We hold our monthly ultrasound rounds (“UltraRounds”) on the last Monday of each block where we review interesting cases from the month. As the timing and location does not work for all, I have attempted to do a brief recap of some of our discussion and interesting cases yesterday. Enjoy and hope to see you at the next session on March 10, 2014.
This pocketcard is handed out at our very popular annual critical care ultrasound course held each August. It features quick bullet points guiding you in the use of various cardiac, thoracic and vascular ultrasound applications.
If you wish to use non-digitally, I suggest you print double sided on to medium card stock and laminate.
So you’re feeling comfortable with assessing LV function, RV function, the pericardium, the IVC and some basic valve stuff. What next? What should you focus on to take your critical care echo game to the next level?
For some inspiration, check out this handbook that Dr. Mark Tutschka (PGY5 – Critical Care) has put together. It is a nice, succinct guide to some of the advanced applications for echocardiography in the ICU that he (and I) feel are most valuable in the initial venture in to Doppler, grading regurgitation severity and some more quantitative analysis that will help with hemodynamics. It is by no means comprehensive but should whet your appetite for something more substantial, like a definitive echocardiography text or this excellent ICU echocardiography book.
The book can be easily bound in to a pocket-sized handbook. We have some here at Western if you’re interested in a free copy.
The transesophageal approach echocardiography has numerous advantages for those providing resuscitation to the critically ill, including those with cardiac arrest. While the transthoracic approach is often quite useful, quality images in ventilated patients are more challenging. Thus, the reliable, high quality image acquisition of TEE is very attractive for the resus room. It is, however, the continuous nature of TEE – due to the probe being left in-situ throughout the resuscitation – that makes this the ideal tool for the resuscitator. Continuous, live updates on the functional and hemodynamic evolution during a resuscitation, including during CPR, is a sublime experience for anybody who has used this approach.
Given these obvious advantages, it is important that emergency physicians be enabled and empowered to engage in this method of image acquisition.
On October 30th, 15 motivated emergency physicians at Western were exposed to a structured 4 hour curriculum on TEE that included:
-didactic lecture and overview of TEE and focused, limited 2D TEE exam protocol
-haptic simulation: inserting TEE probes (using airway mannequins and actual TEE probes)
-image generation simulation: practice generating TEE views on high fidelity simulator
-TEE image review session
Subjectively, the day was a great success Stay tuned for some more objective metrics regarding its success!
For anybody looking for an excellent, free online resource to better understand TEE and the various views should check out this site.
The 2014 Critical Care Ultrasound Course will be offered August 21-22, 2014.
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 region 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 PICC lines
-Critical Care Echocardiography
The course will be directed by Robert Arntfield.
Additional faculty, agenda and brochure will be announced closer to the 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 in the spring of 2014.