About

Stephen Alerhand is an Associate Professor of Emergency Medicine and serves as the Fellowship Director for Clinical Ultrasound at Rutgers New Jersey Medical School. He completed his medical education at Boston University School of Medicine and his residency training at Icahn School of Medicine/Mt. Sinai Hospital in New York. He also completed a fellowship in Emergency Ultrasound at Icahn School of Medicine/Mt. Sinai Hospital. His professional interests include emergency ultrasound, medical education, critical care, and echocardiography.

Research topics

• Medicine
• Computer Science
• Cardiology
• Radiology
• Internal medicine
• Artificial Intelligence
• Political Science
• Intensive care medicine
• Psychology
• Nuclear medicine
• Medical emergency
• Pathology
• Surgery
• Mathematics
• Medical physics

Selected publications

• Cardiac Point-Of-Care Ultrasound

  Emergency Medicine Clinics of North America · 2024-08-14 · 8 citations

  review1st authorCorresponding
  PublisherDOI

• Is pulmonary hypertension protective against cardiac tamponade? A systematic review

  Internal and Emergency Medicine · 2024-04-15 · 3 citations

  review
  PublisherDOI

• Gastric Ultrasound in the Management of Emergency Department Patients with Upper Gastrointestinal Bleeding: A Case Series and Sonographic Technique

  Journal of Emergency Medicine · 2024-08-09 · 1 citations

  articleSenior author
  PublisherDOI

• Point of Care Ultrasound Diagnosis of Maxillary Artery Pseudoaneurysm in the Emergency Department

  POCUS Journal · 2024-04-22

  articleOpen access1st authorCorresponding

  A pseudoaneurysm results from a tear in a vessel wall. This leads to extravasation of blood into adjacent tissue and eventual formation of a fibrous sac that maintains continuity with the lumen. These vascular injuries very rarely occur in deeper vessels of the face (e.g. maxillary artery) due to protection from structures like the bony mandible and parotid gland. If left untreated, these pseudoaneurysms can lead to infection, thromboembolism, hemorrhage, and compression of surrounding structures such as facial nerve branches. Pseudoaneurysms are typically diagnosed by advanced imaging techniques including computed tomography angiography and magnetic resonance angiography. However, these tests require time to perform and interpret, are costly, and take place outside the patient care area. Computed tomography also confers ionizing radiation. Fortunately, point of care ultrasound (POCUS) is a readily available, dynamic imaging tool that can be performed at the bedside. Here we present the first known case report of a maxillary artery pseudoaneurysm diagnosed by POCUS in the emergency department. Early differentiation from a typical hematoma led to rapid management in the form of a compression bandage, as well as expedited consultation to the appropriate services.

  PublisherOA PDFDOI

• Echocardiographic diagnosis and clinical implications of wide-open tricuspid regurgitation for evaluating right ventricular dysfunction in the emergency department

  The American Journal of Emergency Medicine · 2024-04-23 · 3 citations

  articleOpen accessSenior authorCorresponding

  ). Its estimation by echocardiography correlates well with that obtained using right-heart catheterization. An elevated TRPG is an important marker for identifying right ventricular dysfunction in both the acute and chronic settings. However, in the "wide-open" variant of TR, the TRPG counterintuitively falls. Failure to recognize this potential pitfall and underlying pathophysiology can cause underestimation of the severity of right ventricular dysfunction. This could lead to erroneous fluid tolerance assessments, and potentially harmful resuscitative and airway management strategies. In this manuscript, we illustrate the pathophysiology and potential pitfall of wide-open TR through a series of cases in which emergency physicians made the diagnosis using cardiac point-of-care ultrasound. To our knowledge, this clinical series is the first to demonstrate recognition of the paradoxically-low TRPG of wide-open TR, which guided appropriate management of critically ill patients in the emergency department.

  PublisherDOI

• Invasive Fungus Balls Diagnosed by Point-of-Care Ultrasound in the Emergency Department

  Journal of Emergency Medicine · 2023-11-04

  articleSenior authorCorresponding
  PublisherDOI

• What echocardiographic findings differentiate acute pulmonary embolism and chronic pulmonary hypertension?

