Ultrasound First

We previously reported on AIUM’s Ultrasound First initiative back in March. Since then a number of helpful articles have been published in the Journal of Ultrasound in Medicine, each highlighting the utility of ultrasound as the primary imaging modality.

Thus far, topics include:

Sonography in Postmenopausal Bleeding – Steven R. Goldstein, MD

Think Ultrasound When Evaluating for Pneumothorax – Vicki E. Noble, MD

Sonography Should Be the First Imaging Examination Done to Evaluate Patients With Suspected Endometriosis – Beryl R. Benacerraf, MD, and Yvette Groszmann, MD

Sonography of Adenomyosis – Khaled Sakhel, MD, and Alfred Abuhamad, MD

Lung Ultrasound in Evaluation of Pneumonia – Michael Blaivas, MD

Ultrasound-Guided Interscalene Blocks – Andrew Gorlin, MD, and Lisa Warren, MD

Sonography for Surveillance of Patients With Crohn Disease – Kerri L. Novak, MSc, MD, FRCPC, and Stephanie R. Wilson, MD, FRCPC

Sonography as the First Line of Evaluation in Children With Suspected Acute Appendicitis – Leann E. Linam, MD, and Martha Munden, MD

Shoulder Sonography: Why We Do It – Sharlene A. Teefey, MD

Sonographically Guided Enema for Intussusception Reduction: A Safer Alternative to Fluoroscopy – Thomas Ray S. Sanchez, MD, Aaron Potnick, MD, Joy L. Graf, MD, Lisa P. Abramson, MD and Chirag V. Patel, MD

Sonography First for Subcutaneous Abscess and Cellulitis Evaluation – Srikar Adhikari, MD, RDMS, and Michael Blaivas, MD

Sonography in the Treatment of Calcific Tendinitis of the Rotator Cuff – Gregory R. Saboeiro

More articles on best evidence are forthcoming- please check out Ultrasoundfirst.org for more information!

On November 11-12, AIUM will host its first Ultrasound First Forum in New York City.

Ultrasound First

The AIUM recently announced a initiative to increase awareness of ultrasound as the first imaging modality to be considered when radiation exposure and cost are factors.  If you are a fan of the Image Gently campaign from the Alliance for Radiation Safety in Pediatric Imaging, you’ll like this ultrasound-centric vision even more. More information below, including the AIUM’s press release.

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AIUM 2012 Preconference

This year AIUM is hosting its annual conference at the JW Marriott Desert Ridge Resort and Spa in Phoenix, AZ. The first offering by the Emergency and Critical Care Community of Practice was a great success. The conference proper hasn’t even started yet and the sessions have already started off with a bang.

Moderator Bret Nelson organized the session which was attended by Emergency Physicians, Intensivists, Sonographers, Perinatologists, and Primary Care physicians:


Point-of-care ultrasound in the evaluation and treatment of the unstable patient

  • Bret Nelson
    • Introduction- Ultrasound for airway, breathing and circulation
  •  Srikar Adhikari
    • Ultrasound assessment of airway anatomy and intubation
  • Eitan Dickman
    • Thoracic ultrasound: Beyond pneumothorax
  • Anthony Dean
    • Basic cardiac assessments
  • Chris Moore
    • Advanced cardiac assessments
  • Robert Arntfield
    • Transesophageal echo- practical utility in the critical patient
  • Rajesh Geria
    • Vascular assessment- IVC (volume assessment), aorta (AAA, dissection)
  • Betty Chang
    • Ultrasound guidance for bedside procedures
  •  Jerry Chiricolo
    • Putting it all together- ultrasound use in Resuscitation
  • All Faculty
    • Panel Discussion and wrap up

AIUM 2010- Day 3

Another beautiful sunny day. Although some people left for early flights back home, there was still some life left in the conference on Saturday.

Notable events included:

Sinai’s own Henrietta Rosenberg, MD, hosting a meet-the-professor session on sonography of the infant hip

EM/Critical Care track session on the ultrasound evaluation of dyspnea, featuring Anthony Dean, Paul Sierzenski, Vicki Noble, David Bahner, and Jim Tsung.

Scientific session on Emergency Sonography research in the afternoon

Just Images- cardiac ultrasound in the ED and ICU, including contributions by Chris Moore, Alexander Levitov, Jim Tsung, and Erika Kube.

San Diego 2010 Final Thoughts:


The Transcranial Doppler session was great. The best part of the AIUM conferences for me is learning something new and getting outside of my comfort zone. The faculty for the TCD course made the technique look easy. Although you can’t hope to master a new clinical skill in an afternoon, I was inspired to learn more about this technique and how it could impact care in the ED.

Zsolt Garami, director of the TCD Center at Methodist Hospital in Houston, demonstrated the perfect blend of knowledge, technique, wit, and sarcasm to make for a fantastic experience!


The Just Images sessions were really useful. Lots of great cases, and an excellent video of a pupillary reflex from Chris Moore.


The coolest thing I saw was in one of the OB sessions- a 4D/3D plus real-time movie of an ultrasound guided needle sampling of fetal blood cells from an umbilical cord floating in the amniotic sac.  That was pretty cool- and the future for ultrasound guided procedures.

AIUM 2010- Day 2

Another great day for the Emergency and Critical Care track.

8:15 head and neck US

9:45 Emergency and Critical Care Community of Practice meeting

Michael Blaivas was at the helm as the new Chair of the EM/CC community of practice. Bret Nelson was elected the incoming Secretary, and thus took notes. Apparently poor handwriting and the inability to touch type were not obstacles in the selection process.

11:00 clinical sonography – emergency sonography

1:30  transcranial Doppler session

This was an excellent session, with great hands-on instruction by experienced and enthusiastic instructors. They made everything look easy.

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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.

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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