EMUS Journal Club Wednesday Dec 12

9:15 am, civic campus, teaching room 4.


The Effect of Soft-tissue Ultrasound on
the Management of Cellulitis in the
Emergency Department
Vivek S. Tayal, MD, Nael Hasan, MD, H. James Norton, PhD, Christian A. Tomaszewski, MD

ACADEMIC EMERGENCY MEDICINE 2006; 13:384–388

Hello!

Just wanted to let you know that I have donated "The EDE Book" to the Emergency Medicine Resident's Library. Full disclosure I am one of the chapter authors. Having said that I am sure you will find it an excellent resource. Further information about the book can be found at: The EDE Book
Enjoy!! Tell us what you think and write a comment. Also, if you know of a good ultrasound resource then comment about it on the blog!! Michael

Tips to Improve your Ultrasound Teaching

Ever wonder how to teach point-of-care ultrasound?  Sure, YOU know what to do but you just can't seem to explain why your student is struggling.  Check out this video for some teaching tips:

Elliot Stansfield, uOttawa MSY3 has won 1^st place in the UGME Education Summer Studentship Poster presentation competition for his summer project titled: Designing a multi-disciplinary comprehensive undergraduate ultrasonography curriculum. His supervisors were Dr. Michael Woo (Emerg), Dr. Ron Tam (Pediatrics), and Dr. Stan Hamstra (AIME). Congratulations!!

Pictured from left to right Dr. Susan Humphrey-Murto (Associate Director, AIME), Elliot Stansfield, Dr. Melissa Forgie (Associate Dean, UGME), Dr. Stan Hamstra (Acting Assistant Dean, AIME)

Journal club article

9:15 on Wednesday morning, EM conference room.

The ultrasound-guided superficial cervical plexus block for anesthesia and analgesia in emergency care settings

American Journal of Emergency Medicine (2012) 30, 1263–1267    

Andrew A. Herring MDa,⁎, Michael B. Stone MDa,b, Oron Frenkel MDa, Annie Chipman MDa, Arun D. Nagdev MD

Winfocus Barcelona 2012

Winfocus Barcelona 2012

 

Greetings from Barcelona! Winfocus has been a truly wonderful conference with world renowned speakers. A review of the consensus statement on lung ultrasonography was presented by Dr. Volpicelli. Another highlight was the talk given by Dr. Duchalvsky who described the role of POCUS in austere environments such as space and remote environments such as on Mt. Everest. Dr. Hoppmann, Dean of the School of Medicine at the University of South Carolina gave an inspiring and visionary talk of the role of ultrasonography for medical students. Medical schools around the world are trying to catch up with what has already been accomplished (including uOttawa - stay tuned!). Finally it was also great to hear the work in developing countries that Winfocus has provided and their work with the United Nations with a mandate for healthcare for all, with ultrasound being the most common imaging tool in the world.

Another highlight has been the opportunity to meet up with old friends. It was great to see Dr. Majid Al-Salamah (uOttawa FRCPC grad) and Dr. Khaled Al-Rajhi (uOttawa EMUS Fellow and FRCPC grad). A good Canadian contingent was also there from Montreal to St. John's. Hope to see more and more Canadians participate in this organization in the future.

And a personal highlight was the Champions' League game at Camp Nou with FC Barcelona pulling out a last minute goal to win the game. Can't beat the excitement of 80,000 fans screaming in a stadium ... well maybe my own ultrasound machine with a probe that hooks up to my phone....

Journal Club article for tomorrow

EMUS Journal club is tomorrow, Wednesday 17 October.
Location: Small Conference Room (near ED billing office) Civic Campus

Article:

Thoracic Ultrasound for Diagnosing Pulmonary Embolism* 

Gebhard Mathis, MD; Wolfgang Blank, MD; Angelika Reißig, MD; Peter Lechleitner, MD; Joachim Reuß, MD; Andreas Schuler, MD; and Sonja Beckh, MD
Chest 2005; 128: 1531-38.

