UltraRounds - Dec 10, 2014 @ noon!

Hi Everyone,

In our never ending quest to find the best time for ultrasound rounds (ultrarounds?), we're going to give Wednesdays at noon a whirl. As usual, we'll be digging into the Qpath archives and pulling out the interesting cases we've captured since last time.

Don't miss it!
Wednesday, December 10th, 2014
Noon to 13:00.
Civic - McCoy Room (near the ICU); host site.
General - ICU Conference Room; teleconference.

Cheers,

Scott

Ottawa POCUS Course

Announcing the 2015 Ottawa POCUS Course: Save the date!

See the poster below for more information.
More information will be posted here as it becomes available, including registration info.
If you would like more information, please email POCUS2015@gmail.com.
See you there!

Scott

POCUS Rounds June 17, 2014

Hi Everyone,

Our most recent POCUS rounds is now up!
Check out the "POCUS Rounds" page (top right).
Email me for the password...

Cheers
Scott

POCUS Research

We had a very successful POCUS research year. Congratulations to all the staff and residents on their projects!

Here are the following projects that were presented at our annual DEM research day:

Dr. Mark Taylor (Woo, McInnes, Pageau, Watterson, Thompson, Perry)
Ultrasonography for the prediction of surgical intervention in renal colic patients

Dr. Lindsey Forest (Pageau, Worrall, Calder)
Diagnosis in the Fast Lane: the use of point-of-care ultrasound by the Ottawa Hospital Emergency Physicians for the diagnosis of ectopic pregnancy

Dr. Nathan Hecht (Woo, Hurley, Stitt,  Pageau, Worrall, Reardon, Taylor, Thiruganasambandamoorthy)
Test characteristics of point-of-care ultrasonography for the diagnosis of acute posterior ocular pathology in emergency department patients
Also presented at: CAEP Annual Conference - Ottawa; ICEM Annual Conference - Hong Kong; Canadian Ophthalmalogical Society - Halifax.

Dr. Ashley Krywenky (Pageau, Bidlake, Woo, Spacek, Vaillancourt)
Barriers and facilitators to integrating point-of-care ultrasonography into the emergency medicine clinical clerkship

Dr. Brandon Ritcey (Pageau, Woo, Perry)
Femoral nerve blocks and fascia iliaca blocks for emergency department patients with femoral neck and hip fractures: a systematic review

Other presentations:
Dr. Robert Ohle (McIsaac, Woo, Perry)
Ultrasonography of the optic nerve sheath diameter for the detection of raised intracranial pressure: a systematic review and meta-analysis.
CAEP Annual Conference - Ottawa

Dr. Hasan Alzahrani (Woo, Johnson, Pageau, Millington, Thiruganasambandamoorthy)
Can a simplified two view echocardiogram screen for severe aortic stenosis?
CAEP Annual Conference - Ottawa

Dr. Michael Woo (Bradley, Moore, Liew, Lalonde, Stiell)
Pilot prospective cohort study for the use of ultrasound guided 3 in  1 femoral nerve blocks in a tertiary care emergency department in patients presenting with a hip fracture.
CAEP Annual Conference - Ottawa

POCUS Rounds

Great multi-disciplinary rounds last Tuesday with Critical Care, Emerg, and Cardiology represented!

Bottom lines:

• Look at pleural line to differentiate between cardiogenic vs non cardiogenic B-lines
• Pericardial effusion can appear larger in subxiphoid view
• Need multiple views to determine size of pericardial effusion and sonographic signs of tamponade
• Cardiac tamponade is a clinical diagnosis
• Beware sludge filled gallbladder that can appear like liver and be missed

Want to learn more? Come to POCUS rounds for enlightened multidisciplinary discussion or catch the recorded versions at clinsonoottawa.blogspot.ca

We'll be taking a summer break so next POCUS rounds will be:
Tuesday September 9, 2014 
Civic - McCoy Room (ICU teaching room) with teleconference to General ICU Teaching room
4-5pm

Save the Date!

No indeterminate scans for 1st trimester

Dr. James Worrall explains the differences in interpretation for the primary scans for primary POCUS-EM. In particular, why the safest approach is no indeterminate scans in 1st trimester scanning to rule in pregnancy.

