Ultrasound Gel



Review and discussion of recent literature in point of care ultrasound.


  • Carotid Intima-Media Thickening

    02/09/2019 Duración: 09min

    We know that the carotid arteries are easily seen on ultrasound, but usually we think of this scan in the context of comprehensive sonography. Certainly, it is not hard to believe that having increased atherosclerotic build up would put someone at increased risk for coronary artery disease, but what can we do with that in the acute setting? These authors had an idea - maybe measuring the Carotid Intima-Media Thickness (CIMT), could be a predictor of the outcomes of a cardiac stress test. Is this brilliance or craziness? Decide for yourself! https://www.ncbi.nlm.nih.gov/pubmed/30612781/

  • Necrotizing Fasciitis

    19/08/2019 Duración: 15min

    Necrotizing fasciitis (NF) is a real bad deal. We usually rely on clinical exam (which can be misleading) or other imaging studies (which can take forever) to make the diagnosis. POCUS would be an awesome solution in helping to make this time-sensitive determination. We know it can pick up fascial fluid, air, subcutaneous changes...but really how good is it when it comes down to diagnosing this deadly disease? https://www.ncbi.nlm.nih.gov/pubmed/31031033

  • WAMAMI! Wall Motion Abnormalities in Acute Myocardial Infarction

    05/08/2019 Duración: 16min

    Theoretically, regional wall motion abnormalities (RWMA) would be really useful in the acute care setting. In the patient with concern for cardiac ischemia, this finding might help push to definitive management. The problem is that this is a nuanced exam - it takes some experience and practice. It hasn't been studied much in the point-of-care world. So can emergency physicians with relatively little training do this accurately? Find out in this next adventure into the world of point-of-care echocardiography! https://www.ncbi.nlm.nih.gov/pubmed/30987914

  • CASA and POCUS in Cardiac Arrest

    22/07/2019 Duración: 14min

    In part 2 (and the finale) of the series from the IAEM conference, the discussion heats up even more! The same star-studded international band of wisdom and wizardry tackles POCUS in cardiac arrest. They discuss the CASA exam and other pointers for using POCUS in the pulseless patient. A must listen!

  • SHoC-ED & the Erector Spinae Block

    08/07/2019 Duración: 22min

    In October 2018, an all-star group met during the Irish Association for Emergency Medicine annual conference to talk about point-of-care ultrasound. The result was a convivial discussion of a few key papers and topics, packed with pearls and perspectives. In part 1 of 2, the group talks about the landmark original SHoC-ED trial and performing the erector spinae plane block for rib fractures.

  • The Impact of POCUS on Resus Effort & Outcomes in Arrest

    24/06/2019 Duración: 19min

    It is great to see more and more research on ultrasound in cardiac arrest. Although many people are already using this, there is still much work to be done to tease out the details of how exactly POCUS should affect our decision making. Here is a nice study that looks to see if ultrasound is associated with increased resuscitation efforts or better survival outcomes. https://www.ncbi.nlm.nih.gov/pubmed/31205842

  • Ocular POCUS of Retinal Detachment, Vitreous Hemorrhage, and Vitreous Detachment

    10/06/2019 Duración: 14min

    They say seeing is believing...what about seeing a study about a machine that listens in order to see an organ that itself is used to see? Most scholars agree this too is believing. Of course, we are (in a convoluted way) referring to ocular ultrasound. Historically a great party trick, can this modality accurately diagnose visual problems in the emergency department? It's been done before, but it hasn't been done to this degree. Sit back, relax, and visualize the latest in ocular POCUS research. https://www.ncbi.nlm.nih.gov/pubmed/30977855

  • The Future of POCUS Research

    27/05/2019 Duración: 30min

    The annual conference of the Society of Clinical Ultrasound Fellowships (SCUF) is an incredible opportunity to converse and interact with many leaders in point-of-care ultrasound education and research. We took advantage of having so many brilliant people in one place to ask them all a few question about what they think are the next steps in POCUS research.

  • FemInEM and Ultrasound GEL Co-Podcast

    13/05/2019 Duración: 17min

    Resa and Mike team up to discuss important happening at SCUF 2019 Annual conference. Guest stars Nova Panebianco and Sara Damewood!

  • Unselected Patients

    29/04/2019 Duración: 14min

    We use ultrasound a lot. Sometimes we find things that are not clearly related to the reason the patient came in. The prevalence of these incidental findings relates to the usefulness of the diagnostic test. These authors take the bull by the horns, randomly whole-body-POCUS scanning emergency department patients to see what sort of findings might pop up. But should disease prevalence change our use of the tool? https://www.ncbi.nlm.nih.gov/pubmed/30587153

  • POCUS in the Reduction of Distal Radius Fractures

    15/04/2019 Duración: 12min

    Fractures of the distal radius are pretty common among people who choose not to break their fall with their face. Sure - it's not hard to see these on xray, but is there a better way? Ultrasound is great for finding fractures, but what about being able to guide the reduction? This has been shown to be useful in a pediatric population, but this study looks at a population of adult patients in the emergency department to see just how accurate ultrasound is for determining if the pieces have been put back together. https://www.ncbi.nlm.nih.gov/pubmed/30191190