PMID:

 

16162754

 

See you there!

You CAN Scan the Aorta

Yes you can!  Here is a handy video showing you proper aorta scanning technique, as well as a few tips.

http://youtu.be/7N7L2xUlayM

Two amazing ocular cases

These two cases were kindly submitted to us by Dr. Lloyd Gordon of Toronto.

Case 1:
An elderly patient woke up with only peripheral vision in one eye.  Fundoscopy was non-diagnostic.

Ocular ultrasound showed the following:

Diagnosis: Macular hole

Case 2:

One Saturday evening, a dashing young emergency physician noticed a flashing arc of light in his eye whenever he moved it.  The next morning, while on shift, he performed an ultrasound of his own eye (while simultaneously intubating).  Check out the video!

Near the retina, you can see a thin white line separated from the back of the eye.  As the eye moves, the line sways as if riding a fluid wave.  This is the classic appearance of a posterior vitreous detachment.

QA session room change

Room M2389d at the general, 9:15am on Wednesday sept 19.

Journal Club Sept 12

Here is the article:

Haydar SA, Moore ET, Higgins GL et al. Effect of Bedside Ultrasonography on the Certainty of Physician Clinical Decisionmaking for Septic Patients in the ED. Ann Emerg Med. 2012;60:346-358.

See you Wednesday, 9:15am in the EM Conference Room (Coughlin Room) at the Civic.

Dr. Krywenky's great case

Another great case....

A patient with a history of breast cancer presented with what appeared to be an abscess in the right inguinal area.

Soft-tissue POCUS showed fluid, but also lots of solid material inside.  This raised the possibility that the abscess was in fact a necrotic cancerous lymph node.

Instead of performing an I&D, she ultimately referred the patient to surgery, and involved the patient's oncologist.

POCUS Journal Club at TOH

This year, we are starting a monthly journal club.  All residents on EMUS rotations are expected to attend the journal club that month.

Journal club is at the Civic, 9:15am.  EM Conference Room (Coughlin Room)

Dates are:

Sept 12
Oct 10
Nov 7
Dec 5
Jan 30
Feb 27
March 13
March 27
April 10 (Peds ultrasound month)
May 22

Articles will be posted here on the blog!

Going live...

The blog is going live soon....hope all the twitter and Facebook integration works.  Yes this is a test post.

Performing the FAST - a review

Need a refresher on how to generate super images on your FAST exam?  Look no further...

Sim Boot Camp Tomorrow

Hope all the new residents are ready for the ultrasound part of the sim boot camp!  See you tomorrow.

Intro Course a Success!

We held our annual intro course last week...I think it was a great success!  Thanks to all the participants, teachers, our sponsor, and the organizers who helped pull it off.  -  James

An unexpected finding...

Great Ultrasound Case

A recent case of mine.

HPI:  Fifty yo man presents complaining of constipation.  It started five days before, and he attributes it to new medications.  Two days before that he had been seen at a walk-in-clinic with cough and shortness of breath.  A chest x-ray had been done (I did not have the results).  He had been told he had infection and fluid on the lungs, and started on clarithromycin and furosemide.  Now, he feels his breathing is better but he feels constipated and his belly feels distended.

Something smells fishy here.

PMHx: smoker, nil else

Exam: All vitals normal.  Patient in no distress and looks generally well.  Abdomen distended but non-tender, nothing else noted.

POCUS saves the day:
Abdomen: lots of free fluid
Cardiac: large pericardial effusion with signs of RV collapse.

He is moved to a monitored area, where an ECG shows electrical alternans and he is found to have a pulsus paradoxus of 20 mmHg.

Diagnosis: pericardial tamponade.  He is admitted to cardiology.  He is ultimately found to have an unrecognized lung mass and the effusion is malignant.

Share your recent great ultrasound cases and we will post them here!  - James