Journal Club May 21, 2014

9:15 at the civic DEM conference room

http://dx.doi.org/10.1016/j.jemermed.2013.11.102

PATIENT PERCEPTIONS OF ULTRASOUND EDUCATIONAL SCANS IN THE EMERGENCY DEPARTMENT

Katja Goldflam, MD,* Rebecca R. Goett, MD,† Resa E. Lewiss, MD, RDMS,‡ Theodore C. Bania, MD,‡ and Turandot Saul, MD, RDMS‡ 

Canadian Conference on Medical Education April 26, 2014

At CCME, we were invited to the Association of Faculties of Medicine of Canada (AFMC) Clinical Skills group meeting to talk about Ultrasonography in Undergraduate Medical Education. We managed to assemble National leaders in this area to provide different perspectives.

 Dr. Andrew Smith (Memorial) - evidence for ultrasound in undergraduate medical education

Dr. Adrian Yee (UVic/UBC) - administration considerations

Dr. Irena Ma (UCalgary) - research in undergraduate ultrasonography

Dr. Michael Woo (uOttawa) - medical student perspectives

In addition we had recorded interviews of Dr. Catherine Nix (UToronto/Ireland) and Dr. Peter Steinmetz (McGill) to talk about their respective programs with an additional presentation by Dr. John Lewis (McGill).

It was a fantastic occasion to learn about how many things in common we have and also the diversity in the programs to accomplish the same goal of integrating ultrasonography into undergraduate medical education. Hopefully this will continue the momentum for a national curriculum!

I hope you enjoy the video!

Thank you to the Class of 2016 uOttawa.

EM Ultrasound Journal Club, April 23

9:15 am at the Civic

American Journal of Emergency Medicine 2014 Feb 17;

Towards a less invasive approach to the early goal-directed treatment of septic shock in the ED.
Daniele Coen, Francesca Cortellaro, Simone Pasini, Valeria Tombini, Angelica Vaccaro, Lorenzo Montalbetti, Michela Cazzaniga, Daniele Boghi

PMID: 24666743

POCUS Rounds, March 27, 2014

Hi Everyone,

I've posted the video from our recent multidisciplinary POCUS rounds, which were help on March 27, 2014. I've posted the first 2 cases that were discussed. Sorry for the audio quality, we're working on it!

Keep an eye on the calendar (right side of screen) for the next rounds, likely early June. Hope to see you there!

The video is available under the "POCUS ROUNDS" tab above, or here.

This part of the blog is password protected, so email me for the password...

Scott

TEE in ICU

Hi Everyone,

Here's a talk I gave at the American Institute of Ultrasound in Medicine conference in Las Vegas.

It's about TEE in ICU, but it applies to all acute care environments (ED, OR, etc.)


Scott

Journal Club - April 10, 2014 - Room DM178 - 10am

In keeping with our pediatric month....

The effect of point-of-care ultrasonography on emergency department length of stay and computed tomography utilization in children with suspected appendicitis.

Elikashvili I, Tay EE, Tsung JW

Academic Emergency Medicine 2014;21:163-170.

Journal Club April 2, 2014

Civic, coughlin room

10:15 am

Bedside Ultrasound Diagnosis of Nonangulated Distal Forearm Fractures in the Pediatric Emergency Department

Frances M. Chaar-Alvarez, MD, MSc,* Fred Warkentine, MD, MSc,Þ Keith Cross, MD, MSc,Þ Sandra Herr, MD,Þ and Ronald I. Paul, MDÞ

 (Pediatr Emer Care 2011;27: 1027Y1032)

 

Saving images for Q-Path

A short video to help you get started with Q-Path.

Cardiology Rounds FOCUS - You're invited!

Cardiology Heart Institute Rounds will
be available via Videoconferencing in the CCU Conference Room at the
General Campus on Wednesday, February 12th, 2014 at 7:30 am.
Live at Foustanellas Heart Institute

Presenter:   Dr. Katie Giles

Topic:         Focused Cardiac Ultrasound:  A Review

Q-path Go Live Date Set

Q-path goes LIVE Tuesday February 18, 2014!!

Ultrasound-guided central venous catheterization tutorial

POCUS Rounds!

