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

A final happy Christmas to you all!

This episode features loads of POCUS images, many of which you have kindly shared over Twitter. Thanks to all concerned and I have acknowledged you where I can.

There is also a lot on flu, ARDS, OOHCA, less is more in sepsis and our usual run of infographics for you.

I hope you all have a prosperous 2018 and more to come from us in the New Year! 👍

Blogs!

ARDS in under a minute!

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Which bloomin’ one should we be using then?!!

So contention out there regarding stress ulcer prophylaxis…PPI or H2 receptor antagonist…Pharmacy Joe talks us through the confusion.

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More is less and….less is more!

Lovely brief piece from Paul Marik here:

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The points below are taken from the blog, so click in to see the references he quotes👍👍

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Forthcoming!

Improving Cardiac arrest outcomes!

Can we, should we, will we…here are some trials forthcoming in the Netherlands.

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Papers, Articles & Reviews!

Could it be in the HME??

Sampling the ‘crud’ we collect within our HME’s may be stuff we shouldn’t throw in the bin!

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Will they survive after that OOHCA??

A neat study looking at a large cohort of OOHCA patients presenting to ED’s. But which parameters on the ABG should we pay most attention to??

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The flu…sounds like nothing!?

A fascinating look at a cohort of influenza patients in the Netherlands. You may be surprised at a lot of what you read…some of these patients are horrendously sick!

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ARDS…whats going on?

This snappy editorial walks us through recent trials and advances and sort of answers the question as to why we can’t seem to get any better with this condition despite all we are trying!

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Could we be catching them earlier??

So it seems that some patients who are breathless, have CXR changes and are receiving NIV may be identified as having ARDS by the Berlin criteria….but can we prevent them escalating to invasive ventilation is the burning question!?

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Brilliance in US guided line placement!

Check out this fabulous article which takes traditional ultrasound placement of lines a few steps further, then read the correspondence article below it which goes a mile further with POCUS!

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Then…a step EVEN further

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Killer pneumonia!

An excellent article on pneumonia and the role of immunomodulaton in combination with antimicrobial therapy.

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It’s a boy..no, it’s a girl…no, it’s hypotension?!!

Nice paper here on the role of good old POCUS to predict hypotension in C Section patients. Some might say…overcomplicating things a tad?!

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The ESICM Top 10!

Have a look at the top 10 open access articles from the ESICM.

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Restraint shouldn’t be the way!

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Iron Man….and improve peri-op outcomes?

There has been a lot of chat about this of late, but can IV iron therapy improve outcomes if given pre / peri or post-op…read on!

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Scans any good?? Rate them!

Here is a great article presenting a useful scoring system for thoracic ultrasound. The ACTS (assessment of Competency in Thoracic Ultrasound) score will certainly be one I use from now…

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Is intubation dangerous on ITU??

Yes is the answer, as this article demonstrates:

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We have said it before on an infogram:

Failure to plan!

 

Case Reports!

Here’s one to look out for after your #NOF repair!

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Top POCUS!

 

The Senning repair!

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Ever seen pericardial locations??

J Christian Fox has!

 

 

Medics shouldn’t do POCUS???!

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Check out the LVOT..or lack of!

 

 

Whats with the valve?

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How full is it??

Check out this vid on bladder volume measurement!

How full is it, again….and is it safe!?

Gastric ultrasound could be a sure fire way of quantifying whether patients are adequately starved. How many times have you seen gastric contents appear through the gastric port of an iGel even when the patient is ‘starved’.

See also:

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The article below from the BJA highlights the use of Gastric ultrasound and anaesthetic risk:

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Figure 2
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Figure 3
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Figure 4

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DVT??

Check out this video on typical US findings in DVT.

Pleural or pericardial??

Look at the descending aorta…key!

 

 

Severe AR!

Another J Christian Fox beaut!

 

 

Even More AR!!

 

 

Pleural effusion…look closer?!

More like a horrible located empyema!

 

 

Something you do not want to see!!

Suspected Broncho pleural fistula

 

 

Good bit of TR!

A good shot from J Christian Fox.

 

 

Don’t Fall into the Morrison’s Trap!

From Sam Ghali…goes to show if you focus on what you want to see, you’ll miss what you certainly didn’t want to see!

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Good old SAP Block..

Seems to be being utilised more and more these days…take a look at the blog and vids too. You can find other trunk blocks on our site here

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Sweep that chest!

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The Oesophagus perf…there may be trouble ahead!

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And my heart stood still!

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You thought B-lines were be bad in your chest!!

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Useful Infograms and Graphics!

The U-wave!

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Check out these fab festive X-rays!!

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TBL summarised!

So the crew at TBL blogged their favourite / most influential papers of 2017 below:

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Then Dave Lyness took their summary…and did a summary!! Nice work:

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One of the above in an infographic from ISNEducation:

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What the heart really does!

A great inform from Mike Natter!

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Change…it can go wrong!!

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Steroids!

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All in the Brains!

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Murmurs…my ass!!

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Some Dixie-dissection!

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Heart Failure explained!

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Role of sedation…not so simple!

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A very happy new year to you all! Look out for many forthcoming changes, collaborations and other great stuff from us in 2018.

JW

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