Mount Sinai Emergency Medicine Ultrasound

On August 20-21, King Chulalongkorn Hospital Memorial Hospital was host to the WINFOCUS course:
Essential Ultrasound Guided Invasive Procedures in Emergency and Critical Settings

Dr. Suthaporn Lumlertgul was the director of this course, held at the hospital’s cutting edge surgical training center. Faculty including Mount Sinai’s Bret Nelson, as well as Luca Neri (past president of WINFOCUS), Yuen Chi Kit, Henry Cheng and Mok Ka Leung.

Left to right: Luca Neri, Bret Nelson, Suthaporn Lumlertgul, Henry Cheng, Mok Ka Leung, Yuen Chi Kit

The course covered ultrasound guidance for procedures such as venous access, pericardiocentesis, thoracentesis, nerve blocks, foreign body localization, and others. Physicians from many countries were in attendance.

Upcoming WINFOCUS training courses around the world are listed here.

The Adriatic Vascular Ultrasound Society will host its 7th annual meeting and CME conference September 23-25 in Montecatini Terme.

The official language for the conference is English, and it will be held in Tuscany!

This is an EFSUMB accredited Euroson school event. For more information please visit here.

As promised, here are selected references from today’s talk on Airway Management Mythology. Thanks to the organizers of the International Conference on Emergency Medicine (ICEM) for the invitation to speak.

Some of the topics discussed are supported by plenty of evidence (ie the use of RSI as an intubation technique), some were simply fun to discuss (holding your breath while intubating) and some remain quite reasonably controversial (the use of etomidate for RSI in sepsis).

I highly recommend visiting Dr. Reuben Strayer’s blog for a brief and enlightening discussion of the use of rocuronium for RSI. Also, Dr. Scott Weingart’s EMCrit blog and podcasts are an excellent source for ED critical care topics. Finally, The Airway Site contains links to key airway management references as well as information on the Difficult Airway Course.

Selected References:

• Farmery AD, Roe PG: A model to describe the rate of oxyhemoglobin desaturation during apnoea. Br J Anaesth 1996; 76:284-91
• Naguib et al. Optimal dose of succinylcholine revisited. Anesthesiology 2003; 99:1045-1049
• Bozeman et al. A comparison of rapid sequence intubation and etomidate-only intubation in the prehospital air medical setting. Prehosp Emerg Care: 2006; 10:8-13
• Sackles et al. Airway management in the emergency department: a one-year study of 610 tracheal intubations. Ann Emerg Med 1998; 31:325-332
• Li J et al. Complications of emergency intubation with and without paralysis. AJEM 1999: 17(2); 141-143
• Mallon WK et al. Rocuronium vs. succinylcholine in the emergency department: A critical appraisal. JEM 37(2); 183-188
• Strayer RJ. Rocuronium vs. succinylcholine revisited. JEM 2010 Apr 22. [Epub ahead of print]
• Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): an observational study, Lancet 369 (2007), pp. 920–926.
• Bobrow et al. Passive oxygen insufflation is superior to bag-valve-mask ventilation for witnessed ventricular fibrillation out-of-hospital cardiac arrest. Ann Emerg Med. 2009;54:656-662.
• Brimacombe JR and Berry JM. Cricoid pressure. Can J Anaesth. 1997 Apr;44(4):414-25

Here are some key references from today’s lecture on Status Epilepticus at ICEM:

FERNE’s seizure and status epilepticus management guide

Key practice guidelines related to seizures:

Special thanks to Professor Andy Jagoda (Department of Emergency Medicine, Mount Sinai, New York)

We are pleased to present our annual critical care ultrasound pre-conference course at the Clinical Decision Making in Emergency Medicine symposium in Ponte Vedra, Florida on June 23. Each year this intensive, hands on course features ultrasound faculty from across the country working in small groups with live models and plenty of hands-on scanning time.

Highlights of the four-hour course include:

1. Cardiac ultrasound
2. Thoracic ultrasound
3. Ultrasound for venous access
4. Assessment of the hypotensive patient

Faculty for this year’s course include:

• Bret Nelson, MD, RDMS (course director)
• Phillip Andrus, MD
• Petra Duran, MD
• Daniel Duque, MD, RDMS
• Joe Wood, MD, JD, RDMS