Scholars@Duke
Rebecca George Theophanous

Rebecca George Theophanous

Associate Professor of Emergency Medicine
Emergency Medicine

Selected Publications

Multispecialty comparison of point-of-care-ultrasound use, training, and barriers: a national survey of VA medical centers

Journal Article Ultrasound Journal · December 1, 2025 Background: As more specialties have begun to use Point-of-Care Ultrasound (POCUS) in patient care, hospitals and healthcare systems have been investing increasing resources in POCUS infrastructure (training, equipment, and administration). Since each spec ... Full text Cite

A comparison of blood culture diagnostic stewardship across three emergency departments in a healthcare network.

Journal Article Am J Emerg Med · July 2025 BACKGROUND: Blood culture (BCx) diagnostic stewardship is essential for reducing unnecessary treatments, minimizing false-positive results, and improving patient outcomes and hospital resource utilization. The objective of this study was to compare the eff ... Full text Link to item Cite

Incidence and Clinical Relevance of Echocardiographic Visualization of Occult Ventricular Fibrillation: A Multicenter Prospective Study of Patients Presenting to the Emergency Department After Out-of-Hospital Cardiac Arrest.

Journal Article Ann Emerg Med · June 30, 2025 STUDY OBJECTIVES: Ventricular fibrillation (VF) is traditionally identified on ECG but echocardiography can visualize myocardial fibrillation. The prevalence and importance of occult VF defined as a nonshockable ECG rhythm but VF by echocardiography is unk ... Full text Link to item Cite

Co-designed point-of-care ultrasound program development and implementation at a Veterans Affairs emergency department.

Journal Article Intern Emerg Med · April 25, 2025 Integrating point-of-care ultrasound (POCUS) into patient care requires a multifaceted culture change using a multi-pronged approach. A standardized implementation method is lacking for POCUS program sustainability. We developed a standardized training cur ... Full text Link to item Cite

Identifying enablers and barriers to teleultrasound use for remote settings: A scoping review.

Journal Article Australas J Ultrasound Med · February 2025 INTRODUCTION/PURPOSE: Teleultrasound connects expert point-of-care ultrasound (POCUS) users with remote community and rural sites. Evolving technologies including handheld devices, upgraded image quality, and the ability to transmit over low bandwidth conn ... Full text Link to item Cite

Impact of an Algorithm to Triage Patients Discharged From the Emergency Department With Blood Cultures Positive for Staphylococcus aureus or Coagulase-Negative Staphylococcus.

Journal Article J Am Coll Emerg Physicians Open · February 2025 OBJECTIVES: Blood cultures obtained in the emergency department (ED) may become positive after discharge. Healthcare professionals must determine if these results represent true infection or a likely contaminant. An institutional algorithm was developed to ... Full text Link to item Cite

Ultrasound-guided thoracic nerve blocks for emergency department patients with rib fractures: A review.

Journal Article J Emerg Med · January 2025 BACKGROUND: Rib fractures are frequently diagnosed and treated in the emergency department (ED). Thoracic trauma has serious morbidity and mortality, particularly in older adults, with complications including pulmonary contusions, hemorrhage, pneumonia, or ... Full text Link to item Cite

Cholecystoduodenal Fistula and Urosepsis in A Febrile Emergency Department Patient: A Case Report

Journal Article Clinical Practice and Cases in Emergency Medicine · January 1, 2025 Introduction: Point-of-care ultrasound (POCUS) is a rapid bedside tool, particularly in undifferentiated emergency department patients. Point-of-care ultrasound can investigate potential intra-abdominal infections in febrile patients, especially in the eld ... Full text Cite

Blood culture algorithm implementation in emergency department patients as a diagnostic stewardship intervention.

Journal Article Am J Infect Control · September 2024 OBJECTIVE: Blood cultures (BCx) are important for selecting appropriate antibiotic treatment. Ordering BCx for conditions with a low probability of bacteremia has limited utility, thus improved guidance for ordering BCx is needed. Inpatient studies have im ... Full text Link to item Cite

Accuracy and Feasibility of Three-Dimensional Ultrasound Testing in Eye Clinic and Emergency Department Patients with Vision Complaints.

Journal Article J Emerg Med · February 2024 BACKGROUND: Ocular emergencies comprise 2-3% of emergency department (ED) visits, with retinal detachment requiring emergency surgery. Two-dimensional ultrasound is a rapid bedside tool but is highly operator dependent. OBJECTIVE: We determined three-dimen ... Full text Link to item Cite

A qualitative study of perceived barriers and facilitators to point-of-care ultrasound use among Veterans Affairs Emergency Department providers.

Journal Article PLoS One · 2024 Consistent point-of-care ultrasound (POCUS) use and retention is difficult to achieve, with prior studies citing a lack of provider training, credentialed ultrasound users, and image review as contributing factors. We aimed to assess user feedback on a POC ... Full text Link to item Cite

Point-of-care ultrasound use in austere environments: A scoping review.

