Josie Galarza Acuña

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Courses

Scholarly Contributions

Chapters

• Situ-LaCasse, E., & Acuna, J. (2019). Principles of Ultrasound Guidance. In The Ultimate Guide to Point-of-Care Ultrasound-Guided Procedures. Springer Nature.
• Acuna, J. (2018). Peritoneal Fluid. In Practical Guide to Critical Care Ultrasound(pp 56-66). American College of Emergency Physicians.
• Acuna, J., & Situ-LaCasse, E. (2019). Principles of Ultrasound Guidance. In The Ultimate Guide to Point-of-Care Ultrasound-Guided Procedures. Springer Nature.

Journals/Publications

• Adhikari, S. R., McNinch, N., Yarnish, A., Situ-LaCasse, E. H., & Acuna, J. G. (2023). Does Size Matter? A Prospective Study on the Feasibility of Using a Handheld Ultrasound Device in Place of a Cart-based System in the Evaluation of Trauma Patients. Journal of Emergency Medicine.
• Acuna, J., Pacheco, G., Yarnish, A., Haight, S., Carter, J., Coe, I., & Adhikari, S. R. (2022). A Novel Simulation Model for Training Emergency Medicine Residents in the Ultrasound Identification of Landmarks for Cricothyrotomy. Cureus, 12(12). doi:10.7759/cureus.33003
• Acuña, J., & Cabrera-Ramirez, J. (2022). The Use of Point-of-Care Ultrasound for the Diagnosis of Müllerian Abnormality in the Pediatric Emergency Department. Pediatric emergency care, 38(3), 136-138.
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  We present a case of an 18-year-old female patient with a history of primary amenorrhea presenting to a pediatric emergency department with complaint of new-onset vaginal bleeding. Upon the patient's presentation, she received a point-of-care ultrasound (POCUS), which promptly identified the lack of a uterus and led to the diagnosis of a müllerian duct anomaly. This is the first published report of müllerian agenesis identified in the pediatric emergency department using a transabdominal approach to pelvic POCUS. We recommend POCUS as a quick, noninvasive diagnostic approach for pediatric patients presenting with undifferentiated vaginal bleeding to guide further management.
• Acuña, J., Situ-LaCasse, E., Yarnish, A. A., Amini, R., McNinch, N. L., & Adhikari, S. (2022). The Status of Women in Emergency Ultrasound Fellowships: A Potential Light for the Future of Gender Inclusion in Academic Medicine. Cureus, 14(9), e28701.
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  The objective of this study is to investigate gender differences in the percentage of men and women who have completed an Emergency Ultrasound (EUS) fellowship over a four-year period. Secondary objectives of this study include evaluation of the career paths and accomplishments of women who have recently completed an EUS fellowship. We will also be assessing program characteristics as reported by the program directors.
• Adhikari, S. R., Yarnish, A., & Acuna, J. (2022). The Status of Women in Emergency Ultrasound Fellowships: A Potential Light for the Future of Gender Inclusion in Academic Medicine. Cureus, 14(9).
• Haidar, D. A., Peterson, W. J., Minges, P. G., Carnell, J., Nomura, J. T., Bailitz, J., Boyd, J. S., Leo, M. M., Liu, E. L., Duanmu, Y., Acuña, J., Kessler, R., Elegante, M. F., Nelson, M., Liu, R. B., Lewiss, R. E., Nagdev, A., & Huang, R. D. (2022). A consensus list of ultrasound competencies for graduating emergency medicine residents. AEM education and training, 6(6), e10817.
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  Emergency ultrasound (EUS) is a critical component of emergency medicine (EM) resident education. Currently, there is no consensus list of competencies for EUS training, and graduating residents have varying levels of skill and comfort. The objective of this study was to define a widely accepted comprehensive list of EUS competencies for graduating EM residents through a modified Delphi method.
• Rosario, J., Lewiss, R. E., Stolz, L. A., Del Rios, M., Acuña, J., Adhikari, S., Amponsah, D., Dessie, A. S., Gottlieb, M., Huang, R. D., Jones, J., Landry, A., Liu, R. B., Ng, L., Panebianco, N. L., Weekes, A. J., & Knight, S. (2022). Creating a more racial-ethnic inclusive clinical ultrasound community. The American journal of emergency medicine, 54, 208-211.
