BACKGROUND: To evaluate the utilization of point-of-care ultrasound (POCUS) for the assessment of emergency department (ED) patients with musculoskeletal symptoms and the impact of musculoskeletal POCUS on medical decision-making and patient management in the ED. METHODS: This was a retrospective review of ED patients presenting with musculoskeletal symptoms who received a POCUS over a 3.5-year period. An ED POCUS database was reviewed for musculoskeletal POCUS examinations used for medical decision-making. Electronic medical records were then reviewed for demographic characteristics, history, physical examination findings, ED course, additional imaging studies, and impact of musculoskeletal POCUS on patient management in ED. RESULTS: A total of 264 subjects (92 females, 172 males) and 292 musculoskeletal POCUS examinations were included in the final analysis. Most common symptomatic sites were knee (31.8％) and ankle (16.3％). Joint effusion was the most common finding on musculoskeletal POCUS, noted in 33.7％ of the patients, and subcutaneous edema/cobblestoning was found in 10.2％ of the patients. Muscle or tendon rupture was found in 2.3％ of the patients, and 1.9％ of the patients had joint dislocation. Bursitis or bursa fluid was found in 3.4％ of patients, and tendonitis/tendinopathy was found in 2.3％. Twenty percent of them were ultrasound-guided musculoskeletal procedures, and most of them (73.3％) were arthrocentesis. Of the included studies, all except three either changed or helped guide patient management as documented in the patients' medical records. CONCLUSION: Our study findings illustrate the utility of POCUS in the evaluation of a variety of musculoskeletal pathologies in the ED.

ABSTRACT:Objective To investigate the treatment and nursing of vacuum sealing drainage (VSD)in the primary stage in repairing exposed dog bite wounds.Methods Conventional de-bridement was carried out by VSD on the dog bite wounds.The negative pressure with 300 mmHg for 2 hours and 130 mmHg for 1 hour were interchangeably applied for 24 hours in total.All the pa-tients were presented with flaps transplantation with VSD for 72 hours.Drainage strips were placed which came from half of the drainage tube bellow flap after repairing the tissue defect,and vacuum sealing drainage was placed over the flap and donor size,and initiatively and alternatively aspirated blood stasis in flap and bellow flap with negative pressure of 130mmHg for 1 hour and 300 mmHg for 2 hours.Vacuum sealing drainage was dismantled after 3 days,and the drainages were pulled out.Special nursing and rehabilitation were carried out during the treatment.Results All the flaps survived with no obvious cicatrix.All the patients had no rabies in the 24-month to 2-year follow-ups.Conclusion The dog bite wounds can be treated well by combining vacuum sealing drainage with primary repairing.This method can remove the bacteria and virus in the wounds and satisfied patients’requirements.Good nursing can promote recovery and shorten the healing time.

ABSTRACT:Objective To investigate the treatment and nursing of vacuum sealing drainage (VSD)in the primary stage in repairing exposed dog bite wounds.Methods Conventional de-bridement was carried out by VSD on the dog bite wounds.The negative pressure with 300 mmHg for 2 hours and 130 mmHg for 1 hour were interchangeably applied for 24 hours in total.All the pa-tients were presented with flaps transplantation with VSD for 72 hours.Drainage strips were placed which came from half of the drainage tube bellow flap after repairing the tissue defect,and vacuum sealing drainage was placed over the flap and donor size,and initiatively and alternatively aspirated blood stasis in flap and bellow flap with negative pressure of 130mmHg for 1 hour and 300 mmHg for 2 hours.Vacuum sealing drainage was dismantled after 3 days,and the drainages were pulled out.Special nursing and rehabilitation were carried out during the treatment.Results All the flaps survived with no obvious cicatrix.All the patients had no rabies in the 24-month to 2-year follow-ups.Conclusion The dog bite wounds can be treated well by combining vacuum sealing drainage with primary repairing.This method can remove the bacteria and virus in the wounds and satisfied patients’requirements.Good nursing can promote recovery and shorten the healing time.