Best #FOAMed #FOAMcc #POCUS finds – July (2)

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!

Screen Shot 2018-07-28 at 14.15.26

Screen Shot 2018-07-28 at 13.55.20

LITFL for CCN!

Thanks to Manny Singh again for letting us know we made LITFL 340!

Screen Shot 2018-07-29 at 12.37.34.png

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.

Screen Shot 2018-07-29 at 14.39.48

Screen Shot 2018-07-29 at 14.39.33

Segun points out – should we quit auscultating the bowel on ICU?

Screen Shot 2018-07-29 at 14.37.21.png

The US looked fine!?

A good 2 part case discussion on the pitfalls of POCUS.

Screen Shot 2018-07-29 at 12.25.03.png

Segun points out med students are good!

A paper from 2003, but shows eyeballing can be very effective from an early stage.

Screen Shot 2018-07-29 at 12.28.38

POCUS Series!

Check out this brilliant series on POCUS from the Southern Medical Association.

Screen Shot 2018-07-29 at 11.13.19.png

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!

Screen Shot 2018-07-29 at 10.16.11.png

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!

Screen Shot 2018-07-29 at 12.55.33.png

Screen Shot 2018-07-29 at 12.56.14.png

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.

Screen Shot 2018-07-29 at 11.08.59.png
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?

Screen Shot 2018-07-29 at 11.11.20

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?

Screen Shot 2018-07-29 at 14.32.38.png

The RELIEF trial got NephJC’d

Take a look at their discussion and the brilliant infographic!

Screen Shot 2018-07-29 at 13.45.53.png

Screen Shot 2018-07-29 at 13.44.44.png

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!

Screen Shot 2018-07-29 at 13.09.24.png

Take a read of Salim and the crew at RebelEM and what they had to say on it too.

Screen Shot 2018-07-29 at 14.28.44.png

Here is the original paper too

Screen Shot 2018-07-29 at 14.18.44.png

following on from this then…perhaps we need an episode dosing study…enter CanROC

Screen Shot 2018-07-29 at 13.12.39Screen Shot 2018-07-29 at 13.12.49Screen Shot 2018-07-29 at 13.12.59

Trache emergency!

Justin Morgenstern runs us through the basics of management of such a situation!

Screen Shot 2018-07-29 at 10.13.42.png

Podcasts!

Fluids and Pressors in sepsis!

Check out this rather noise podcast on fluids / vasopressors in sepsis.

Screen Shot 2018-07-29 at 09.52.57.png

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!

Screen Shot 2018-07-29 at 09.55.09.png

Tweets!

Target BP in stroke?

Screen Shot 2018-07-29 at 13.31.55.png

Raised troponin…the list!

Screen Shot 2018-07-29 at 12.48.59.png

The Parkland Formula is dead! Use Conseusus instead.

Good tips in burns management. See also the guideline below the Tweets.

Screen Shot 2018-07-29 at 14.21.04Screen Shot 2018-07-29 at 14.21.32

Screen Shot 2018-07-29 at 14.23.34Screen Shot 2018-07-29 at 14.23.41

Aidan says…don’t pick up that probe UNLESS!

Screen Shot 2018-07-29 at 12.39.01.png

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!

Screen Shot 2018-07-29 at 13.22.33

Screen Shot 2018-07-29 at 13.22.08Screen Shot 2018-07-29 at 13.22.22

Screen Shot 2018-07-29 at 13.24.22

Adenosine in Action!

A lovely clip demonstrating chemical cardio version on US

Nasty Bowel!

Screen Shot 2018-07-29 at 10.09.39

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.

Screen Shot 2018-07-29 at 11.00.10.png

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.

Screen Shot 2018-07-29 at 11.05.44.png

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.

Screen Shot 2018-07-29 at 10.19.59.png

 

Infographs!

Basics and more advanced FATE!

Thanks to Eric Sloth and USABCD for these images!

Screen Shot 2018-07-29 at 12.58.58Screen Shot 2018-07-29 at 12.59.46Screen Shot 2018-07-29 at 13.00.02Screen Shot 2018-07-29 at 13.00.13

What you can see on a PLAX!

EMSPOCUS show us what gems we can find on a basic PLAX view.

Screen Shot 2018-07-29 at 10.46.19.png

Don’t miss these!Screen Shot 2018-07-29 at 10.22.00.png

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!

Screen Shot 2018-07-29 at 10.37.36.png

Don’t mess with PD!

Another great infographic from Strata5 here on Parkinson’s disease and med cock-ups!

Screen Shot 2018-07-29 at 11.14.42.png

EM3 do Beta blocker OD!

Screen Shot 2018-07-29 at 12.30.41.png

Manual of medicine show us adrenoreceptors!

Screen Shot 2018-07-29 at 12.54.05Screen Shot 2018-07-29 at 12.54.15

Resources!

The Little Orange Book!

Take a look at this lovely guide from Newcastle and Gateshead CCG on management and recognition of sick children.

Screen Shot 2018-07-29 at 13.33.25.png

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…

Screen Shot 2018-07-29 at 12.32.08.png

 

Until next time!

JW

 

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

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

Blog at WordPress.com.

Up ↑

%d bloggers like this: