Point-of-care hemodynamic series

The beauty of point-of-care echo is that we can generally answer our most pressing clinical questions (such as: gross LV function, RV size, IVC size and variability and pericardial effusion) rapidly without relying on measurements, or advanced “knobs” related to spectral Doppler.  The literature and our clinical experience reflect that this approach is accurate and improves confidence and speed to diagnosis.

There ARE however times when the extensive additional training and commitment to learning these skills does pay off at the point-of-care.  This could be in the resus bay in the ED, the peri-operative milieu or in the ICU.

In this series of case presentations, Dr. Vincent Lau, PGY5 in critical care at Western University, articulately and visually takes us through several superb cases where one can only be inspired to possess these advanced skills.  The cases are presented in order of increasing complexity and frequently refer to the use of stroke volume determination.  If you haven’t seen our tutorial on how to determine stroke volume, you may want to check it out first.

Case 1: Hypovolemia

Case 2: Vasoplegia

Case 3: Cardiogenic shock

Case 4: Sepsis with CHF

Case 5: Cardiotoxic drug overdose

Case 6: Aortic stenosis with poor LV

Case 7: Cor pulmonale management

Case 8: Obstructive cardiomyopathy

Advanced point-of-care echo training can be hard to come by.  You can try cozying up to a cardiologist, come rotate at Western or you can have a look at this training statement and consider coming to the advanced echo course held in June each year, just outside Chicago.

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