound (ECUS), we sought to evaluated if ECUS could be diagnostic for acute cholecystitis and thus obviate the need for follow-up imaging. Method We reviewed all ECUS performed between 2012 and 2017 that had a matching radiology performed ultrasound (RADUS) and a discharge diagnosis. 332 studies were identified. The sensitivity and specificity of both ECUS and RADUS were compared to the patient’s discharge diagnosis. The agreement between the ECUS and RADUS was assessed using an unweighted Cohen’s Kappa. The time from patient arrival to diagnosis by ECUS and RADUS was also compared. Results Using discharge diagnosis as the gold standard ECUS was 67% (56–78%) sensitive, 88% (84–92%) specific, NPV 90% (87...
Clinical Ultrasound, 2018
The American Journal of Cardiology, 2021
A 17-year-old girl with no significant medical, surgical, or family history presented to the emer... more A 17-year-old girl with no significant medical, surgical, or family history presented to the emergency department following an episode of sudden cardiac arrest after being punched in the chest by her brother. Bystander CPR was immediately initiated, and she was found to be in ventricular fibrillation by emergency services. The patient had return of spontaneous circulation after one defibrillation event. No other significant injuries were found, and she eventually experienced a complete neurologic recovery and was discharged with no other identified cause for her arrest. The objective of this clinical case report is to highlight this unusual and rare injury to increase awareness and avoid incorrect diagnosis.
AEM Education and Training, 2020
The emergency physician (EP) must provide timely diagnosis and care to patients who often have su... more The emergency physician (EP) must provide timely diagnosis and care to patients who often have sudden and life-threatening emergencies. Residents must develop into this independent role through graduated responsibility through entrustment. Attending physicians in supervisory roles have the added challenge of overseeing the delivery of emergent clinical care by trainees, while assuring that all patients receive appropriate stabilization and care. The principle of entrustment of diagnostic and management skills is critical in the training and advancement of residents in the emergency department (ED). The attending EP or supervising senior resident must direct, monitor, and observe his or her residents, while educating and empowering them accordingly. The EP must continually assess and coach his or her trainees while ensuring patient safety. There are four factors affecting entrustment: the resident, the patient or family, the environment, and the faculty (Table 1). To help attendings and residents navigate this dynamic environment and foster a safe workplace for learners and patients, we developed the ABCDs of entrustment (Figure 1).
Clinical Ultrasound, 2018
Venous thromboembolism is a common condition found in patients of all walks of life, whether idio... more Venous thromboembolism is a common condition found in patients of all walks of life, whether idiopathic, secondary to a clotting disorder, or provoked due to recent surgery, trauma, or supplemental hormone use. Point-of-care ultrasound allows for rapid screening and diagnosis of deep venous thrombosis in patients who may present in the outpatient setting with a painful or swollen leg or those immobilized in the intensive care unit. While there are multiple different causes of a painful and/or swollen leg such as cellulitis, thrombophlebitis, injury, lymphadenopathy, etc., deep venous thrombosis can become life-threatening if the clot propagates toward the heart and enters the pulmonary arteries causing a pulmonary embolism. For this reason, diagnosing and treating deep venous thrombosis is of great importance. This chapter will review basic lower extremity venous anatomy, image acquisition, normal ultrasound anatomy, and interpretation of pathology.
The evaluation of a patient after Crotalinae envenomation requires assessment of local and system... more The evaluation of a patient after Crotalinae envenomation requires assessment of local and systemic signs and symptoms in conjunction with laboratory data. Point-of-care ultrasound (POCUS) is an em...
