Best of #FOAMed #FOAMcc #POCUS finds – February 2018

Back, from investigating the infographics, perusing the POCUS and limboing the literature. There’s a lot out there as ever in the Critical Care world.

Please see my infographics sections for Crit care trials and other areas within anaesthesia, including statistics and valve pathologies. See them all in the slideshow below and the latest one on the MACMAN trial! I am more than happy for you to download them and use them, just acknowledge the source👍

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Also, see some fabulous stuff from the PlagueMD and Hannah Ames.

JW Infographic Compendium!


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Jonathan Downham has also started to Vlog on many of my infographics, thanks to him…see them below


February ICU Trial Activity

…in a lovely infograph! Below are the links to them all too. Thanks to Dave Lyness for this at

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Other Papers and Reviews

ARDS…a lovely little guide

Loads out there, but really, only 3 main recommendations. Have a read and download the ARDSnet pocket Card here.

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Newer red cells/…atre they in fact worse for you?

We’ve seen the results of ABLE and various other trials involving blood transfusion, but have look at this systematic review.

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Tranexamic Acid…know how it works?

Have a read of this fabulous article all about fibrinolysis. Well worth a brush up on the mechanisms behind clotting and the drugs we use as gospel to prevent intra-op bleeding

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Know what to do in theatre when it all goes a bit wrong!

Great article about what goes wrong during routine cases. Some handy pointers.

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Part 2 talks about special situations

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There’s a lot to weaning!

This article is a fabulous insight into the weaning process, why it’s so important and equally, why it’s so difficult!

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Are we any better having been shown how to “READS” the CXR?!

So TBL take us through a study that looked at whether education in interpretation of CXR’s would improve our diagnostic yield in ARDS?

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 Get in there early!!

Celia Bradford at TBL discusses further follow up on early initiation of RRT in the critically ill…it appears to be beneficial! So we await initiation and results of the forthcoming STAART-AKI Trial which looks at very early initiation of RRT!

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Inhaled corticosteroids for COPD…useless?!

An interesting one for you! The mantra may be rubbish then. ICS are perhaps no longer beneficial according to the WISDOM trial results (NEJM paper).

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Drip them out of heart failure!

This article in anaesthesia debates whether IV furosemide infusion is any better than single boluses in acute heart failure…look at thePlagueMD’s infographic too!

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Is ATLS dead…or does it just need updating!

As an ATLS instructor, I get the feeling repeatedly I am teaching the wrong, outdated facts to delegates!

So, the crew at emDOCS talk to ups about the 10th edition updates and how they are at least trying to stay up to date as it were!

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What reveals whether you’ll get out or not?

This paper talks about some potential factors that may preclude the likelihood of a patient escaping from ITU quicker. Some might surprise you!

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Global strain…and not just the economy!

We should perhaps be looking at GLS instead of hanging our hats poorly on EF measurement…because after all, you can have heart failure with preserved EF, or reduced EF. Global strain perhaps holds a better prognostic handle?

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Fabulous Infogams!

Pulmonary Hypertension!

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Downham does plan A!

Nice infographic on the plan A scenario!

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Downham does NAP 4!

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Focus on Anaphylaxis

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Local Anaesthetic Systemic Toxicity – LAST

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Time to cool it on cooling??

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More lovely Plagues…Cardiac Axis!

Also see our section on his other stuff on the link above!

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Don’t pour it in!!!

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 POCUS…so valuable on ITU!

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 It’s a WOBBLER!

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 Ever heard of BRASH?!

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Great Whiteboard stuff!

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POCUS Stuff!

SOB and SAM!



Thrombolysis can be of great benefit then!

Look at the effects pre and post on this PE!



Another Takutsubo



STEMI…and wall invasion!




NGT…is it in?



Look at that low CO…from the arch!



Post MI and LAD stent…Papillary muscle rupture



Post MI…apical rupture and thrombus!



LV free wall rupture



Anatomy displayed with the aid of ascites!

IVC / Aorta and a lovely hydronephrotic kidney



Why did they arrest??

CPR and the cause below…AAA!




Full screen tells you why the patient is shocked!



ST elevation and POCUS reveals…


PE…of course it is…or is it??!

Ultrasound at the front door take us through why we shouldn’t always assume PE in every dyspneic collapse!

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Video of note!

The good old modified Valsalva in action!




Take a look at how to refer to ITU

Thanks to Dave Lyness for this!

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And how to interpret ABG’s

Dave Lyness again!

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That’s all for now….more to come soon, including more exciting collaborations, infographics and POCUS!



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