TEE in the ICU: ECMO Management

Here at Western we use a fair amount of TEE in resuscitation in the ICU, the ED and the trauma bay.  The below video highlights the utility of seeing the heart and guiding procedures in the context of a complex critically ill patient receiving extra-corporeal membrane oxygenation (ECMO).  This is a “photo essay” so there is no sound (your volume isn’t broken!).  We hope to publish more or our illustrative cases that demonstrate the value of TEE at the bedside for your critically ill patients.  Stay tuned.

CRUS Course 2017 – Expanding POCUS Horizons

 

 

A sold out CRUS 2017 brought new teaching strategies and continued legacy of training cutting edge point-of-care ultrasound techniques to a broad cross section of physicians.  Residents and consultants from 8 different specialties took to University Hospital in the middle of August to begin the journey to ultrasound mastery in point-of-care techniques such as lung, cardiac and abdominal ultrasound.

This course marked the introduction of a series of new innovations. We unveiled a new 3rd day of simulation enriched ultrasound teaching, lead by Dr. Rob Leeper.  We also launched an inaugural retention strategy following the course that will allow participants to continue to receive mentorship and support following the course to ensure they sustain and grow their skills.

Timing and location of CRUS 2018 to be announced but please stay tuned and check http://www.resus.us regularly.

See a full repository of images from the course here.

Emergency Medicine Courses : ‘Introduction to POCUS’ & ‘Introduction to Extended Applications’ Ring in the 2017 Academic Year

The Division of Emergency Medicine 2017-2018 academic year has kicked off with our annual educational showcase in POCUS. With 32 participants from across Canada, including undergraduates from several institutions, resident trainees in EM, Peds EM and Vascular Surgery, as well as local community physicians, the day was bound to be great. Concentrating on the fundamental applications, and this year’s addition of thoracic POCUS, attendees experienced a flipped classroom and a 2:1 participant:instructor ratio allowing maximal probe time for all.

This year also marked our inaugural ‘Introduction to Extended Applications in POCUS’ for local Faculty and incoming resident trainees. Featuring bedside scanning and image interpretation sessions, participants stepped into the realm of POCUS applications for DVT, gallbladder, renal, extended cardiac and thoracic assessments. All will follow up this educational day with a one-month rotation in the ED honing their skills with clinically based scans in these applications.

A huge thank you to our dedicated @emergencylondon instructors, our amazing POCUS Faculty for all of their content development and delivery, the organizing and leadership prowess of Dr. Heather Hames, the support staff at CSTAR, vendor support from Sonosite and Phillips, and of course all of our volunteer models. The team effort made this an awesome educational event for all.

We are already looking forward to next year!

 

The medium to success

Dr. Myslik helping to target an interface

EM POCUS Fellow, Dr. Scott Brady pointing out areas of interest

Dr. Hames at the bedside

Dr. Liz Haney – eager to point out pertinent landmarks

Dr. Haney offering some scanning tips

Dr. Hames assists with pelvic free fluid assessment

EM POCUS Fellow, Dr. Barbara Tatham teaching with a smile

All smiles as the POCUS images become demystified

Dr. Behzad Hassani beginning the journey into cardiac scanning

Dr. Marcus VanAarsen – EM Resident Instructor

Happy Scanner. Happy model.

A steady hand scanning the pelvis

Dr. Myslik demystifying the artifacts of lung ultrasound

Dr. Roebotham pointing out pleural vs intra-peritoneal fluid

Dr. Mary Fotheringham supervises a successful pelvic scan

Dr. Hames ensuring perfect LUQ scanning technique

Dr. Drew Thompson reinforcing pertinent findings

Dr. Myslik teaching with his relaxed style

Dr. Mary Fotheringham, EM Faculty

Super set-up at CSTAR

Off to a successful start with the probe

Dr. Coome and Dr. Hassani impress with the multi-media instruction

Dr. Roy Roebotham supervising at the bedside

Gaining confidence with the probe.

Canadian Resuscitative Ultrasound Course – Registration OPEN!

The 8th Annual Canadian Resuscitative Ultrasound Course is now OPEN for registration.

http://www.resus.us

The 2 day course (with the option of a 3rd half-day) is being held on August 16th, 17th (and 18th) 2017 at the sophisticated CSTAR facility at University Hospital in London, Ontario.  This is the biggest and most comprehensive course of its kind offered in Canada. It is ideal for any clinician involved in resuscitation, such as intensivists, emergency physicians, anesthesiologists or internists.

In the core 2-day course, we emphasize resuscitative ultrasound in the following domains:

-critical care echocardiography
-lung and pleural ultrasound
-abdominal free fluid
-ultrasound guided vascular access (central, peripheral and arterial lines)
-DVT

For those who wish to stay for the 3rd day, a half-day ultrasound enriched simulation experience run by our local sim experts.

NEW this year – we have a new “retention” package that is looking to help those physicians working without much ultrasound mentorship to retain their skills after the course through regular video conference sessions for the year following our course.  Be sure to check out all the different registration options on our course website.

Introduction to ED Point of Care Ultrasound 2017

 

The Division of Emergency Medicine is once again pleased to host its annual “Introduction to ED Point of Care Ultrasound” course on July 6th, 2017.

This course will emphasize  fundamental techniques in image acquisition and interpretation and  7 indications of point of care ultrasound in the ED. Course content is aimed at practitioners who are beginning their pathway to competence in point of care ultrasound.

Topics covered will be:

• Abdominal : Presence of intra-peritoneal fluid? (Yes/No)

• Abdominal : Presence of abdominal aortic aneurysm? (Yes/No)

• Subcostal Cardiac : Presence of pericardial fluid? (Yes/No)                                                  Cardiac activity during arrest? (Yes/No)

• Pelvic : Presence of an intra-uterine pregnancy? (Yes/No)

• Thoracic: Presence of pneumothorax (Yes/No)                                                     Presence of a pleural effusion (Yes/No)

The course will feature an outstanding faculty to learner ratio for hands-on sessions as well as innovative image interpretation sessions.  These small group sessions emphasize image interpretation skills and serve as intimate venues to reinforce clinical integration pathways.

Course director is Dr. Heather Hames. Bedside instructors will include faculty from within the Division of EM’s experienced group of point of care sonographers.

If you have interest in attending as a participant please contact us via email at westernsono@gmail.com (please include Emergency Course in subject line).

Last years course filled up quickly so please contact us if interested.

 

Some pics from our previous courses can be found here.