If you didn't find what you were looking for, try a new search!
Critical Care Ultrasound Fellows Current Fellows Alex is a practicing Intensivist in Winnipeg, having completed medical school and an Internal Medicine residency at Queen’s University, followed by a Critical Care fellowship at the University of Manitoba. He was introduced to POCUS early in his career and gravitated to it to better connect with [...]
This is a 74yo F with a past medical history significant for ESRD and severe PVD who was transferred to the ICU overnight with presumed septic shock thought to be related to left foot osteomyelitis. She had presented to the ED with refractory hypotension and altered LOC necessitating intubation and high dose vasopressors. The POCUS team went to do a focused cardiac exam, primarily to see if there was a cardiogenic component to his shock. The following TTE images were taken and the decision was made to perform a point-of-care TEE. What do you think is going on?
This is a case of a 52 yo F trauma patient with severe traumatic brain injury. She was intubated and transferred to the ICU where, given the severity of her TBI, an intraparenchymal ICP monitor was placed by neurosurgery. The ICP monitor was initially showing an ICP of 10. Overnight, however, despite no apparent clinical change, the ICP waveform was inconsistent and the readings were now showing values around 40-50. We thus performed a point-of-care TCD to help determine whether her ICP was truly elevated or whether the ICP monitor was giving spurious information. Have a look at the following images. Do you think the TCD spectral waveform is consistent with markedly elevated ICP?
This is a 54 yo M who presented with acute hypoxic respiratory failure necessitating intubation and ICU admission. Post-intubation he had a P/F ratio of 54 despite a relatively unremarkable CXR. The PEEP was increased to try to improve oxygenation. A CTPA was ordered which was negative for PE and showed just a small right lower lobe consolidation. Given that the refractory hypoxia seemed discordant with the pulmonary pathology, concern was raised for an intracardiac shunt. A point-of-care TEE was performed including a bubble study. Have a look at the selected clips below and see what you think!
This is a case of a 56 yo F admitted with sepsis and MSSA bacteremia. A CT Head revealed several lesions concerning for septic emboli. She had known chronic significant mitral valve pathology documented prior to her admission. The POCUS team keen to see this pathology and to look for any additional signs of infective endocarditis. What do you notice about the valve on the 2D echo images and what specifically do you see on its colour doppler interrogation?
Emergency Medicine POCUS Series Fundamentals Please click here for a module covering point-of-care ultrasound basics by Dr. Rob Arntfield https://vimeo.com/218103744 Abdominal Aorta https://youtu.be/HAX7d3EMveg Abdomen https://youtu.be/orL-bSlwBTA https://youtu.be/E6J06ta07QA https://youtu.be/X_Ui91kjfag Female Pelvis https://youtu.be/jgyYftAAQgk https://youtu.be/By8TPKMRfdc https://youtu.be/Ww-_VGPlqdo Cardiac https://www.youtube.com/watch?v=_9GG3fiZpGshttps://www.youtube.com/watch?v=_9GG3fiZpGs https://youtu.be/rzBoRbuc4-0 Your Content Goes Here http://www.aesplin.com/tee-howtoscan/#Menu Cardiac POCUS Hi all,I wanted to forward another free resource for your [...]
This is 54 yo M who presented for an elective surgery. On POD # 0 he became tachycardic with subjective dyspnea and hypotension progressing into a PEA arrest. ROSC was quickly obtained with typical ACLS and he was placed on life support and transferred to the ICU for further management. A CTPA was negative, and his EKG was unremarkable with no evidence of coronary ischemia. On POD # 1 he remained hemodynamically unstable, and given very poor transthoracic windows, the decision was made to perform a TEE. Have a look at the images and Doppler information below. Is there a finding that may explain the etiology of his arrest? What would your recommendation be to the treating team?
Advanced Critical Care Ultrasound Quantitative Assessment Resource Disclaimer Quantitative measurements are generally de-emphasized for POCUS applications. When quantitative measures are used, we are more closely approximating diagnostic level echocardiographic standards and thorough training is generally required. This resource is meant to assist the advanced critical care ultrasound clinician by providing a summary of some core normal/abnormal values, equations [...]
Hi POCUS enthusiasts, We set a new record with >65 participants in last week's case voting. Unfortunately this will be our last COTW/COTG until we are back in action in early April. For all those who haven't signed up for automatic distribution do it now by going to westernsono.ca and filling in your name and email address. This will be the last email reminder! Now let's jump into [...]
Hi POCUS enthusiasts,Thanks again to the more than 20 participants in the online voting for last week's case! For those who have yet to sign up, just go to westernsono.ca and insert your name and email into the text box on the right side of the webpage. Then get ready to flex your POCUS muscles and post your answers/votes. Or click here to access the case directly: https://westernsono.ca/category/cases/ The [...]
