Mount Sinai Emergency Medicine Ultrasound

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

The second session of the 1st International Consensus Conference on Pleural and Lung Ultrasound was held in Pisa, Italy May 11-12.  Ultrasound leaders from across the globe were present, including Mount Sinai’s Jim Tsung. Thwarting recent Icelandic ash clouds, Dr. Tsung teleconferenced in as the the conferences’ first virtual attendee.

Dr. Tsung joined notable faculty including:

• Roberto Copetti
• Mahmoud El Barbary
• Luna Gargani
• Daniel Lichtenstein
• Gerhard Mathis
• Andrea Reissig
• Gino Soldati
• Giovanni Volpicelli

As well as other leaders in thoracic ultrasound imaging. The conference focused on establishing common nomenclature for thoracic ultrasound anatomy, a review of literature published on the topic, and presentations of research by Dr. Roberto Copetti (neonatal & pediatric lung ultrasound) and Jim Tsung (pediatric pneumonia and bronchiolitis).

Read the rest of this entry »

Featuring a bold new cover design, the Russian language translation of the Manual of Emergency and Critical Care Ultrasound is now available!

This book marks the third language for the Manual, which was first published by Cambridge University Press in 2007. The book’s concise focus and many illustrations and images have made it quite popular with physicians worldwide, and additional translations are planned for the future.

Data from the TRUST (Thoracic Rapid Ultrasound in Trauma) study was presented at the fifth EM Congress in Valencia, Spain on 9/17/2009. The project was selected as one of the top 50 abstracts at the conference. Special thanks to Danny Duque, Vicki Noble, and Betty Chang, our co-investigators on the study.

Bret presenting TRUST data

WINFOCUS Singapore faculty and participants- February 2009

Bret Nelson joined the faculty for the WINFOCUS ultrasound course at Alexandra Hospital in Singapore from February 23-26, 2009. There was an incredibly diverse group of physicians participating, as well as the WINFOCUS past president, Luca Neri (who organized the course). The Society for Emergency Medicine in Singapore annual conference followed on the heels of the ultrasound course. It was well-attended by emergency physicians from all over the world.