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!
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
*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
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
*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.
The innovation and leadership of Western University’s and LHSC’s Point-of-Care Ultrasound program recently garnered regional media attention. With leading programs in emergency medicine and critical care and emerging programs in anesthesia, internal medicine and surgery, the collaborative, interdisciplinary vision of our POCUS program is being actualized to the betterment of the patient and physician experience. See the news piece below or the full news story at this link.
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It is hard to believe that only one year ago we celebrated the success of the first ever Western Medical Student Ultrasound Symposium. This year’s symposium took place the weekend of August 23rd & 24th and was bigger and better than ever. Continue reading