• Acuna, J., Yarnish, A., Situ-LaCasse, E., Amini, R., & Adhikari, S. (2021). The Use of Point-of-Care Ultrasound for Arthrocentesis Among Emergency Medicine Residents. Open access emergency medicine : OAEM, 13, 161-167.
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  The objective of this study is to determine if EM resident physicians are able to successfully utilize POCUS to perform an arthrocentesis in the ED. This is a retrospective review of ED patients who received an ultrasound-guided or ultrasound-assisted arthrocentesis performed in the ED over a 6-year period by an EM resident physician.
• Acuña, J., & Adhikari, S. (2021). Point-of-care Ultrasound to Distinguish Subgaleal and Cephalohematoma: Case Report. Clinical practice and cases in emergency medicine, 5(2), 198-201.
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  Cephalohematomas generally do not pose a significant risk to the patient and resolve spontaneously. Conversely, a subgaleal hematoma is a rare but more serious condition. While it may be challenging to make this diagnostic distinction based on a physical examination alone, the findings that differentiate these two conditions can be appreciated on point-of-care ultrasound (POCUS). We describe two pediatric patient cases where POCUS was used to distinguish between a subgaleal hematoma and a cephalohematoma.
• Acuña, J., Pierre, C. M., Sorenson, J., & Adhikari, S. (2021). Point-of-care Ultrasound to Evaluate Breast Pathology in the Emergency Department. The western journal of emergency medicine, 22(2), 284-290.
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  As physician-performed point-of-care ultrasound (POCUS) becomes more prevalent in the evaluation of patients presenting with various complaints in the emergency department (ED), one application that is significantly less used is breast ultrasound. This study evaluates the utility of POCUS for the assessment of patients with breast complaints who present to the ED and the impact of POCUS on medical decision-making and patient management in the ED.
• Adhikari, S. R., Stea, N., Drachman, M., & Acuña, J. (2020). Handheld ultrasound: Overcoming the challenge of difficult peripheral intravenous access in the emergency department. Journal of Ultrasound in Medicine.
• Dessie, A. S., Lewiss, R. E., Stolz, L. A., Acuña, J., Adhikari, S., Amponsah, D., Del Rios, M., Huang, R. D., Knight, R. S., Landry, A., Liu, R. B., Gottlieb, M., Ng, L., Panebianco, N. L., Rosario, J., Weekes, A. J., & Jones, J. D. (2021). The state of gender inclusion in the point-of-care ultrasound community. The American journal of emergency medicine.
• Situ-LaCasse, E., Acuña, J., Huynh, D., Amini, R., Irving, S., Samsel, K., Patanwala, A. E., Biffar, D. E., & Adhikari, S. (2021). Can ultrasound novices develop image acquisition skills after reviewing online ultrasound modules?. BMC medical education, 21(1), 175.
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  Point-of-care ultrasound is becoming a ubiquitous diagnostic tool, and there has been increasing interest to teach novice practitioners. One of the challenges is the scarcity of qualified instructors, and with COVID-19, another challenge is the difficulty with social distancing between learners and educators. The purpose of our study was to determine if ultrasound-naïve operators can learn ultrasound techniques and develop the psychomotor skills to acquire ultrasound images after reviewing SonoSim® online modules.
• Stolz, L., Situ-LaCasse, E., Acuña, J., Thompson, M., Hawbaker, N., Valenzuela, J., Stolz, U., & Adhikari, S. (2021). What is the ideal approach for emergent pericardiocentesis using point-of-care ultrasound guidance?. World journal of emergency medicine, 12(3), 169-173.
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  Traditionally performed using a subxiphoid approach, the increasing use of point-of-care ultrasound in the emergency department has made other approaches (parasternal and apical) for pericardiocentesis viable. The aim of this study is to identify the ideal approach for emergency-physician-performed ultrasound-guided pericardiocentesis as determined by ultrasound image quality, distance from surface to pericardial fluid, and likely obstructions or complications.
• Acuña, J., Rubin, M., Hahn, B., Das, D., Kapoor, M., Adhikari, S., & Greenstein, J. (2020). Point-of-Care Ultrasound in United States Pediatric Emergency Medicine Fellowship Programs: The Current State of Practice and Training. Pediatric emergency care.
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  In 2015, the American Academy of Pediatrics (AAP) released a policy statement regarding point-of-care ultrasonography (POCUS) by pediatric emergency physicians, which included recommendations on education and training. In the 3 years since the AAP policy statement and its accompanying technical report were published, it is unclear which aspects of the recommendations set forth by this policy have been instituted by POCUS programs throughout the country. The objective of this study was to conduct a survey of pediatric emergency medicine (PEM) fellowship directors throughout the United States regarding the current state of education and training of POCUS in their department.
• Acuña, J., Sorenson, J., Gades, A., Wyatt, R., Stea, N., Drachman, M., & Adhikari, S. (2020). Handheld Ultrasound: Overcoming the Challenge of Difficult Peripheral Intravenous Access in the Emergency Department. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 39(10), 1985-1991.
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  The purpose of this study was to evaluate the performance of a handheld ultrasound device for difficult peripheral intravenous (PIV) access performed by nurses and paramedics in the emergency department (ED).
• Acuña, J., Stolz, U., Stolz, L. A., Situ-LaCasse, E. H., Bell, G., Berkeley, R. P., Boyd, J. S., Castle, D., Carmody, K., Fong, T., Grewal, E., Jones, R., Hilberts, S., Kanter, C., Kelley, K., Leetch, S. J., Pazderka, P., Shaver, E., Stowell, J. R., , Josephson, E. B., et al. (2020). Evaluation of Gender Differences in Ultrasound Milestone Evaluations During Emergency Medicine Residency Training: A Multicenter Study. AEM education and training, 4(2), 94-102.
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  Prior literature has demonstrated incongruities among faculty evaluation of male and female residents' procedural competency during residency training. There are no known studies investigating gender differences in the assessment of procedural skills among emergency medicine (EM) residents, such as those required by ultrasound. The objective of this study was to determine if there are significant gender differences in ultrasound milestone evaluations during EM residency training.
• Adhikari, S., Situ-LaCasse, E., Acuña, J., Irving, S., Weaver, C., Samsel, K., Biffar, D. E., Motlagh, M., & Sakles, J. (2020). Integration of Pre-intubation Ultrasound into Airway Management Course: A Novel Training Program. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 24(3), 179-183.
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  To determine the feasibility of integrating pre-intubation ultrasound into airway course and assess emergency medicine (EM) residents' confidence and comfort level in using ultrasound for pre-intubation hemodynamic stabilization and identifying cricothyroid membrane after the training session.
• Amini, R., Camacho, L., Acuña, J., Situ-La Casse, E. H., & Adhikari, S. (2020). Point of Care Ultrasound in Pyogenic Tenosynovitis: A Case Report. Bulletin of emergency and trauma, 8(1), 41-46.
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  Pyogenic tenosynovitis is caused by hematogenous spread of infection or trauma with direct inoculation of a tendon sheath. Symptoms and clinical examination findings associated with pyogenic tenosynovitis may be confused with superficial soft tissue infections, however management plans between pyogenic tenosynovitis and superficial soft tissue infection vary significantly. In patients with pyogenic tenosynovitis, operative intervention and subsequent irrigation and debridement offer a definitive therapy. Bedside ultrasound helps clinicians inspect the involved tendon sheath and may help assisting diagnosis of pyogenic tenosynovitis. In this case report, we described three cases, where point of care ultrasound was used to assist the diagnosis of pyogenic tenosynovitis, to accelerate consultation, and to expedite operative intervention.
• Acuna, J., Adhikari, S. R., & Situ-LaCasse, E. (2019). Evaluation of Gender Differences in Ultrasound Milestone Assessments during Emergency Medicine Residency Training: A Multicenter Study. AEM Education and Training.
• Acuña, J., Situ-LaCasse, E. H., Patanwala, A. E., Stolz, L. A., Amini, R., Friedman, L., & Adhikari, S. (2019). Identification of gender differences in ultrasound milestone assessments during emergency medicine residency training: a pilot study. Advances in medical education and practice, 10, 141-145.