Southern Medical Journal, 2020
Annals of Emergency Medicine, 2020
Critical ultrasound journal, Jan 15, 2018
Traditional landmark thoracostomy technique has a known complication rate up to 30%. The goal of ... more Traditional landmark thoracostomy technique has a known complication rate up to 30%. The goal of this study is to determine whether novice providers could more accurately identify the appropriate intercostal site for thoracostomy by ultrasound guidance. 33 emergency medicine residents and medical students volunteered to participate in this study during routine thoracostomy tube education. A healthy volunteer was used as the standardized patient for this study. An experienced physician sonographer used ultrasound to locate a site at mid-axillary line between ribs 4 and 5 and marked the site with invisible ink that can only be revealed with a commercially available UV LED light. Participants were asked to identify the thoracostomy site by placing an opaque marker where they would make their incision. The distance from the correct insertion site was measured in rib spaces. The participants were then given a brief hands-on training session using ultrasound to identify the diaphragm and ...
Ocular ultrasound is an invaluable tool for the evaluation of the eye and orbit. However, the eye... more Ocular ultrasound is an invaluable tool for the evaluation of the eye and orbit. However, the eye and orbit are potentially sensitive to the thermal and mechanical effects of ultrasound. When performing B-mode imaging, dedicated ocular settings should be used. If these settings are not available, limiting the acoustic output to Food and Drug Administration (FDA) recommended maximum levels is strongly advised. Especially important is the acoustic output in spectral (pulsed) and color Doppler modes, which can exceed the FDA's maximum recommended levels for the eye. Adjusting settings to decrease acoustic output and limiting the time of the examination should be done when performing a Doppler examination. The acoustic output of shear wave elastography is significantly higher than FDA guidelines for the eye and should be considered experimental.
Clinical Practice and Cases in Emergency Medicine, Apr 20, 2018
The western journal of emergency medicine, 2017
Transesophageal echocardiography (TEE) is a well-established method of evaluating cardiac patholo... more Transesophageal echocardiography (TEE) is a well-established method of evaluating cardiac pathology. It has many advantages over transthoracic echocardiography (TTE), including the ability to image the heart during active cardiopulmonary resuscitation. This prospective simulation study aims to evaluate the ability of emergency medicine (EM) residents to learn TEE image acquisition techniques and demonstrate those techniques to identify common pathologic causes of cardiac arrest. This was a prospective educational cohort study with 40 EM residents from two participating academic medical centers who underwent an educational model and testing protocol. All participants were tested across six cases, including two normals, pericardial tamponade, acute myocardial infarction (MI), ventricular fibrillation (VF), and asystole presented in random order. Primary endpoints were correct identification of the cardiac pathology, if any, and time to sonographic diagnosis. Calculated endpoints inclu...
The Ultrasound Journal, 2021
Background In 2008 the Council of Emergency Medicine Residency Directors delineated consensus rec... more Background In 2008 the Council of Emergency Medicine Residency Directors delineated consensus recommendations for training in biliary ultrasound for the “detection of biliary pathology”. Objectives While studies have looked at the accuracy of emergency provider performed clinical ultrasound (ECUS), we sought to evaluated if ECUS could be diagnostic for acute cholecystitis and thus obviate the need for follow-up imaging. Method We reviewed all ECUS performed between 2012 and 2017 that had a matching radiology performed ultrasound (RADUS) and a discharge diagnosis. 332 studies were identified. The sensitivity and specificity of both ECUS and RADUS were compared to the patient’s discharge diagnosis. The agreement between the ECUS and RADUS was assessed using an unweighted Cohen’s Kappa. The time from patient arrival to diagnosis by ECUS and RADUS was also compared. Results Using discharge diagnosis as the gold standard ECUS was 67% (56–78%) sensitive, 88% (84–92%) specific, NPV 90% (87...
Clinical Ultrasound, 2018
The American Journal of Cardiology, 2021
A 17-year-old girl with no significant medical, surgical, or family history presented to the emer... more A 17-year-old girl with no significant medical, surgical, or family history presented to the emergency department following an episode of sudden cardiac arrest after being punched in the chest by her brother. Bystander CPR was immediately initiated, and she was found to be in ventricular fibrillation by emergency services. The patient had return of spontaneous circulation after one defibrillation event. No other significant injuries were found, and she eventually experienced a complete neurologic recovery and was discharged with no other identified cause for her arrest. The objective of this clinical case report is to highlight this unusual and rare injury to increase awareness and avoid incorrect diagnosis.