  • TEE to Shorten Compression Pauses in Cardiac Arrest

    18/03/2019 Duración: 12min

    TEE has been heralded as the latest and greatest way to monitor a cardiac arrest resuscitation. The advantages include continuous monitoring of cardiac activity, ability to evaluate efficacy of chest compressions, and better evaluation of etiologies of the arrest. Although many places are using it currently, there is not much evidence to support these theoretical benefits. What we do know is that a few studies have shown that transthoracic ultrasound leads to prolonged pauses in cardiac arrest. This study aims to see if TEE is the solution. https://www.ncbi.nlm.nih.gov/pubmed/30773413

  • Integrated Lung Ultrasound for Acute Decompensated Heart Failure

    04/03/2019 Duración: 12min

    Many ultrasound enthusiasts have been using point of care ultrasound to assist in the diagnosis of acute decompensated heart failure, but it has not been widely adopted. It has been shown by many studies that ultrasound can visualize pulmonary edema easily so that treatment can be started quickly. However, some still cling to their chest xrays and their natriuretic peptides, just hoping it won't lead them astray. Well this trial aims to prove the superior accuracy of lung ultrasound combined with clinical assessment over chest xray and pro-BNP (also combined with clinical assessment). Hold onto your hats, because there is a lot we can learn from this well done randomized controlled trial of over 500 patients! https://www.ncbi.nlm.nih.gov/pubmed/30690825

  • POCUS in Preeclampsia

    18/02/2019 Duración: 12min

    Point of care ultrasound can be used for a great many things, but I don't think many people grab for the probe when a patient comes in with suspected pre-eclampsia. However, we know that pre-eclampsia can lead to pathophysiology that is readily identified on ultrasound - things like interstitial edema, cardiac dysfunction, and increased intracranial pressure. This study takes the first step by examining patients in pre-eclampsia and determining how often you might find something if you go a lookin. https://www.ncbi.nlm.nih.gov/pubmed/30211771

  • Biliary POCUS & Surgical Referral

    04/02/2019 Duración: 12min

    The gallbladder loves to be scanned - a fluid filled sac nestled against a wonderful acoustic window? Are you kidding me? In any case, here is what we know: ultrasound is good for diagnosing cholecystitis, point of care ultrasound in the emergency department is good for diagnosing cholecystitis, BUT many surgeons still prefer a comprehensive RUQ ultrasound prior to cuttin' anyone. This article takes a look to see if these positive findings in the ED lead to people requiring cholecystectomy. Also - does it actually save time? https://www.ncbi.nlm.nih.gov/pubmed/30109274

  • Chest Pain and Shortness of Breath

    21/01/2019 Duración: 12min

    Chest pain is fun, right? Maybe add in some shortness of breath? It can be hard to sort through the potentially sick from the okay to go home. We know that point of care ultrasound (POCUS) can be helpful in making or excluding many cardiothoracic pathologies, but we don't even know if it really makes a difference! This article takes the first step by asking, "when you use POCUS, does it help lower the diagnostic uncertainty about that patient?" Secondly, it takes on an old rivalry by comparing POCUS to chest xray in these patients. https://www.ncbi.nlm.nih.gov/pubmed/30413369

  • Carotid Flow Time for Fluid Responsiveness

    07/01/2019 Duración: 12min

    Fluid responsiveness has been all the rage in emergency and critical care medicine. Trying to determine which patients will benefit from fluids or how much fluids is a daily struggle for providers. However, every new measurement or technique to quantify a patients possible responsiveness to fluids has been riddled with problems. Is carotid flow time, the holy grail that we have been waiting for? This study dives into the use of carotid flow time in an ICU patient population and attempts to answer if flow time can predict fluid responsiveness.

  • FAST for Hemorrhage from Pelvic Fracture

    10/12/2018 Duración: 12min

    The FAST exam is tried and true for trauma, but in the past it hasn't been super useful for patients with isolated pelvic fractures. This study teases out a very sick subset of this population - patient who have significant hemorrhage associated with their fracture. The question is how well can the FAST identify intraabdominal hemorrhage in these people. The authors' idea is that if the FAST can find intraperitoneal blood, it might help determine who would benefit from REBOA instead of laparotomy.

  • Speckle Tracking for Acute Coronary Syndrome

    26/11/2018 Duración: 12min

    Speckle tracking? Is that the technology that the government uses to mine data from your phone?! No - totally different! This is an ultrasound technology that recognizes tiny specks in the myocardium, allowing for a measurement of the movement of the heart wall. This has the potential to quantify the contractility of different parts of the heart, and therefore can be used to help diagnose numerous cardiac pathologies. At this time, not many people are using this in the emergency department. This is the first study to take a look to see if this is feasible and if it is accurate in diagnosing patients with acute coronary syndrome.

  • Small Bowel Obstruction

    12/11/2018 Duración: 12min

    Ultrasound was made for the diagnosis of small bowel obstruction. It loves when air filled things are turned into fluid filled things - its helps us see it better. When the bowel gets backed up and distends with digested cheeseburgers, ultrasound is there to save the day. As easy as this may seem, it has not been well studied. There are a few small studies that show it can be accurate compared to a CT, but without a large body of evidence - a lot of people are (quite reasonably) unwilling to put their faith in it. Well, we can't say this study is going to turn all that around, but its one more piece of the puzzle of figuring out how we can use POCUS for this diagnosis.

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