AIUM 2010- Day 1

Thursday was a great day for the EM/Crit Care track.

Not sure what happened in the AM – I was on a plane – not on a boat – on a plane!

The hands-on vascular access course was held in the afternoon.  The opening lecture covering short and long axis approaches by Jason Nomura was an excellent example of clear, concise presentation of complicated information.  Clearly, Jason has mastered the zen of well…presentation zen.  I’m sure no one in that room had a hard time remembering the importance of distinguishing the tip of the needle from the shaft after his talk.

The day ended with a Just Images session presented by Anthony Dean and Chris Moore titled “Patients in Shock.” Fascinating clips of patients with pulmonary embolism, atrial myxoma, tamponade, dissection, and more.

Mount Sinai’s Director of Pediatric Radiology, Henrietta Rosenberg presented data on the use of ultrasound in pediatric hip evaluations this afternoon as well.

Limited Focused Point of Care Ultrasound

As the ultrasound fellow, I have the privilege of scanning with the ultrasound faculty, all of our residents and all of our non-ultrasound faculty.  It is so refreshing to have such a variety to work with.  At times, the non-ultrasound faculty will bring issues to light that neither residents nor ultrasound faculty would.
On my most recent scanning shift, one of our faculty ended every encounter with a reassurance for the patient that “absolutely everything is normal.  Your heart is entirely normal.  All of your organs are normal.  You will live forever.”  The patients laughed and appreciated his humor, but each time, a little part of me died.  As soon as he stepped out of the room, I followed up with “Yes, Dr. X is a riot.  However, you should know that the ultrasound study we are doing today is limited and really looking to answer very focused questions.  This is not a comprehensive exam.”

Being scanned can be reassuring to patients.  You are taking the time to do  something that they don’t normally have done by their PMD, but your patients’ report of the results of the studies can be misconstrued by the patients themselves, their family, their providers, your colleagues in the ED, OB, Radiology.  So, when you are scanning your patients and you have answered your very focused questions for yourself, please, please save the humor for the next thought and let your patients know that this is not a comprehensive ultrasound, but a study designed only to answer very focused questions”.

AIUM 2010- preconference

Michael Blaivas organized an exciting preconference course on evaluation of the acutely decompensating patient.  Bret Nelson (speaking about vascular catastrophes) and Jim Tsung (describing the nuances of this evaluation in the pediatric patient) were among those presenting.

Faculty from emergency and critical care backgrounds gave cutting-edge presentations and the feedback from registrants was excellent. Faculty and their lectures after the break!

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