Best of #FOAMed #FOAMcc #POCUS finds – Oct (2)

News

There has been so much action on Twitter his week, I have focussed almost solely on this, rather than digging about like DJ Shadow in a record shop, for papers! Focus on portable ultrasound, being dead, or not! Loads of great POCUS, fluids and the usual capture of top tweets. We have also dug out a lot of excellent video resources for you all….so enjoy!

We were very proud to become officially affiliated with the International Fluid Academy this week, and are looking forward to what is going to be an amazing meeting 23-25th November in Antwerp! Come and meet us there…

Screen Shot 2017-10-31 at 16.11.18.png

Screen Shot 2017-10-31 at 16.09.21.png

To start!

Please check out the JICS this month! Now indexed and FOAM!! We love it….loads of great stuff to peruse and we will be featuring it each release on our blog.

Screen Shot 2017-11-01 at 16.36.49.png

 

Those care bundles again!

A great paper from @Flaviasepsis on those good old bundles, the time to sepsis diagnosis, but not the compliance with bundles, was associated with a reduction in the risk of death. Good stuff!

Screen Shot 2017-11-01 at 16.44.23.png

 

Now what do we think of this?!

So this paper appeared to look at a fair cohort of patients 13,000+ and makes a very bold conclusion regarding saline Vs balanced crystalloid solution in the ED and overall outcome measures. As many have said – there are certainly big numbers, but was it a RCT? They used very low volumes, and of solutions you could argue weren’t truly balanced.  MAKE30 as a composite endpoint is also debatable. So; bold results and we would like to see the full paper…read on!

Screen Shot 2017-11-02 at 09.20.30.png

 

Top Blogs!

Sepsis in all its glory!

Check out this brilliant series on sepsis from EMCrit! Take your time, as there’s a hell of a lot to get through!

Screen Shot 2017-10-27 at 11.50.54.png

 

Are you sure?!

Here is a rather scary one…the Lazarus phenomenon. Could be where POCUS plays a big part again…and maybe 10m minutes after death!

Screen Shot 2017-11-02 at 09.03.38.png

 

The Bottom Line got eating!

Surely then, getting early goal directed nutrition into your patients is going be of overall benefit to your ITU patients? It might even have a mortality benefit? Read on……perhaps not!

Screen Shot 2017-10-27 at 13.03.46.png

 

You gotta love Smith’s ECG cases!

And this one is a belter! I find it amazing what that pink ‘wiggly thing’, can tell us! Excusing the unintended rude pun!

Screen Shot 2017-10-27 at 12.59.01.png

 

The ABC’s of extubation with Dr Rishi!

So, we should all check they are really ready…but how do we know? Extubate’abilty is something you just feel ‘in your waters’ as they say. Well, you do with experience, and often thats what counts more than following an EBM approach to it with SBT’s etc etc. Dr Rishi explains…

Screen Shot 2017-10-27 at 14.59.55.png

 

Anaemia…remember the causes and types?!

CanadiEM takes us through a brilliant interactive session here.

Screen Shot 2017-10-27 at 15.31.02.png

Adrenaline…who needs it?!

Interesting table this…always gets me!

Screen Shot 2017-11-01 at 15.50.53.png

 

Start it in the ED!

So it appears, despite bizarre numbers actually entered into the overall intervention arm (far less than the standard arm), that starting lung protective strategies in the ED may decrease the incidence of ALI / ARDS later. But….bigger trial needed as ever!

Screen Shot 2017-10-27 at 11.03.42.png

And from ACEP17:

Screen Shot 2017-10-30 at 13.51.06Screen Shot 2017-10-30 at 13.51.13

 

Platelets are where it’s at…clearly!

A very interesting article on the role of platelets in the septic process. It appears that platelet cross-talk occurs on a fairly widespread scale and goes to show just how complex

Screen Shot 2017-10-27 at 09.51.08.png

 

Want to revert that SVT with success…?

So…it appears the good old modified Valsalva trumps standard attempts. I believe we have featured this before…see the REVERT trial.

Top POCUS!

Which bloody one!!!???

I have been engaged own a debate regarding which portable probe is the best! Watch this site as we plan top review with pro’s and cons!

Wireless or not…portablilty seems to be the key here! Here is a video of a few to watch…

And one on one of my favourites (and I just might own one!)….