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  Prior literature suggests that incongruities between male and female resident's procedural competency may be explained by gender bias during the evaluation process. There are no known studies investigating gender differences in the assessment of ultrasound-based procedural skills among emergency medicine (EM) residents. The purpose of this study was to evaluate for gender differences in ultrasound milestone assessments among EM residents. This is a retrospective study including EM residents. Milestone assessment data were collected from a total of 3 Accreditation Council for Graduate Medical Education (ACGME) EM residency programs representing a 3-year period The outcome measures included mean milestone levels, milestone levels at baseline and graduation and differences in milestone achievement between female and male EM residents. An unpaired Student's -test was used to compare milestone scores between female and male residents. A total of 456 ultrasound milestone evaluations were collected from 91 EM residents (34 females [37%] and 57 males [63%]). No significant differences were noted in the overall mean milestone level between females (2.3±0.6) and males (2.2±0.6) (=0.387). There were no significant differences noted in the ultrasound milestone level between females (0.8±0.6) and males (0.7±0.7) at baseline (=0.754). Although it did not reach statistical significance (=0.197), the increase in the mean ultrasound milestone level from baseline to graduation was greater in males (3.4±0.7) compared to females (3.1±0.7). Overall, there were no statistically significant differences in the mean ultrasound milestone levels between females and males. The rate of ultrasound milestone level achievement during EM residency training at our institution had a slight tendency to be higher for males than females in the observed residency programs; however, this also did not reach statistical significance. Possible gender bias while evaluating ultrasound milestone levels needs to be further studied on a larger scale.
• Amini, R., Camacho, L. D., Valenzuela, J., Ringleberg, J. K., Patanwala, A. E., Stearns, J., Situ-LaCasse, E. H., Acuña, J., & Adhikari, S. (2019). Cadaver Models in Residency Training for Uncommonly Encountered Ultrasound-Guided Procedures. Journal of medical education and curricular development, 6, 2382120519885638.
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  Arthrocentesis of the ankle and elbow and brachial plexus nerve blocks are infrequently performed procedures; however, clinicians in specialties such as emergency medicine are required to be proficient in these procedures in the event of emergent or urgent necessity.
• Amini, R., Situ-LaCasse, E. H., Acuña, J., Theodoro, D., Blaivas, M., Tayal, V., & Adhikari, S. (2019). Impact of Point-of-Care Ultrasound in Critically Ill Patients: Flawed Data and Wrong Conclusions. Critical care explorations, 1(9), e0042.
• Situ-LaCasse, E. H., Amini, R., Bain, V., Acuña, J., Samsel, K., Weaver, C., Valenzuela, J., Pratt, L., Patanwala, A. E., & Adhikari, S. (2019). Performance of Ultrasound-guided Peripheral Nerve Blocks by Medical Students After One-day Training Session. Cureus, 11(1), e3911.
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  Introduction  Ultrasound-guided peripheral nerve blocks (USGPNB) are performed by various specialists and are excellent, non-addicting pain control techniques. Alternative pain management approaches are needed to combat opiate abuse. Medical students should be aware of alternative pain management therapies before they begin clinical practice. Objective  Our objective was to determine if medical students can identify peripheral nerves under ultrasound and perform a USGPNB after a one-day hands-on training session. Methods  This was a cross-sectional study at an academic medical center. The study participants were third-year medical students with minimal prior ultrasound experience. Students were given an introductory lecture highlighting the opiate epidemic and benefits of USGPNB prior to the workshop. The one-day hands-on educational workshop consisted of learning basic sonographic anatomy, indications for USGPNB, and practicing needle guidance under ultrasound guidance. After the educational workshop, students' procedural competency was assessed by ultrasound-trained emergency medicine clinicians. Results  A total of 94 participants were included in this study. The average pre-test score was 68.4% (95% confidence interval [CI]; 65.4% to 71.4%). After the one-day educational workshop, the post-test score was 92.8% (95% CI; 90.8% to 94.8%). The average hands-on evaluation score was 84.4% (95% CI; 81.6% to 87.3%). All students agreed that this educational session is a good start to learning about USGPNB, and they felt comfortable identifying the peripheral nerves using ultrasound. On a confidence scale of one (low) through 10 (high), 83% (95% CI; 75.9% to 90.15%) rated their confidence as ≥6. All except one student either agreed that this educational session helped them understand how USGPNB could be integrated into acute pain management. The majority (84% [95% CI; 77% to 91%]) agreed that the session will change how they manage patients' acute pain in their future medical practice. Conclusion  Medical students can learn the sonographic anatomy of peripheral nerves and techniques of USGPNB after a one-day educational session.