Hi Everyone, I'm pleased to announce that the screencast from our inaugural POCUS rounds is now posted. A very interesting case was presented by myself and Dr. Woo. In accordance with TOH policy, any talk where specific cases are discussed in detail (even though no names are mentioned and all US images are de-identified) will be password protected. Please click on the link at the top called "POCUS Rounds". Email me for the password. Enjoy! Scott

Journal Club February 5, 2014

Here's the article for this week's journal club:

Am J Emerg Med. 2012 Oct;30(8):1414-1419.e1.
doi: 10.1016/j.ajem.2011.10.017. Epub 2012 Jan 4.
Role of inferior vena cava diameter in assessment of volume status: a meta-analysis. Dipti A, Soucy Z, Surana A, Chandra S.

Lung Ultrasound; Anesthesia Winterlude Meeting Jan 27, 2014

Hi Everyone,



Here's a talk I gave at the Ottawa Anesthesia Winter Meeting this weekend on lung ultrasound...

Scott

Troubleshooting the machines

The following document describes common troubleshooting solutions with the machines in the ED.

Troubleshooting - January 21, 2014

Image Archiving and Quality Assurance for the ED

The following documents describe the image archiving requirements and quality assurance process for the Department of Emergency Medicine.

DEM Image Archiving Requirements for PoCUS scans - Jan 2017

2. Quality Assurance Process for Training Scans (PDF)
3. Quality Assurance Process for Clinical Scans (PDF)
4. Quality Assurance Codes (PDF)

Q-path for the ED

Sending your scans from machine to Q-path (1:27)

Q-path - ED - Getting Q-path onto MyTOH (2:00)

Q-path - ED - Using basic filters (2:27)

 

Q-path - ED - Essential fields to complete (3:13)

Q-path - ED - How to split studies (3:40)

 

Q-path - ED - Completing worksheets (4:53)

 

Q-path - ED - What to do with training scans (3:45)

Q-path - ED - What to do with clinical scans (2:06)

 

Q-path - ED - How to view statistics (1:07)

Q-path - ED - How to annotate (2:09)

 

Q-path - ED - How to export studies (1:49)

Setting up to scan in the ED

 Setting up to scan with Zonare US Machine (1:36)

 

Setting up to scan with GE LogiqE US Machine (1:55)

How to use the M-turbo machine - Basics

For new users out there, a quick tutorial on how to get started using the M-turbo...

Qpath ICU Intro Video 5 - Advanced Qpath

And finally, Part 5.
Congrats on making it this far.
Scott

Qpath ICU Intro Video 4 - Quality Assurance

Part 4...

Qpath ICU Intro Video 3 - Qpath Basics

Part 3...

Qpath ICU Intro Video 2 - US Machine Use

Part 2...

Qpath ICU Intro Video 1 - Qpath Flow

Here's the first in a 5-part series of short introductory videos on how to use Qpath, specifically as it relates to the ICU environment. There will be significant overlap with Qpath use in the ED, but with some important differences. Stay tuned for another series of videos specific to ED application.

Qpath, by the way, is a wireless image archiving system that facilitates POCUS learning (with easy image review and portfolio building), and improves patient safety (by allowing quality assurance, archiving, etc.).

Enjoy!

Scott

Clinical Sonography and ICU...

Hi Everyone,

I'm very excited to be part of the newly re-branded Clinical Sonography Blog at TOH, big thanks to Dr. Michael Woo and Dr. James Worrall.

I'll be posting content with a specific focus on the ICU branch of point-of-care ultrasound, and will be collaborating with the ED group as well as other users of POCUS. A few announcements / reminders:

1) Remember POCUS rounds will be next Thursday:
Topic: A case of chest pain - Illustrative POCUS in the ED to the Floor to the ICU
Date: Thursday January 23, 2013
Time: 4:00 - 5:00 pm
Location: Coughlin Room (EM Conference Room) - Civic Campus - ground floor near F elevators (melrose entrance)

For those who can't attend - don't worry! A recording of the talk with be posted on this blog. In future, the rounds will be teleconferenced to the General.

2) Twitter
Twitter fans can follow this blog at: twitter.com/ClinSonoOttawa 

3) Facebook
Facebook users can follow this blog at: www.facebook.com/ClinSonoOttawa 

4) Qpath
There will be lots of info forthcoming about Qpath, our new hospital-wide wireless archiving system for POCUS.

Thanks everyone, and please don't hesitate to contact me with any questions...

Scott

Welcome to ClinSonoOttawa!

We are changing the name of this blog!

To encourage collaboration with other departments at the University of Ottawa, this blog will be renamed.  Look for lots of great stuff in 2014!