2015 Critical Care Ultrasound Course

23 Mar Screen Shot 2012-07-16 at 11.03.38 PM

The 2015 Critical Care Ultrasound Course will be offered August 20-21, 2015.

This annual course is offered as the official course of our Critical Care training program and is attended by all critical care fellows.  Further, it will be the most comprehensive course offered in the country for the intensivist or resuscitative physician who seeks to acquired fundamental skills in the assessment of:

-Thoracic and lung ultrasound
-Vascular access, including peripheral veins and arteries
-Assessment for DVT
-Critical Care Echocardiography including assessment of LV function, RV, pericardium, valves and IVC.

The course will be directed by Robert Arntfield.

Additional faculty, agenda and brochure will be announced closer to the course but for a sense of what is in store for you, see the images from the 2014 course.

If you have interest in attending this course please email Tammy.Mills@lhsc.on.ca who will be able to notify you when registration for this course opens early in 2015.

Introduction to Point of Care Ultrasound 2015

23 Mar IMG_2379-001

The Division of Emergency Medicine is pleased to announce the 2015 iteration of its annual introductory course in ED point of care ultrasound.  This course will emphasize the “Fundamental 4″ views and 5 indications of point of care ultrasound in the ED and is aimed at practitioners who are beginning their pathway to competence in point of care ultrasound.

The “Fundamental 4″ are:

  • Abdominal : Presence of intra-peritoneal fluid? (Yes/No)
  • Abdominal : Presence of abdominal aortic aneurysm? (Yes/No)
  • Subcostal Cardiac : Presence of pericardial fluid? (Yes/No)                                                                     Cardiac activity during arrest? (Yes/No)
  • Pelvic : Presence of intra-uterine pregnancy? (Yes/No)

The course will feature an outstanding faculty to learner ratio for hands-on sessions as well as innovative image interpretation sessions.  These small group sessions emphasize image interpretation skills and serve as intimate venues to reinforce clinical integration pathways.

Course directors are Drs. Behzad Hassani, Heather Hames and Grant Coome. Bedside instructors will include faculty from within the Division of EM’s experienced group of point of care sonographers.

The date for the 2015 course will be July 9, 2015.  If you have interest in attending as a participant please contact us via email at westernsono@gmail.com (please include Emergency Course in subject line).

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Nerve Blocks, Lumbar Punctures and the Probe

10 Feb IMG_1562

A fun filled educational day with our colleagues in Regional Anesthesia here @westernsono. A great opportunity for our keen POCUS Faculty and Senior learners to be introduced to the topics of nerve blocks and POCUS-facilitated lumbar punctures. A special thanks to Dr. Su Ganapathy and Dr. Rakesh Sondekoppam for imparting some pearls of wisdom, augmented learning with gross anatomy dissections and help identifying the important landmarks. Multi-disciplinary collaboration in action!

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Case #6 – ED TEE for Cardiac Arrest

27 Jan

In this case a sudden deterioration in the emergency department prompts a TTE which shows some concerning physiology.  It is not until the TEE is inserted, however, that the culprit disease can be identified.

*Images courtesy of Dr. Drew Thompson, Division of EM, Western University

Case Highlights:

*TEE in the ED is valuable for critically ill patients

*TEE has advanced diagnostic potential, including the identification of aortic dissection in a rare number of cases

*TEE has value in cardiac arrest in particular for its ability to provide all the benefits of echocardiography (identification of reversible causes, prognostication, subjective and objective evaluation of CPR quality) without any need to interrupt chest compressions

Case #5: What a difference a day makes

17 Dec

In this case you will see 2 echos from the same patient only 1 day apart.  The patient had raging septic shock from a skin source and was requiring significant hemodynamic support.  You can appreciate the cardiac dysfunction from a 2D point of view but also from a quantitative point of view.  The next day – you will see significant changes, now off inotropes (epinephrine, milrinone and norepinephrine).

*Images courtesy of Dr. Vincent Lau, critical care fellow, Western University

Case Highlights:

*Septic cardiomyopathy is a common cause of LV and/or RV dysfunction in the context of severe sepsis or septic shock

*Point-of-care echo can be used repeatedly to recognize  often rapid changes in cardiac function that occur during septic illness

*Quantitative stroke volume determination (using VTI from the LVOT) can additionally support your findings and guide management

For a similar case on septic cardiomyopathy, check out CHEST ultrasound corner here.

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