News!
We have Sonosite, GE, Limbs & Things, Clarius and soon…Butterfly IQ lined up ready to battle it out in our portable US device review. Coming soon!
We reviewed rather a good book!
And we suggest you go get a copy! Take a look and theres a link to buy it too. Well done Nitin, Shond et al for a great effort!
LITFL for CCN!
Thanks to Manny Singh again for letting us know we made LITFL 340!
AF got real!
Thanks to Sam Ghali for this one! AF at cardiac surgery!
Papers!
A-F is all it’s about for chest pain!
A great paper looking at a POCUS based A-F evaluation for chest pain patients. Looking for the main culprits in the vast part.
Segun points out – should we quit auscultating the bowel on ICU?
The US looked fine!?
A good 2 part case discussion on the pitfalls of POCUS.
Segun points out med students are good!
A paper from 2003, but shows eyeballing can be very effective from an early stage.
POCUS Series!
Check out this brilliant series on POCUS from the Southern Medical Association.
Get the probe out after cardiac surgery!
So this rather nice paper from Anaesthesia highlights the point that it may be swifter and better for the patient we suspect is developing post operative pulmonary complications, to get the US out rather than wait for radiation that may change little!
Scan the neck…but not in extremis!
A good paper, pointing out that pre-intubation (when things are calm), scanning and marking out of the CTM may help you when the doo doo hits the spinning thing!
US for weanability?
Take a look at this paper looking at diaphragm thickening index and inter observer variability in predicting those who may get stuck on the vent.

ECMO got better
We have been using it a lot in those where influenza got the better of them. How have things changed over time though?
Blogs!
TBL do terlipressin!
My good friend Adrian Wong takes us through this trial. In critically ill patients with septic shock, does the use of terlipressin compared to norepinephrine reduced 28-day mortality?
The RELIEF trial got NephJC’d
Take a look at their discussion and the brilliant infographic!
PARAMEDIC-2 came out
And TBL took it apart here. Take a look and decide for yourself. In adult patients with out-of-hospital cardiac arrest (OOHCA), does the administration of epinephrine compared to placebo improve survival?
Is epi worth leaving out. Are we achieving ROSC without the need for not and they may have achieved ROSC anyway….neurological outcomes?? Questions questions questions!
Take a read of Salim and the crew at RebelEM and what they had to say on it too.
Here is the original paper too
following on from this then…perhaps we need an episode dosing study…enter CanROC
Trache emergency!
Justin Morgenstern runs us through the basics of management of such a situation!
Podcasts!
Fluids and Pressors in sepsis!
Check out this rather noise podcast on fluids / vasopressors in sepsis.
Meetings!
iFAD returns!
Get booking now for this fabulous 2 day meeting! Day 1 – 7th International Fluid Academy Day followed by Day 2 – the 5th Critical care ultrasound course!
Tweets!
Target BP in stroke?
Raised troponin…the list!
The Parkland Formula is dead! Use Conseusus instead.
Good tips in burns management. See also the guideline below the Tweets.
Aidan says…don’t pick up that probe UNLESS!
POCUS!
The Butterfly flies…..
So, we FINALLY may have some images from this much anticipated machine, the Butterfly IQ. Well, Elias Jaffa does anyway. He shows us there’s a lot of fluid collecting in a rather breathless patient….what’s the cause?
then…Sara Nikravan shows some others…
Blunt trauma after MVC
Thanks to IUEM ultrasound for this
Flow = Not hydro!
Thanks to Jacob Avila for this! If you throw colour across the kidney and you see it…it’s unlikely to be hydronephrosis….simples!
Empyema!
Thanks to West JEM for this
Another cracker case of dyspnoea.
Thanks to TrEMATUS again.
Check out this distal radius reduction
Thanks to EMATUS again for this.
Beware the old man with no abodo pain and tachycardia!
Pneumatosis intestinalis! Take a look at the vid here.
Complete CXR rotation
Thanks to Oschner Radiology for this.
Check out the air bronchograms
Thanks to Eric Abrams again.
Tension hydrothorax!
Thanks to Joel Turner for this!
Justin’s case
The thing you don’t want to find in the chest!
Adenosine in Action!
A lovely clip demonstrating chemical cardio version on US
Nasty Bowel!
Don’t let that blood collect!
Sam Ghali points out, don’t let the pressure build up. Echo early in your shocked patient.
The breathless patient…all the heart?
Phillip Gary shows us how useful US can be in suspected cardiac SOB1
Collapse in a 30 year old?
Thanks to Yale Emus for this.
Watch that fluid leave!
Brilliant image of realtime thoracic cavity drainage.
Pleural effusions!
Thanks to Eric Abrams for pointing out this large complex one!
What’s the lung point?
Have a look at this lovely video uploaded by James Rippey on the subject.
The power of TAPSE!
Look at this brilliant lecture on the subject. How reliable is TAPSE for prediction of PE and the dreaded thrombolysis? Sit down and take a look here.
AR can be a killer!
Check out this fabulous series from Daniel Ambinder. Too long to clog your RAM, so click the Tweet to see the video of a CT / echo series we can all learn from.
Infographs!
Basics and more advanced FATE!
Thanks to Eric Sloth and USABCD for these images!
What you can see on a PLAX!
EMSPOCUS show us what gems we can find on a basic PLAX view.
Don’t miss these!
Some ECG traces not to be missed in an ED near you! Nicve stuff from the ALiEM team.
A great day in Bangor!
Brilliant little update from this meeting here!
Don’t mess with PD!
Another great infographic from Strata5 here on Parkinson’s disease and med cock-ups!
EM3 do Beta blocker OD!
Manual of medicine show us adrenoreceptors!
Resources!
The Little Orange Book!
Take a look at this lovely guide from Newcastle and Gateshead CCG on management and recognition of sick children.
Amusement Factor!
Where did the I/O go?!
Here is a brilliant video on the use of I/O!
We shouldn’t laugh about hyponatraemia…but…
Until next time!
JW
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