AEM Education and Training, 2020
The emergency physician (EP) must provide timely diagnosis and care to patients who often have su... more The emergency physician (EP) must provide timely diagnosis and care to patients who often have sudden and life-threatening emergencies. Residents must develop into this independent role through graduated responsibility through entrustment. Attending physicians in supervisory roles have the added challenge of overseeing the delivery of emergent clinical care by trainees, while assuring that all patients receive appropriate stabilization and care. The principle of entrustment of diagnostic and management skills is critical in the training and advancement of residents in the emergency department (ED). The attending EP or supervising senior resident must direct, monitor, and observe his or her residents, while educating and empowering them accordingly. The EP must continually assess and coach his or her trainees while ensuring patient safety. There are four factors affecting entrustment: the resident, the patient or family, the environment, and the faculty (Table 1). To help attendings and residents navigate this dynamic environment and foster a safe workplace for learners and patients, we developed the ABCDs of entrustment (Figure 1).
Clinical Ultrasound, 2018
Venous thromboembolism is a common condition found in patients of all walks of life, whether idio... more Venous thromboembolism is a common condition found in patients of all walks of life, whether idiopathic, secondary to a clotting disorder, or provoked due to recent surgery, trauma, or supplemental hormone use. Point-of-care ultrasound allows for rapid screening and diagnosis of deep venous thrombosis in patients who may present in the outpatient setting with a painful or swollen leg or those immobilized in the intensive care unit. While there are multiple different causes of a painful and/or swollen leg such as cellulitis, thrombophlebitis, injury, lymphadenopathy, etc., deep venous thrombosis can become life-threatening if the clot propagates toward the heart and enters the pulmonary arteries causing a pulmonary embolism. For this reason, diagnosing and treating deep venous thrombosis is of great importance. This chapter will review basic lower extremity venous anatomy, image acquisition, normal ultrasound anatomy, and interpretation of pathology.
The evaluation of a patient after Crotalinae envenomation requires assessment of local and system... more The evaluation of a patient after Crotalinae envenomation requires assessment of local and systemic signs and symptoms in conjunction with laboratory data. Point-of-care ultrasound (POCUS) is an em...
Southern Medical Journal, 2020
Annals of Emergency Medicine, 2020
Critical ultrasound journal, Jan 15, 2018
Traditional landmark thoracostomy technique has a known complication rate up to 30%. The goal of ... more Traditional landmark thoracostomy technique has a known complication rate up to 30%. The goal of this study is to determine whether novice providers could more accurately identify the appropriate intercostal site for thoracostomy by ultrasound guidance. 33 emergency medicine residents and medical students volunteered to participate in this study during routine thoracostomy tube education. A healthy volunteer was used as the standardized patient for this study. An experienced physician sonographer used ultrasound to locate a site at mid-axillary line between ribs 4 and 5 and marked the site with invisible ink that can only be revealed with a commercially available UV LED light. Participants were asked to identify the thoracostomy site by placing an opaque marker where they would make their incision. The distance from the correct insertion site was measured in rib spaces. The participants were then given a brief hands-on training session using ultrasound to identify the diaphragm and ...
Ocular ultrasound is an invaluable tool for the evaluation of the eye and orbit. However, the eye... more Ocular ultrasound is an invaluable tool for the evaluation of the eye and orbit. However, the eye and orbit are potentially sensitive to the thermal and mechanical effects of ultrasound. When performing B-mode imaging, dedicated ocular settings should be used. If these settings are not available, limiting the acoustic output to Food and Drug Administration (FDA) recommended maximum levels is strongly advised. Especially important is the acoustic output in spectral (pulsed) and color Doppler modes, which can exceed the FDA's maximum recommended levels for the eye. Adjusting settings to decrease acoustic output and limiting the time of the examination should be done when performing a Doppler examination. The acoustic output of shear wave elastography is significantly higher than FDA guidelines for the eye and should be considered experimental.