• Situ-LaCasse, E., Situ-LaCasse, E., Adhikari, S. R., Adhikari, S. R., Acuna, J., & Acuna, J. (2019). Evaluation of Gender Differences in Ultrasound Milestone Assessments during Emergency Medicine Residency Training: A Multicenter Study. AEM Education and Training.
• Acuna, J., Situ-LaCasse, E., Jamplis, R. P., Amini, R., & Adhikari, S. (2018). Point-of-care Ultrasound Evaluation of Tibial Avulsion Fractures. Cureus, 10(5), e2677.
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  It can be difficult to diagnose a tibial avulsion fracture based on physical examination alone as findings are often non-specific. Emergency physicians will usually opt for radiography as their initial imaging modality, which has several disadvantages in evaluating tibial avulsion fractures. The objective of this case series is to describe the utility of point-of-care ultrasound (POCUS) in the evaluation of tibial avulsion injuries. A 15-year-old male presented to the emergency department (ED) after sustaining a left knee injury while playing soccer. The clinician had a high suspicion for patellar tendon involvement. A POCUS exam revealed a cortical irregularity and interruption of the left proximal tibia. The patellar tendon was found attached to an avulsed bony portion. Findings were consistent with a tibial tuberosity avulsion fracture. The patient was admitted and scheduled for surgery the following day. Our second case is a 31-year-old male who presented to the ED with a complaint of left knee pain after a 10-foot fall from a ladder. A POCUS exam revealed a bony avulsion over the anterior tibia that was not noted on the initial radiography read by radiology. His patellar tendon showed no evidence of rupture. This led to prompt consultation with orthopedics who evaluated the patient in the ED. Radiographs were reviewed again and it appeared that there was a missed anterior tibial spine fracture. The patient was placed in a knee immobilizer and discharged with instructions to follow up with orthopedics for outpatient surgery. The use of POCUS in the evaluation of these patients led to prompt diagnosis of tibial avulsion injuries, which led to early consultation and appropriate patient management. POCUS allows for expedited diagnosis and appropriate management of patients with tibial avulsion injuries.
• Acuña, J., Rukh, S., & Adhikari, S. (2018). Point-of-care ultrasound identification of yolk stalk sign in a case of failed first trimester pregnancy. World journal of emergency medicine, 9(2), 149-151.
• Acuña, J., Situ-LaCasse, E., & Mosier, J. (2018). A 33-Year-Old Woman With Progressive Dyspnea and Fatigue. Chest, 154(3), e65-e67.
• Amini, R., Baker, N., Situ-LaCasse, E. H., Acuña, J., Nuño, T., Stolz, U., & Adhikari, S. (2018). Can emergency physicians accurately distinguish retinal detachment from posterior vitreous detachment?: A response. The American journal of emergency medicine, 36(8), 1499-1500.
• Friedman, L., Situ-LaCasse, E., Acuna, J., Amini, R., Irving, S. C., Stolz, L. A., Sterling, R., Jung, C., Sanders, A. B., & Adhikari, S. (2018). Point-of-care Head and Neck Sonography for Clinical Problem-solving: Impact of One-day Training Sessions on Medical Student Education. Cureus, 10(12), e3740.
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  Introduction The curriculum for medical student education is continuously evolving to emphasize knowledge acquisition with critical problem-solving skills. Medical schools have started to implement curricula to teach point-of-care ultrasound skills. To our knowledge, the expansion into head and neck sonography for medical student education is novel and has never been studied. Our objective was to determine the feasibility of implementing point-of-care head and neck sonography and critical problem-solving instruction for medical student education. Methods This was a cross-sectional study enrolling third-year medical students with minimal prior ultrasound experience. A one-day educational curriculum focusing on the use of head and neck ultrasound for clinical problem-solving was integrated into one of the week-long intersessions. The components of point-of-care ultrasound workshop included asynchronous learning, one-hour didactic lecture, followed by a pre-test assessment, then a one-day hands-on workshop, and finally a post-test assessment administered at the end of the training session. Results A total of 123 subjects participated in this study. Ninety-one percent completed the questionnaire prior to the workshop and 83% completed the post-test questionnaire. The level of comfort with using an ultrasound system significantly increased from 31% to 92%. Additionally, the comfort level in interpreting ultrasound images also significantly increased from 21% to 84%. Eighty-nine percent (95% CI, 86%-97%) had an interest in learning ultrasound and would enroll in an optional ultrasound curriculum if given the opportunity. Knowledge of specific ultrasound applications also increased from 60% (after asynchronous learning and lectures) to 95% (after additional hands-on sonographic training). Conclusion At our institution, we successfully integrated point-of-care head and neck sonography and critical problem-solving instruction for medical student education.