 

Pleural Vs Pericardial effusion…a reminder!

A nice little reminder which is which on POCUS!

Screen Shot 2017-11-01 at 15.02.04.png

 

How to Lung Ultrasound

Another great guide from Phillips! Take a look!

Screen Shot 2017-10-31 at 18.01.21.png

 

Don’t base everything on research!!!

Wow…not a phrase you thought we would use! But the crew at ultrasound Gel explain why:

Screen Shot 2017-10-31 at 15.51.53.png

Check out the Atlas…ever growing!

Fabulous resource of images from clincians all over the world…the focus is POCUS and this is a #POCUSfans dream site!

Screen Shot 2017-10-30 at 16.13.06.png

We need to teach em’ young!

So this paper adds fuel to the fire that we need to start teaching POCUS early. Get them before they leave the nest I say – med school!

Screen Shot 2017-10-30 at 13.38.45.png

 

Unintended advert for Phillips…but helped heart failure!

 

Don’t underestimate the power of G.I ultrasound…DPL is definitely dead!!

Lovely case from the chaps at the Emergency Medicine Association of Turkey US group. Shows free fluid and artefacts around the belly are not to be ignored!

 

Look at this for a belter!!

So portable POCUS is where it’s. I carry a GE Vscan almost everywhere…except to the pub! But.. this looks amazing and we are all getting excited about it already. The seller for me however, will be just how versatile this thing is going to be. Will it offer linear high freq ability, phased array and echo ability, as well as the ability to fire out lower frequencies to scan abdo’s and chests. The GE does with it’s dual probe…but can this. We will soon see and hear undoubtedly!

I may have ordered one…ooops!

Screen Shot 2017-10-27 at 16.41.46.png

And some vids for you on it too…

 

 

Top Vids!

Just look at what a ‘wrong’ position can do!!

A brilliant Tweet from @chrisck!

Some great ones from the Osmosis crew…

 

Hyponatraemia confusing…not any more!

Check out this brilliant video animation

 

Top Tweets!

You can see it, even when you aren’t necessarily looking for it!

Screen Shot 2017-10-30 at 13.43.01.png

 

Can’t seem to get interest??

Screen Shot 2017-10-30 at 13.46.26.png

 

Plop goes the tumour!

Screen Shot 2017-10-27 at 16.12.30.png

 

EF.. what EF!!!

Screen Shot 2017-10-27 at 16.56.28.png

 

Echo is great!

Screen Shot 2017-10-30 at 13.34.35

Screen Shot 2017-10-30 at 13.34.22

EF…what EF…again!

Screen Shot 2017-10-27 at 16.58.49.png

 

EF, more EF and what EF….again!

Screen Shot 2017-11-01 at 16.18.24.png

 

 

Critical Interventions!

Screen Shot 2017-10-30 at 13.52.40.png

 

Not working…might be the pads!

Screen Shot 2017-10-30 at 13.58.43.png

Screen Shot 2017-10-30 at 14.00.28.png

That probe is causing a stir!

Screen Shot 2017-10-30 at 15.08.35.png

 

And the winner was….

Screen Shot 2017-10-30 at 15.25.00.png

 

Look at this PMVL!

Screen Shot 2017-10-30 at 15.38.13.png

 

2 organs…and potentially out unfortunately

Nice ePoster from Nitin Arora et al, demonstrating escalation and often futility

Screen Shot 2017-10-30 at 16.07.32.png

 

Don’t leave POCUS out…even if you don’t yet believe in it!

Screen Shot 2017-10-31 at 15.55.45.png

 

TAPSE and PE..not to be missed!

Screen Shot 2017-10-31 at 17.55.17

Screen Shot 2017-10-31 at 17.54.51Screen Shot 2017-10-31 at 17.54.58

 

Liver met on incidental Scan!

Screen Shot 2017-11-01 at 14.53.30.png

 

PSAX…lives on in Infograph!

Screen Shot 2017-11-01 at 16.13.23Screen Shot 2017-11-01 at 16.13.30

 

Woah!

Screen Shot 2017-11-01 at 16.20.04.png

 

You can POCUS for your NG placement!

Screen Shot 2017-11-01 at 16.28.53.png

 

Until next time!

JW 1/11/17

 

 

 

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Powered by WordPress.com.

Up ↑

%d bloggers like this: