Best of #FOAMed #FOAMcc #POCUS Finds – April (1)

There are a lot of fabulous echo images here this week! You are all posting some brilliant stuff to keep us all interested and excusing the pun, in the loop! Thank you…

Also, lots of journal club stuff going on on the Twittersphere!

Papers, blogs and a lot more….settle down and get your CME done quick here!

 

News!

iFAD mentions Northampton!

Manu Malbrain continues his great work in spreading the fluid safety word. Here, you can check out the blog. Below that, you can watch the video of his talk from ISICEM Brussels.

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Aoife is in print!!

So our Aoife Abbey (@whistlingdixie4) is releasing her first book about the trials and tribulations of an ICU doc. I can’t wait for this and we will review it for you when it’s out…Jan 2019

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Papers and Stuff!

STOP BEFORE YOU BLOCK!!

Sorry for shouting! A lovely piece by Iain Moppet on this subject in anaesthesia.

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Annual Updates

Here is the selection from the annual updates in intensive care.

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Diastolic dysfunction…can you diagnose it?

This is a fabulous article by Marcus Peck et al on this rather difficult to diagnose disorder….it’s more common than you think!

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Get the DDAVP out to treat hyponatraemia…really!?

A fabulous #NEPHJC chat this week regarding the paper on Aakash Shingada’s lovely infographic below. Click it to see the Twitter moment!

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Lets rip into APRV shall we?

The ICMJC was back this week again, this time focussing on the Zhou et al paper on APRV. This is a brilliant session held by Aoife Abbey and Nitin Arora and is well worth tuning into. You can find the excerpts of the session here

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See the original paper here

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Our infographic on it is also here

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Strain is certainly not just the LV!!

This is an excellent and novel paper where the authors boldly describe ‘Strain’ on ICU services. This could form a scoresheet for all of us to look at our units’ levels of activity. One we will certainly be looking at here in Northampton. Thanks to Adrian Wong for pointing this one out.

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Tastes like s@@t…but it may safe your life!!?

So, FMT or faecal microbial transplant may not be everyones ‘bag’, but actually, there is a lot of evidence to suggest it may restore G.I function in severe illness. Could placement of what comes out and put back in, actually reduce ICU LOS and improve poitcome….read on!

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Blogs

I/O Vs. I.V…will one Vs. the other do you a dis-service?!

Great blog here from CoreEM, which from the outset says, if you arrest and have IO access, you fair worse! But…read on…

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Secondary endpoints – ignore them all!!

Should we? The answer may be no…particularly in critical care. Read this lovely piece by Josh Farakas. Goes with a piece we featured last time on mortality focus by PulmCrit.

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TXA OD!!!

A lovely piece by EmDocs on tricyclic overdose and what to look for.

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Take a re-read about WPW!

A lovely, brief, snippet reminding us all about WPW and what to look for on the ECG.

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Not all about echo!

Here is a nice 10 point article on the assessment and optimisation of volume status in CCF.

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TBL talk stroke!

TBL take us through the DEFUSE-3 trial. Is it best to do a double with these patients? Thrombectomy AND medical therapy together?

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MAP’s where it’s at!

NIBP Vs Invasive and outcomes…which is best and why?

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The origins of (AB)normal Saline

A nice article delineating thew early usage of IV fluids.

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Amazing POCUS!

So is this a simple case of HCM?

Not quite…this is the heart of a Friedrich’s ataxia patient….very similar! Thanks to Fernando Morcerf for sharing these. Some fantastic speckle tracking images!!

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Is it a bird….is it a plane….no, it’s the gallbladder!?

Looks like sub-hepatic fluid!! But no, just an unusually positioned GB!

Ever seen this?!

There’s a membrane dividing up the left atrium…Cortriatriarum!!

Plaque or fluid

Justin Kirk-Bailey explains how you can tell it’s fluid, not a pleural plaque. No M-Mode sinusoid sign on a plaque and NO colour flow either…therefore this is fluid.

Where will it go?!

Seen a clot in transit…here’s one! You can also see a cracking McConnel’s sign!

McConnel’s sign can be seen below in PE. Preserved RV apical movement with impaired basal / mid section contraction:

Antiphospholipid Syndrome…veg or not veg??

Who knows whether this is thrombotic or infectious…but a definitive mass is present!

And more thrombi!

How many Jets can you see??

4 to be precise! TR, AR, OS ASD, perimembranous VSD.

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Post MI VSD!

Get the subclavian in PART …or fully!

Mourad Senussi has Tweeted some lovely images demonstrating the utilisation of POCUS in placement of SC lines.

Intimal flap in Aortic dissection!

Pleural septations within that effusion!?

Nitin Arora found this image…excellent example!

Aortic Valve Vegetation

Nitin Arora is on a roll…found this on routine echo of a sick patient.

Drain that fluid!

What’s the optimum time / place to drain a pericardial effusion?

The article below demonstrates. Seems the best option is actually when the effusion is at it’s smallest during the cardiac cycle…i.e. end diastole.

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Emergency Pericardiocentesis

Another lovely blog on this here too from criticalcaresonography.com

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Fabulous Infographs and pics!

Scrap Epi in OOHCA?

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Remember the immune system?

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Shock assessment the GE way

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Pre-oxygenation…do the triple!

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The 3’p’s of uncomplicated syncope

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The Plague does peripheral artery disease Vs DVT!

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ALS made palatable!

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ASD Types

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Tranexamic….is there anything bad about it?!

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4’H’s and 4’T’s!

Another beauty!

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Resources and downloads

Mobilise them ASAP!

More great stuff from the Portsmouth crew. Download yours below

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Finally…

See you all at CCS hopefully. Fab faculty and a great meeting with some very well versed and innovative speakers from all around the world!

Click the first pic to download the programme and the second for bookings.

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All the best

JW 4th April 2018

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