• Greenstein, J., Das, D., Acuna, J., Kapoor, M., Brown, C., Husain, A., Lally, B., & Hahn, B. (2018). The use of cadaver models to diagnose rib fractures: A pilot study. The American journal of emergency medicine.
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  In the emergency department, rib fractures are a common finding in patients who sustain chest trauma. Rib fractures may be a sign of significant, underlying pathology, especially in the elderly patients where rib fractures are associated with significant morbidity and mortality. To date, no studies have evaluated the ability of ultrasound to detect rib fractures using cadaver models and subsequently use this model as a teaching tool.
• Stolz, L. A., Acuna, J. G., Gaskin, K., Murphy, A. M., Friedman, L., Stears-Ellis, S., Javedani, P., Stolz, U., & Adhikari, S. (2018). Echogenicity and ultrasound visibility of peripheral nerves of the upper extremity. Medical ultrasonography, 20(2), 199-204.
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  Regional anesthesia with ultrasound-guidance is an excellent option for pain control if nerves are adequately visualized. Gender, body mass index (BMI), history of diabetes, neck and forearm circumference may affect echotexture and visualization. This study evaluates patient characteristics for their ability to predict the echogenicity or visibility of upper extremity peripheral nerves.
• Stolz, L. A., Amini, R., Situ-LaCasse, E., Acuna, J., Irving, S., Friedman, L., Fiorello, A. B., Stea, N., Fan, H., & Adhikari, S. R. (2018). Multimodular Ultrasound Orientation: Residents’ Confidence and Skill in Performing Point-of-care Ultrasound. Cureus, 10(11). doi:10.7759/cureus.3597
• Stolz, L. A., Amini, R., Situ-LaCasse, E., Acuña, J., Irving, S. C., Friedman, L., Fiorello, A. B., Stea, N., Fan, H., & Adhikari, S. (2018). Multimodular Ultrasound Orientation: Residents' Confidence and Skill in Performing Point-of-care Ultrasound. Cureus, 10(11), e3597.
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  Introduction The objectives of this study were to determine if a multimodular introductory ultrasound course improved emergency medicine intern confidence in performing a point-of-care ultrasound and if our educational objectives could be met with our chosen structure. Methods This is a prospective, observational study evaluating three consecutive incoming emergency medicine residency classes from three residency programs. A one-day introductory ultrasound course was delivered. The course consisted of 1) flipped classroom didactics, 2) in-person, case-based interactive teaching sessions, and 3) check-listed, goal-driven, hands-on instruction. Results Over three years, 73 residents participated in this study. There was no significant difference in performance on the written test (p = 0.54) or the skills assessment (p = 0.16) between years. Performance on the written pre-test was not a predictor of performance on the skills test (R= 0.028; p = 0.19). Prior to training, residents were most confident in performing a focused assessment with sonography for trauma examination (median confidence 5.5 (interquartile range (IQR): 3 - 7) on a 10-point Likert scale where 1 represents low confidence and 10 represents high confidence). They reported the lowest confidence in performing a cardiac ultrasound (3 (IQR: 2 - 6)). Following training, residents reported increased confidence with all applications (p < 0.001). Eighty-five percent (confidence interval (CI): 73, 92) of residents agreed that the online ultrasound lectures effectively teach point-of-care ultrasound applications and 98% (CI: 88, 100) agreed that case-based interactive sessions helped them understand how ultrasound changes the management of acutely ill patients. Conclusions A written test of knowledge regarding the use of point-of-care ultrasound does not correlate with procedural skills at the start of residency, suggesting that teaching and evaluation of both types of skills are necessary. Following a multimodular introductory ultrasound course, residents showed increased confidence in performing the seven basic ultrasound applications. Residents reported that an asynchronous curriculum and case-based interactive sessions met the learning objectives and effectively taught point-of-care ultrasound applications.
