vascular access & how ultrasound is being utilised with cardiac assessments as well as lungs for the COVID-19 PATIENT
Matthew Ostroff, a 2020 Suzanne Herbst Award recipient, hosts an on-demand Webinar in which he discusses vascular access for the COVID-19 patient, delivered by Fujifilm Sonosite.
The UK has been one of the worst-hit countries in the Coronavirus fight.
Watch Sonosite's CMO, Dr Diku Mandavia interview with Dr Justin Kirk-Bayley as he speaks about his own frontline experience as well as contracting the virus himself. Justin also looks at how ultrasound is being utilised with cardiac assessments as well as lungs.
This post is sponsored by Fujifilm Sonosite.
Watch this on-demand webinar hosted by Canadian ICU Medical Director, Dr Robert Arntfield in conjunction with Fujifilm Sonosite, discussing Goal-Directed Echo in Respiratory Failure.
This Content is Sponsored by Fujifilm Sonosite.
High-level disinfection is critical in the #COVID19 environment. Watch this video from 123sonography and GE Healthcare for helpful tips on disinfecting your ultrasound system and probes.
This is a sponsored blog post from GE Healthcare
Watch a replay of the GE Healthcare webinar featuring Dr. Jonny Wilkinson to learn about the role of point of care ultrasound in the #COVID19 patient journey and the importance of lung and cardiac ultrasound in managing patients with this disease.
This is a sponsored blog post from GE Healthcare.
Discordance Between Pulse Palpation And Focused EchocardiographyFindings In Adult Cardiopulmonary Arrest Patients
AUTHOR: Dr Michael Blaivas, MD, MBA
Department of Emergency Medicine, St. Francis Hospital, Columbus, Georgia, USA
Objectives: Define the frequency of agreement between focused bedside
echocardiography (Echo) and pulse checks during cardiopulmonary resuscitation (CPR).
Methods: This was a retrospective review of multi-year quality assurance logs on cardiac
arrest patients evaluated with point-of-care Echo during CPR, over a seven year period.
All patients in cardiopulmonary arrest that presented when physicians trained in Echo
were availabile and had quality assurance documentation completed, were eligible for
enrollment. Patients for whom incomplete data was present in the logs were excluded
from the study. This study took place at a busy emergency medicine department with a
large cardiac population and an approximate annual census of 80,000 visits per year.
Emergency physicians (EPs), with hospital credentialing in point-of-care Echo, routinely
used ultrasound as part of their standard management of CPR patients. During all pulse
checks, nurses and physicians attempted to locate pulses while one EP performed a brief
Echo of the heart with a compact ultrasound machine. Echo checks were limited to the
time available during pulse checks and ended when the treating EP ordered resumption of
chest compressions. Myocardial function was graded into normal ejection fraction (EF),
mildly, moderately, severely depressed, negligible function and asystole as previously
defined in the literature. If Echo suggested sufficient EF to generate blood flow but pulse
check was negative, the carotid arteries were evaluated with Doppler when interference
with resuscitative efforts could be avoided. Statistical analysis included descriptive
statistics and Cohen Kappa coefficient for agreement analysis.
Results: A total of 693 pulse checks occurred concomitantly with Echo checks in 226
patients. Of the 226 patients, 59 (26.1%) had resumption of spontaneous circulation at some point in their resuscitation based on pulse palpation and electrocardiographic
monitor tracing. A total of 178 (25.7%) Echo checks revealed an EF felt to likely
generate a detectable blood pressure. In 47% (84) of those Echo checks, no pulses were
palpable. Conversely, in 31 (6%) pulse checks (when electrical cardiac activity was noted
on the monitor) and a healthcare provider felt palpable pulses, the echo showed either
myocardial standstill or negligible EF. Echo results and pulse palpation during pulse
checks showed poor correlation with a Kappa of 0.52.
