Point-of-care ultrasound diagnosis of intravascular air after lower extremity intraossesous access

Air Embolism Article

When you come across peripheral intravascular air, take steps to minimize further entrainment of air and migration of air to the heart and lungs.

ASE President supports Point of Care Ultrasound

There is no denying that if I were to suffer a sudden hemodynamic collapse and would wind up in an emergency department, I would want it to be one in which the emergency physicians were fully trained in POCUS (point of care ultrasound) and knew how to apply it to patient care.

– Susan Weigers, MD, FASE, FACEP

ASE President on POCUS

Thanks to Mike Zwank, MD, RDMS, FACEP at Regions for forwarding this.

Arntfield on TEE

We miss having Rob in NYC, but he has certainly hasn’t been slacking off in the depths of Ontarian Polar Vortices.  Here’s the latest from London on Arntfield’s ED TEE protocol.

Arntfield TEE Protocol

Owyang and Meyers Fluid Responsiveness

Passive Leg Raise

Owyang and Meyers sounds like a great east village restaurant (critics rave “you just have to get the foie and cheetos”).  Instead, they’ve published a great systematic review of fluids responsiveness assessment with TTE and passive leg raise in the latest issue of the annals of em.

 

 

ACEP Resolution 27

Resolution 27    

Reimbursement for Ultrasound Performed by Emergency Physicians (as amended)

RESOLVED, That ACEP develop a statement declaring that insurance companies and other payers reimburse emergency physicians for ultrasound studies and services that they perform and interpret as separate and identifiable procedures while providing patient care services in the Emergency Department; and be it further

RESOLVED, That ACEP support efforts to reduce payment denials for appropriately performed and documented clinical ultrasonography.

EVMS OBGYN POCUS ebookTip of the hat to Dr. Blaivas who forwarded the link to this free OB GYN ultrasound ebook. The book is a PDF download.  The authors also maintain a fairly extensive YouTube Channel that is worth a look.
Phil

ACEP Policy Statement on Emergency Ultrasound by External Entities

Approved by the ACEP Board of Directors, June 2014

The American College of Emergency Physicians (ACEP) believes that certification by non-emergency medicine external bodies, organizations, societies or other medical specialties or upon short course completion is inadequate to demonstrate comprehensive training, knowledge, and skill in the practice of emergency ultrasound.

Emergency ultrasound comprises a set of focused applications utilized to diagnose life-threatening conditions, guide invasive procedures, and treat emergency medical conditions. Both residency-based and practice-based pathways exist for emergency physicians to demonstrate competency in emergency ultrasound as detailed in the ACEP policy statement, “Emergency Ultrasound Guidelines.”

Any non-emergency medicine external certification process would impede the use of this critical clinical skill and adversely affect patient care.

ACEP strongly opposes the use of any non-emergency medicine external certification process to validate competency in the use of emergency ultrasound. Furthermore, any such process should not be utilized as a requirement for hospital privileges or credentialing, nor for reimbursement by accountable care organizations (ACOs), managed care organizations (MCOs), the Centers for Medicare and Medicaid Services (CMS) or other third-party payers.