• Baker, N., Amini, R., Situ-LaCasse, E. H., Acuña, J., Nuño, T., Stolz, U., & Adhikari, S. (2017). Can emergency physicians accurately distinguish retinal detachment from posterior vitreous detachment with point-of-care ocular ultrasound?. The American journal of emergency medicine.
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  There is significant overlap between the symptoms of patients presenting with retinal detachment (RD) and posterior vitreous detachment (PVD). Urgency to obtain consultation and treatment are dependent on the ability to accurately distinguish these two conditions. The objective of this study was to determine the ability of emergency physicians to differentiate RDs from PVDs using point-of-care (POC) ocular ultrasound.
• Acuna, J., & Hahn, B. (2016). Holstein Lewis humerus fracture. The American journal of emergency medicine, 34(2), 345.e5-6.
• Zielinski, M., Kong, R., Acuna, J., Taflin, G., Noble, A., & Hahn, B. (2016). Man With Acute Eye Lesion. Annals of emergency medicine, 67(6), e23-e24.

Presentations

• Adhikari, S. R., Situ-LaCasse, E., & Acuna, J. (2019, May). Assessment of Gender Differences in Ultrasound Milestone Evaluations in Emergency Medicine Residency Training. Society of Academic Emergency Medicine Annual Meeting. Las Vegas, NV: Society of Academic Emergency Medicine.
• Acuna, J., Patanwala, A. E., Situ-LaCasse, E., Stolz, L., Amini, R., Friedman, L., & Adhikari, S. R. (2018, May). Evaluation of Gender Differences in Ultrasound Milestone Assessments During Emergency Medicine Residency Training. Society of Academic Emergency Medicine Annual Meeting. Indianapolis, IN.
• Adhikari, S. R., Acuna, J., Friedman, L., Patanwala, A. E., Amini, R., Situ-LaCasse, E., Stolz, L., Stolz, L., Situ-LaCasse, E., Amini, R., Friedman, L., Patanwala, A. E., Acuna, J., & Adhikari, S. R. (2018, February). Evaluation of Gender Differences in Ultrasound Milestone Assessments During Emergency Medicine Residency Training. Western Society of Academic Emergency Medicine Annual Meeting. Albuquerque, New Mexico.
• Adhikari, S. R., Fan, H., Stea, N., Fiorello, A. B., Friedman, L., Amini, R., Irving, S., Acuna, J., Situ-LaCasse, E., & Stolz, L. A. (2018, May). Multimodular Ultrasound Orientation: Residents’ Confidence and Skill in Performing Point-of-care Ultrasound. Society of Academic Emergency Medicine Annual Meeting. Indianapolis, IN: Society of Academic Emergency Medicine.
• Adhikari, S. R., Samsel, K., Irving, S., Diffar, D., Patanwala, A. E., Acuna, J., Huynh, D., & Situ-LaCasse, E. (2018, March). Can Ultrasound Naïve First-Year Medical Students Develop Hands-On Skills in Image Acquisition After Reviewing Online Ultrasound Modules?. American Institute of Ultrasound in Medicine Annual Meeting. New York, New York.
• Situ-LaCasse, E., Adhikari, S. R., Pratt, L., Amini, R., Bain, V., Valenzuela, J., Weaver, C., Patanwala, A. E., Samsel, K., Biffar, D., Acuna, J., Acuna, J., Biffar, D., Samsel, K., Weaver, C., Patanwala, A. E., Valenzuela, J., Bain, V., Pratt, L., , Amini, R., et al. (2018, February). Can Medical Students Perform Ultrasound-Guided Peripheral Nerve Blocks After One-Day Training Session?. Western Society of Academic Emergency Medicine Annual Meeting. Albuquerque, New Mexico.

