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
By LUKE PHILIPS: CO-CHAIRPERSON, EMUGs CENTRAL COUNCIL
Dear fellow EMUGers.
2019 has been a huge year for the EMUGS community with a large number of successful events including our Noosa conference and welcoming in both the South Australia and Tasmanian branches of EMUGs.
I’d like to take this opportunity to thank everyone who has helped to organise, assist and teach at these events. Without this grassroots support we wouldn’t be able to push our agenda of advancing Point of Care ultrasound excellence in acute care across Australia and New Zealand.
We have a number of changes at board level with Mark Rewi stepping down from the board and in doing so relinquishing his position as Co-Chairperson. Mark is being replaced as Co-Chairperson by Melody Hiew. Mark has been pivotal in getting EMUGs to where it is today particularly in New Zealand and we are thankful for all his input and support. Allan Whitehead has joined the Central Council, replacing Gaby Blecher, making Allan an official board member, as well as EMUGs secretary and treasurer.
Next year promises to be even bigger with a roadshow of events and our 2nd annual Sonic conference in Queenstown in August. We continue to collaborate and advocate for POCUS with key stakeholders including ACEM and ASUM. As part of this we are looking at how best to make ultrasound education accessible to all trainees and consultants. As part of this process we would like to gauge interest in the development of a focused ultrasound in EM certificate. If you have time and interest, please complete this survey.
In the background, we are developing a set of resources for clinical leads in ultrasound and as part of our outreach/developing country programs we are continuing to offer a scholarships to doctors from developing countries as well as exploring a handheld ultrasound education program.
I look forward to seeing you at a number of events next year and on behalf of the central council we wish you and your families all the best for Christmas and the New Year.
Dr Luke Phillips
Co- Chairperson - EMUGs Central Council
Aidan completed a Bachelor of paramedic practice at the University of Tasmania in Sydney, followed by a BSc Hons looking at ultrasound guided IV cannulation by paramedics; comparing short and long axis techniques.
Aidan was then the first paramedic in Australia to do a Graduate Certificate in Clinical Ultrasound with specialism in EM at CQ University. After that he spent a year in London as a visiting researcher and lecturer at Kingston University and St Georges University. He also took up the role of Course Director for the PoCUS UK and EU with the Prehospital Care Consultancy Ltd. Now, back home in Sydney, Aidan is a medical student, working casually as a paramedic and lecturer, and freelancing as a POCUS educator.
Aidan is a passionate believer in POCUS, particularly within EM and out of hospital care.
What drives your POCUS passion?
Once you’ve seen the impact POCUS can have, it’s hard to go back.
The first ultrasound Aidan ever did was as a volunteer simulated patient for Sydney’s Air Ambulance retrieval courses where he scanned himself after one of the formal lessons. He became fascinated and ended up learning more. The learning went from informal to formal, the fascination grew and he ended up travelling to exciting places to teach POCUS around the world, and, in a full circle, back home in Australia.
Favourite travel destination…
As yet undecided. The beauty of travel is that everywhere you go is different and doesn’t have to be compared. Too many favourite countries depending on when you ask. Nepal, India, Thailand, Austria, Ireland, and Scotland are definitely up there though
Who are you outside of work?
Aidan was a classically trainer baritone in a previous life and finds himself revisiting singing on rare occasions. He is currently enjoying being a new student to Brazilian Jiu Jitsu. Is sleeping a hobby?
What is your vision for EMUGs?
POCUS needs to become accessible, self regulating, and well governed and audited. Hopefully EMUGs are able to agitate for these changes.
What progress have you seen with regard to POCUS? What would you like to see?
POCUS has come a long way since I first started learning in 2012. The evidence base has exploded, and the technology has become ever more accessible.
‘The POCUS person’ is now a recognised asset in most departments. We need to shift from it being a special skill, to a core skill and standard of care where evidence for benefit exists, of course.
A message from Aidan for those new to POCUS...
Safe point of care ultrasonography requires that one can articulate the pretest probability which justifies the scan, and the positive and negative likelihood ratios of that specific POCUS exam performed. POCUS without a basic understanding of Bayesian clinical decision making is dangerous.
I uses a mental Fagan nomogram every single time I perform a scan.
I believe that you will likely never harm a patient with POCUS if you practice with an honest Bayesian framework.
Safe Scanning y’all.
Blogs are written by our EMUGs Team from across Australasia.