  The American Journal of Emergency Medicine · 2023-07-10 · 23 citations

  review1st authorCorresponding
  PublisherDOI

• A Prospective Comparison of Standard Technique, Doppler Ultrasonography, and Pressure Waveform Analysis for Confirming Intraosseous Catheter Placement

  Journal of Intensive Care Medicine · 2023-08-30

  articleSenior author

  Purpose: Intraosseous (IO) catheters allow healthcare workers to rapidly administer fluids and medications to critically ill patients when intravenous access is inadequate or unable to be obtained. An improperly placed IO catheter can lead to delays in care, as well as serious complications such as limb necrosis. Methods: In this single-center, prospective, observational study, we compared 2 established methods of confirming proper IO catheter placement to a novel pressure waveform analysis technique in which the IO catheter is attached to a standard pressure transducer. Attaching a pressure transducer to a properly placed IO catheter produces a pulsatile waveform. Misplacement of the IO catheter produces a flatline waveform. Results: Of 42 IO catheters, 8 (19%) were incorrectly placed per the waveform analysis technique. Compared to the pressure waveform analysis technique, the standard method and the power Doppler method incorrectly classified 4/8 (50%) and 5/8 (62.5%) of the misplaced catheters, respectively. The standard method had a higher positive predictive value for detecting incorrectly placed IO catheters than the power Doppler method (100% vs 63%, respectively). Blinded reviewers demonstrated better agreement using the pressure waveform analysis technique than using power Doppler ( k = 0.77 vs k = 0.58, respectively). Conclusion: The standard and power Doppler ultrasonography techniques identify incorrectly placed IO catheters sub-optimally. The pressure waveform analysis technique is more accurate than the standard of care and has superior interrater agreement compared to the ultrasound method of confirmation. With more than 500 000 IO catheters placed in the United States each year, this novel technique may improve overall IO safety. Trial Registration Number: NCT03908879.

  PublisherDOI

• Delayed Iatrogenic Bladder Rupture Diagnosed by POCUS in the Emergency Department

  POCUS Journal · 2023-04-26 · 3 citations

  articleOpen accessSenior author

  Bladder rupture is an uncommon injury that leads to significant morbidity and mortality. Though occurring mostly due to trauma, this life-threatening pathology may also occur spontaneously or after a procedure such as transurethral resection of bladder tumor (TURBT). Computed tomography (CT) cystography is the standard imaging modality for diagnosis. However, this test is unlikely to be ordered in a patient with undifferentiated abdominal pain unless there is specific suspicion for this diagnosis. In our emergency department, a 48 year-old male with history of bladder cancer and TURBT two weeks prior to arrival presented with severe abdominal pain and difficulty urinating for 3 days. Point of care ultrasound (POCUS) revealed an irregularly shaped bladder, likely site of bladder rupture, and large amount of abdominal free fluid with sediment. These findings prompted an expedited diagnostic CT scan with cystography. Emergent exploratory laparotomy ultimately confirmed a small bladder defect with 2.5 L of urinary ascites. The diagnosis of non-traumatic bladder rupture can be overlooked in patients presenting with a peritonitic abdominen. The typically ordered test for such patients is standard CT, which carries a high false-negative rate for bladder rupture. This case highlights the utility of POCUS in facilitating a rapid diagnosis.

  PublisherOA PDFDOI

• Managing Cardiac Arrest Using Ultrasound

  Annals of Emergency Medicine · 2022-11-02 · 32 citations

  reviewOpen accessSenior author
  PublisherOA PDFDOI

Frequent coauthors

• Michael Gottlieb

  32 shared

• Christine Ramdin

  Bridge University

  24 shared

• Robert James Adrian

  Harvard University

  24 shared

• Elaine Situ-LaCasse

  18 shared

• Ilya Ostrovsky

  16 shared

• Ariel Sena

  12 shared

• Sangeeta Lamba

  12 shared

• Alex Koyfman

  11 shared

Education

• M.D.

  University of Illinois at Chicago

• Other

  Rutgers New Jersey Medical School