Poster Presentations

• Gaither, J. B., Hannan, P., Munn, R., Rice, A., & Acuna, J. G. (2024, January). Acuna JG, Snell EW, Rice AD, Hannan PL, Munn R, Wise JN, Bradley G, Zenuk-Garcia R, Gaither JB.Ultrasound-Guidance for Peripheral Intravenous Access Among Paramedics in the Emergency Department. . National Association of EMS Physicians Annual Meeting.
• Acuna, J., Acuna, J., Pacheco, G., Pacheco, G., Yarnish, A., & Yarnish, A. (2022, spring). Assessment of a Novel Anterior Neck Model for training emergency medicine residents in the ultrasound identification of anatomic landmarks for cricothyroidotomy. The Society for Academic Emergency Medicine (SAEM) Annual Meeting. New Orleans, LA.
• Acuna, J., Cabrera-Ramirez, J., & Adhikari, S. R. (2021, April). The Use of Point-of-Care Ultrasound in the Diagnosis of Mullerian Abnormality in the Pediatric Emergency Department.. American Institute of Ultrasound in Medicine Annual Convention. Virtual: American Institute of Ultrasound in Medicine.
• Acuna, J., Shockey, D., & Adhikari, S. R. (2021, April). The Use of Point-of-Care Ultrasound to Differentiate Between Subgaleal and Cephalohematomas in Pediatric Patients.. American Institute of Ultrasound in Medicine Annual Convention. Virtual: American Institute of Ultrasound in Medicine.
• Adhikari, S. R., Adhikari, S. R., Amini, R., Amini, R., Situ-LaCasse, E., Situ-LaCasse, E., Yarnish, A., Yarnish, A., Acuna, J., & Acuna, J. (2021, April). Teaching Arthrocentesis Protocol in Trainess (TAPiT) An Educational Intervention to Facilitate the Use of Point-of-Care Ultrasound when Performing Arthrocentesis. American Institute of Ultrasound in Medicine Annual Convention. Virtual: American Institute of Ultrasound in Medicine.
• Shirazi, F., Shirazi, F., Situ-LaCasse, E., Situ-LaCasse, E., Acuna, J., Acuna, J., Adhikari, S. R., & Adhikari, S. R. (2020, October/Fall). Point-of-care Ultrasound in the Evaluation of Rattlesnake Envenomation. ACEP Research forum.
• Acuna, J. (2019, April). Use of Point-of-Care Ultrasound to Diagnose Achilles Tendon Rupture in Cadaver Models. American Institute of Ultrasound in Medicine Annual Conference. Orlando, Florida: American Institute of Ultrasound in Medicine.
• Adhikari, S. R., Acuna, J., Acuna, J., & Adhikari, S. R. (2019, April). Feasibility of Using a Handheld Ultrasound Device for Difficult Peripheral Intravenous Access in the Emergency Department. American Institute of Ultrasound in Medicine Annual Conference. Orlando, Florida: American Institute of Ultrasound in Medicine.
• Acuna, J. (2018, March). Point-of-Care Ultrasound in the Evaluation of Tibial Avulsion Fractures. American Institute of Ultrasound in Medicine Annual Conference. New York City, NY.
• Acuna, J., Irving, S., Situ-LaCasse, E., & Adhikari, S. R. (2017, March). Point-of-Care Ultrasound Identification of the Yolk Stalk Sign in a Case of Failed First Trimester Pregnancy. American Institute of Ultrasound in Medicine Annual Convention. Orlando, FL.
• Adhikari, S. R., Irving, S., Acuna, J., & Situ-LaCasse, E. (2017, March). Point-of-care ultrasound in the diagnosis of subglottic stenosis and epiglottitis: The tale of two airways. American Institute of Ultrasound in Medicine Annual Meeting. Orlando, Florida.
• Adhikari, S. R., Irving, S., Acuna, J., Situ-LaCasse, E., & Friedman, L. (2017, March). Point-of-Care Ultrasound Diagnosis of Imperforate Hymen in Pediatric Abdominal Pain. American Institute of Ultrasound in Medicine Annual Meeting. Orlando, Florida.
• Blaivas, M., Tsung, J., Tay, E., Friedman, L., Acuna, J., Situ-LaCasse, E., & Adhikari, S. R. (2017, October). Accuracy of point-of-care ultrasound for the diagnosis of scrotal pathology in the emergency department. American College of Emergency Medicine National Meeting. District of Columbia.