Maili Alexandria Drachman

Interests

Research

Emergency Ultrasound

Teaching

Emergency Ultrasound

Courses

No activities entered.

Scholarly Contributions

Journals/Publications

• 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.
• Acuña, J., Drachman, M., Adhikari, S., Stea, N., Wyatt, R. G., Gades, A. M., & Sorenson, J. (2020). Handheld Ultrasound. Journal of Ultrasound in Medicine, 39(10), 1985-1991. doi:10.1002/jum.15303
  More info

  Objectives The purpose of this study was to evaluate the performance of a handheld ultrasound device for peripheral intravenous (PIV) access performed by nurses and paramedics in the emergency department (ED). Methods This was a retrospective review at an academic medical center. Participants were ED nurses and paramedics with competence in ultrasound-guided PIV placement. Participants were asked to log their use of the handheld device when used on patients deemed to have difficult access and complete a questionnaire, which consisted of items related to the effectiveness and ease of use of the device. Data were collected over the course of 1 year. An electronic medical record review was performed to track the success rates and the occurrence of any associated complications throughout the hospital stay. Results Nurses and paramedics logged a total of 483 cases in which PIV access was attempted with the handheld ultrasound device. Ninety-two percent (95% confidence interval [CI], 89%-94%) of the ultrasound-guided PIV lines attempted were placed successfully. Eighty-four percent (95% CI, 80%-87%) of the lines were placed successfully on the first attempt. In most cases (396 of 483 [82%]), no complications associated with the PIV occurred. A total of 429 questionnaires were completed over the study period. Most of the operators (84%; 95% CI, 80%-87%) stated that the handheld device was adequate to perform ultrasound-guided PIV access. Conclusions The handheld ultrasound device performed well in terms of usability and reliability for PIV access.
• Lahham, S., Becker, B. A., Gari, A., Bunch, S., Alvarado, M., Anderson, C. L., Viquez, E., Spann, S. C., & Fox, J. C. (2018). Utility of common bile duct measurement in ED point of care ultrasound: A prospective study.. The American journal of emergency medicine, 36(6), 962-966. doi:10.1016/j.ajem.2017.10.064
  More info

  Measurement of the common bile duct (CBD) is considered a fundamental component of biliary point-of-care ultrasound (POCUS), but can be technically challenging..The primary objective of this study was to determine whether CBD diameter contributes to the diagnosis of complicated biliary pathology in emergency department (ED) patients with normal laboratory values and no abnormal biliary POCUS findings aside from cholelithiasis..We performed a prospective, observational study of adult ED patients undergoing POCUS of the right upper quadrant (RUQ) and serum laboratory studies for suspected biliary pathology. The primary outcome was complicated biliary pathology occurring in the setting of normal laboratory values and a POCUS demonstrating the absence of gallbladder wall thickening (GWT), pericholecystic fluid (PCF) and sonographic Murphy's sign (SMS). The association between CBD dilation and complicated biliary pathology was assessed using logistic regression to control for other factors, including laboratory findings, cholelithiasis and other sonographic abnormalities..A total of 158 patients were included in the study. 76 (48.1%) received non-biliary diagnoses and 82 (51.9%) were diagnosed with biliary pathology. Complicated biliary pathology was diagnosed in 39 patients. Sensitivity of CBD dilation for complicated biliary pathology was 23.7% and specificity was 77.9%..Of patients diagnosed with biliary pathology, none had isolated CBD dilatation. In the absence of abnormal laboratory values and GWT, PCF or SMS on POCUS, obtaining a CBD measurement is unlikely to contribute to the evaluation of this patient population.
• Lahham, S., Becker, B. A., Gari, A., Bunch, S., Alvarado, M., Anderson, C. L., Viquez, E., Spann, S. C., & Fox, J. C. (2017). Utility of common bile duct measurement in emergency department point of care ultrasound: A prospective study. The American journal of emergency medicine.
  More info

  Measurement of the common bile duct (CBD) is considered a fundamental component of biliary point-of-care ultrasound (POCUS), but can be technically challenging.
• Lee, J. B., Tse, C., Keown, T., Louthan, M., Gabriel, C., Anshus, A., Hasjim, B., Lee, K., Kim, E., Yu, L., Yu, A., Lahham, S., Bunch, S., Alvarado, M., Gari, A., & Fox, J. C. (2017). Evaluation of a point of care ultrasound curriculum for Indonesian physicians taught by first-year medical students. World journal of emergency medicine, 8(4), 281-286.
  More info

  The purpose of this study was to assess the short-term efficacy of a 4-week ultrasound curriculum taught by American first-year medical students to general practitioners working in public health care clinics, or puskesmas, in Bandung, Indonesia.
• Yu, A. R., Hasjim, B., Yu, L. E., Gabriel, C., Anshus, A., Lee, J. B., Louthan, M. J., Kim, E. C., Lee, K., Tse, C., Keown, T., Lahham, S., Alvarado, M., Bunch, S., Gari, A., & Fox, J. C. (2017). Comparison of ultrasound-measured properties of the common carotid artery to tobacco smoke exposure in a cohort of Indonesian patients. World journal of emergency medicine, 8(3), 177-183.
  More info

  The purpose of this study was to use point-of-care ultrasound (POCUS) to investigate the relationship between tobacco smoke exposure and the characteristics of the common carotid artery (CCA). The effect of both primary and secondary smoking on CCA properties was evaluated.
• Bonadio, W., Brazg, J., Telt, N., Pe, M., Doss, F., Dancy, L., & Alvarado, M. (2015). Impact of In-Hospital Timing to Appendectomy on Perforation Rates in Children with Appendicitis. The Journal of emergency medicine, 49(5), 597-604.
  More info

  There is controversy regarding whether in-hospital time delay to appendectomy in children with appendicitis affects risk for perforation.

Case Studies

• Alvarado, M. (2019. Point-of-Care Ultrasound for the Diagnosis of Systolic Heart Failure(pp 4:2).
• Drachman, M. (2019. Bedside Ultrasound for the Rapid Diagnosis of Fournier's Gangrene(pp 4:2).
• Alvarado, M. (2018. Point-of-care Ultrasound for the Diagnosis of a Gluteal Abscess(pp 3:1).
• Alvarado, M. (2018. Tricuspid Annular Plane of Systolic Excursion (TAPSE) in a Patient with Pulmonary Emboli(pp 3:1).
• Drachman, M. (2018. Bedside Ultrasound for the Diagnosis of Retinal Detachment(pp 1-2).
• Drachman, M. (2018. Point-of care-Ultrasound for the Diagnosis of Ovarian and Fallopian Tube Torsion(pp 25-27).
• Alvarado, M. (2017. Bedside Echocardiography for the Rapid Diagnosis of Malignant Cardiac Tamponade(pp 2:1).
• Alvarado, M. (2017. Bedside Ultrasound for the Diagnosis of Peritonsillar Abscess(pp 2:4).
• Alvarado, M. (2017. Bedside Ultrasound for the Diagnosis of Small Bowel Obstruction(pp 2:4).
• Alvarado, M. (2017. Pneumonia Diagnosed by Point-of-Care Ultrasound(pp 2:3).
• Alvarado, M. (2017. Point-of-care Ultrasound for the Diagnosis of Ectopic Pregnancy(pp 2:4).