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  • Book
    Benjamin D. Nicholson, Michael J. Vitto, Harinder S. Dhindsa, editors.
    Summary: Ultrasound has rapidly become integral to the practice of emergency medicine. Over the past few years, with improvements in device size and cost, there has been increasing interest in exploring the utility of ultrasound in the prehospital environment. Much of the available literature on ultrasound in the emergency setting focuses on care delivered in emergency departments and intensive care units within the developed world. As a result, most resources are inappropriate and inadequate for doctors and non-physicians practicing in out-of-hospital environments that, by definition, are resource limited. This manual fills that gap by focusing on simplified discussions of ultrasound studies, ultrasound physics, and research that impacts out-of-hospital care in order to meet the needs of prehospital and austere providers. The manual discusses the use of ultrasound for diagnosis in out-of-hospital care, advanced noninvasive monitoring of patients, and safety in performing procedures common to the prehospital and austere environment. As is the approach for prehospital education, the chapters are complaint based and not diagnosis based where applicable. Chapters cover ultrasound image interpretation and basic physics; common image adjustments to improve image quality; unique challenges found in urban prehospital environments, austere/wilderness environments, tactical environments, and military special operations environments; and initial training, quality improvement/assurance programs, and credentialing. It also includes a section on procedures such as pericardiocentesis, vascular access, cricothyroidotomy, and others specific to austere providers. The Manual of Austere and Prehospital Ultrasound is an essential resource for physicians and related professionals, residents, and medical students in emergency medicine, civilian and military EMS providers, and critical care flight paramedics and nurses.

    Contents:
    Part 1: Introduction and Background
    Chapter 1: Physics and Knobs
    Part 2: Considerations for Specific Environments
    Chapter 2: Ground EMS
    Chapter 3: Helicopter Emergency Medical Services
    Chapter 4: Military Special Operations and Prolonged Field Care
    Chapter 5: Considerations for Ultrasound in the Urban Search and Rescue (USAR) Environment
    Part 3: Diagnosis
    Chapter 6: Shortness of Breath
    Chapter 7: Chest Pain
    Chapter 8: Trauma
    Chapter 9: Undifferentiated Hypotension
    Chapter 10: Advanced Diagnostic Topic for Austere Providers: Abdominal Pain
    Chapter 11: Advanced Diagnostic Topic for Austere Providers: Ocular
    Chapter 12: Advanced Diagnostic Topic for Austere Providers: Obstetric
    Chapter 13: Advanced Diagnostic Topic for Austere Providers: Skin and soft tissue
    Chapter 14: Advanced Diagnostic Topic for Austere Providers: Skeletal Trauma
    Part 4: Monitoring
    Chapter 15: Ultrasound Guidance of Resuscitation in Shock
    Chapter 16: Endotracheal tube placement
    Chapter 17: Intracranial Pressure Evaluation
    Chapter 18: Bladder Volume and Assessment of Hydronephrosis
    Part 5: Procedures
    Chapter 19: Vascular Access
    Chapter 20: Pericardiocentesis
    Chapter 21: Surgical cricothyroidotomy
    Chapter 22: Advanced Procedure Topic for Austere Providers: Thoracentesis
    Chapter 23: Advanced Procedure Topic for Austere Providers: Upper extremity nerve blocks
    Chapter 24: Advanced Procedure Topic for Austere Providers: Lower extremity nerve blocks
    Part 6: Training
    Chapter 25: Initial Training, Credentialing, and Quality Assurance/Quality Improvement Processes
    Chapter 26: Care of Equipment.
    Digital Access Springer 2021
  • Article
    Falco SC, Zivin R, Rothman-Denes LB.
    Proc Natl Acad Sci U S A. 1978 Jul;75(7):3220-4.
    A DNA-dependent RNA polymerase has been purified from disrupted virions of the Escherichia coli bacteriophage N4. The RNA polymerase is phage-coded and is required for class I N4 RNA synthesis, which is defined as RNA synthesized in vivo in the absence of post-infection protein synthesis. A polypeptide of molecular weight 350,000 is detected when the purified enzyme is analyzed by sodium dodecyl sulfate/polyacrylamide gel electrophoresis. N4 RNA polymerase requires denatured DNA as a template in vitro and shows a strong preference for denatured N4 DNA. With this template, transcription is asymmetric. The RNA product is complementary to only the H strand of N4 DNA. Furthermore, only class I N4 RNA is synthesized. In vivo transcription by the N4 virion RNA polymerase is inhibited by coumermycin. This result suggests that the activity of E. coli DNA gyrase, an enzyme that introduces negative supertwists into DNA, is required for N4 transcription.
    Digital Access Access Options