The AHRQ recently published an update to its landmark 2001 report, Making Health Care Safer: A Critical Analysis of Patient Safety Practices (AHRQ Evidence Report No. 43). This report advocated evidence-based practices such as root cause analysis, hand hygiene, ID bracelets for high risk patients, and time-outs prior to procedures.

The 2013 update analyzed 41 patient safety practices and identified 22 which were deemed ready for adoption. Ten were selected as “strongly encouraged” for adoption based on the strength and quality of evidence. Number nine on that list was “Use of real-time ultrasound for central line placement.”

A special supplement to the March issue of Annals of Internal Medicine features articles related to many of these patient safety strategies, and is available for free online.

Looking through the top ten list, most interventions are implemented at most major hospitals, and JCAHO surveyors track adherence to guidelines such as these. Now that ultrasound use has made the top ten in two iterations of these AHRQ safety practices, it may be more difficult to argue that lack of availability or proper training absolves providers of the need to provide this service.

This symposium is always worth the trip.  See you there.

It’s been out awhile now, but if you haven’t seen it yet, take a look at Mike and Matt’s Introduction to Bedside Ultrasound.  The ultrasound pocast guys have released this excellent overview of point of care ultrasound through the iTunes Store.  This is certainly convenient as most of us have 3-12 iDevices on our person at any one time.  Caveats are that this means that it is available only on an iPad using iBooks 2 or later, and ios 5 or later.  Right now it is $29.99.

There is a lot of good content, but I think the best chapter in the book, is probably the RUSH chapter. :)

Were looking forward to the first citywide critical care ultrasound meeting. The idea for this gathering grew out of discussions between ED and ICU folks interested in critical care ultrasound who wanted to share experiences, interesting cases and ongoing research that would benefit from multicenter study.

Date: January 3, 2013
Time: 5pm
Location: 3 E 101st Street, Second Floor Emergency Medicine Conference Room New York, NY

The 9th Edition of Advanced Trauma Life Support(ATLS) has incorporated some important changes, one of which directly impacts the world of point-of-care ultrasound. There is increased emphasis on the FAST examination, and Diagnostic Peritoneal lavage (DPL) is now optional. According to the ATLS 9th Edition Compendium of Changes,

Either DPL or FAST must be taught during the surgical skill station as a method of evaluating the abdomen as a source of hemorrhagic shock

DPL was a required skill station in the ATLS 8th Edition; it is now optional.

Further Reading:

• McKenney M, Lentz K, Nunez D, et al. Can ultrasound replace diagnostic peritoneal lavage in the assessment of blunt trauma? J Trauma. 1994 Sep; 37(3):439-41. (PMID: 8083906)
• Farahmand N, Sirlin CB, Brown MA, Hypotensive patients with blunt abdominal trauma: performance of screening US. Radiology. 2005 May; 235(2):436-43. (PMID: 15798158)