Conclusions: In this study, Echo findings and pulse palpation results periodically
disagreed when myocardial activity was present. When Doppler analysis of carotid flow
was possible in patients with adequate EF but no pulses, flow was always noted. Very
concerning, in 6% of patients apparent palpable pulses occurred when Echo showed no
myocardial contraction or negligible EF
- This is a sponsored post from FUJIFILM SONOSITE -
OCULAR Ultrasound by dr luke Philips
FACEM, MBBS, BSC(BIOMED)(HONS), CCPU
EMERGENCY CONSULTANT - ALFRED HEALTH
CO-DIRECTOR OF EMERGENCY MEDICINE TRAINING (THE ALFRED HOSPITAL
CO-CHAIR OF THE EMERGENCY MEDICINE ULTRASOUND GROUP BOARD OF DIRECTORS
75yo Female presents to the ED with sudden onset right visual loss.
Opportunities with UIE in New Zealand
If you are in the planning stages for 2020 and wish to solidify your POCUS skills or are keen to achieve the ASUM and updated ACEM requirements, please check out the workshops we have available on our website www.uie.co.nz.
Auckland Public Hospital on 13 & 14 February
(ASUM AAA, eFAST, ACEM Education Program Guidelines for eFAST, AAA, Procedural Ultrasound and Lung Ultrasound, pending RNZCGP & CICM)
Echo in Waiheke on 21 March
(ASUM BELS and ACEM FELS, pending RNZCGP and CIC
Our workshops cover a number of scanning techniques including MSK, DVT, Biliary, Gallbladder, Cardiac Views, Testicular and Early Pregnancy.
For a copy of the program please email me (email@example.com) noting the workshop you are interested in.
Please feel free to bring along your own ultrasound machine for those with hand-held devices, i.e all Lumify and Butterfly's welcome.
(PAID ADVERTISING POST)
With POCUS handhelds now more readily available, there is an exciting opportunity to embrace the game changing benefits to patient outcomes in acute and urgent care environments beyond the emergency department.
Increased accessibility to POCUS technology comes with a sense of responsibility for ensuring that those with probes in their hands are adequately trained and supervised.
A group of passionate POCUS users lead by Dr Mick Kileen, FACEM and US Clinical Director at Whangarei Hospital in Northland New Zealand, teamed up with Philips in a partnership to meet this need for clinicians in remote or resource restricted environments.
The project was called The Handheld Collaboration.
Together they conducted a feasibility study on bringing safe, comprehensive and not for profit POCUS education and supervision to frontline doctors via distance learning and video interaction using Philips Lumify and Philips Reacts Telehealth platform.
The study ran over three months with 4 supervisors and 5 trainees each supplied with a Lumify and Reacts platform on loan from our friends at Philips.
The study provided Philips with objective insight to the use of the Lumify and Reacts platform is such a setting and provided EMUGs valuable insights to inform the design of future training and supervision pathways with benefits for our Developing Countries programs and beyond.
The trainees thoroughly enjoyed the use of their loaned Lumify pairing them with large screen phones or small tablets.They report that having the Lumify on them meant they scanned more often, resulting in a faster rate of skill development and logged scans and were able to use the probe for everything they would have otherwise use a standard machine for.
Want to get your hands on a Lumify?
For the month of December, the ‘dream’ under $5000 price point for a Lumify handheld ultrasound is now a reality (for people who move quickly).
This is a special offer to the EMUGs Community and is available in Australia and New Zealand only and only while in country stocks last.
The offer: inventory clearance sale
$7,999 reduced to
AUD$4,999 per Lumify
with 3 years warranty (AUD, before GST)
To buy: ExDemoLumify2019
In the cart, use voucher code ExDemoLumify2019
Want 5 years warranty? You can add $1000 for this in the cart.
DR THOMAS BROUGH
50yoM P/W exertion chest pain and diaphoresis.
Remote history of whitecoat, no medications; completely healthy until today; worked in business.
Inferior STEMI on ECG with some bradycardia.
450km from cath lab, in an ED where we thrombolyse STEMIs.
Aspirin downrange, about to give ticagrelor, heparin bolus, and 40mg tenecteplase.
Had a look for no reason in particular other than it was my want.
And indeed it was worth a look... (PLAX followed by suprasternal views)
Type A dissection, tPA and heparin withheld, flown to tertiary hospital, arrested a few times, survived neurologically intact
Blogs are written by our EMUGs Team from across Australasia.