Journal Article PLoS One · 2024 BACKGROUND/OBJECTIVES: Technological developments in point-of-care ultrasound (POCUS), particularly with portable devices, are transforming POCUS use in austere, resource-limited environments (RLS) distinct from typical hospital or medical settings. POCUS ... Full text Link to item Cite

Current Use, Training, and Barriers of Point-of-Care Ultrasound in Anesthesiology: A National Survey of Veterans Affairs Hospitals.

Journal Article J Cardiothorac Vasc Anesth · August 2023 OBJECTIVES: The purpose of this study was to determine current use, training needs, and barriers to point-of-care ultrasound (POCUS) use among anesthesiologists in practice. DESIGN: Multicenter, prospective, observational study. SETTING: Anesthesiology dep ... Full text Link to item Cite

Robotic Optical Coherence Tomography Retinal Imaging for Emergency Department Patients: A Pilot Study for Emergency Physicians' Diagnostic Performance.

Journal Article Ann Emerg Med · April 2023 STUDY OBJECTIVE: To evaluate the diagnostic performance of emergency physicians' interpretation of robotically acquired retinal optical coherence tomography images for detecting posterior eye abnormalities in patients seen in the emergency department (ED). ... Full text Link to item Cite

Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis.

Journal Article J Vis Exp · February 10, 2023 Acute lower extremity deep venous thrombosis (DVT) is a serious vascular disorder that requires accurate and early diagnosis to prevent life-threatening sequelae. While whole leg compression ultrasound with color and spectral Doppler is commonly performed ... Full text Link to item Cite

Spontaneous renal forniceal rupture in an emergency department patient

Journal Article Visual Journal of Emergency Medicine · October 1, 2022 Full text Cite

Impact of Education and Data Feedback on Antibiotic Prescribing for Urinary Tract Infections in the Emergency Department: An Interrupted Time-Series Analysis.

Journal Article Clin Infect Dis · September 30, 2022 BACKGROUND: Urinary tract infections (UTIs) are often misdiagnosed or treated with exceedingly broad-spectrum antibiotics, leading to negative downstream effects. We aimed to implement antimicrobial stewardship (AS) strategies targeting UTI prescribing in ... Full text Link to item Cite

Molar pregnancy presenting with vaginal bleeding in an emergency department patient

Journal Article Visual Journal of Emergency Medicine · January 1, 2022 Full text Cite

Contributors

Journal Article Emergency Medicine Clinics of North America · May 2021 Full text Cite

Cardiopulmonary Emergencies in Older Adults.

Journal Article Emerg Med Clin North Am · May 2021 Older adults are susceptible to serious illnesses, including atrial fibrillation, congestive heart failure, pneumonia, and pulmonary embolism. Atrial fibrillation is the most common arrhythmia in this age group and can cause complications such as thromboem ... Full text Link to item Cite

45. Antimicrobial Stewardship for Urinary Tract Infection in Three Emergency Departments Across a Health System

Journal Article Open Forum Infectious Diseases · December 31, 2020 AbstractBackgroundBroad spectrum antibiotics are often prescribed to patients presenting to the emergency department (ED) for evaluati ... Full text Cite

A Case Report of a Migrated Pelvic Coil Causing Pulmonary Infarct in an Adult Female.

Journal Article Clin Pract Cases Emerg Med · August 2020 INTRODUCTION: It is possible but rare for a pelvic coil to migrate to the pulmonary vasculature, which can cause cardiac damage, arrhythmias, pulmonary infarct, and thrombophlebitis. The few cases reported typically do not describe removal of the coils, as ... Full text Open Access Link to item Cite

Infant With Abdominal Fullness.

Journal Article Ann Emerg Med · May 2020 Full text Open Access Link to item Cite

Duplicated or Ectopic Renal Collecting System in Two Adult Emergency Department Patients.

Journal Article J Emerg Med · February 2020 BACKGROUND: Duplicated renal collecting system is a urological anomaly often found in pediatric patients. It is less commonly diagnosed in adulthood, particularly in a pregnant patient. Many point-of-care ultrasonography users may not be aware of this diag ... Full text Open Access Link to item Cite

Validity and reliability of telephone administration of the patient-specific functional scale for the assessment of recovery from snakebite envenomation.

Journal Article PLoS Negl Trop Dis · December 2019 OBJECTIVES: Although more than 1.8 million people survive snakebite envenomation each year, their recovery is understudied. Obtaining long-term follow-up is challenging in both high- and low-resource settings. The Patient-Specific Functional Scale (PSFS) i ... Full text Open Access Link to item Cite

Spontaneous spinal epidural hematoma (SSEH): A rare cause of spinal cord compression

Journal Article Visual Journal of Emergency Medicine · July 1, 2018 Full text Open Access Cite