Echo is Arrest Case with @EM_ResUS. Was WEE case by @emcrit….now rest of the story! #FOAMED

So, you’ve been running a code for 45 minutes and your patient keeps going in and out of Vfib and Vtach.  You’ve shocked them more times than you can count and you’ve thrown the kitchen sink at them medication wise.  What do you do?  What do you do?!?!  This can be an extremely frustrating case, because there seems to be no good answer. Check out the Emcrit Wee on this case.
So let’s see how Sam Ghali handles this situation with his magic sound wave machine that shows him pictures of what that stubborn heart is doing.  Would looking at it give clues to what was wrong and maybe guide therapy?  Only one way to find out……click play below!
Also, in this episode, we tell you that our ebooks are now free…..forever.  Spread the word.  They will never cost money again.  The only thing we’re asking for in return is your first born child……or if that’s too much, just give the podcast a 5 start rating and write a review in iTunes.  Actually, now that I think about it, we actually prefer that.  We’ve already got kids.
Thanks!
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US guided injections with @ultrasoundninja, co-director of Sononorway.com.  #foamed

Guiding a needle inside the body with ultrasound is a critical skill.

It makes a tremendous difference, but it’s not always the easiest thing.  It takes some practice, and it takes some time to master.  So that’s why we’ve got a true master to teach you.  Canh Le Nygaard is a GP in Norway and is the Chair of the Norwegian National GP Ultrasound society.  He does an incredible number of injections and has healed with sound more Norwegians than can be counted.
So watch the podcast, go practice, and then watch again.  If you’re a novice, this is a ridiculously awesome video to start with.  If you’re already pretty experienced I’m sure you’ll still get something out of it.  It’s chocked full of great tidbits.
If you want to come meet and learn from Canh in person join us in Norway.  Enjoy!!
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US-guided CPR Part 2. TEE & US=New pulse check. Also, Resus Leadership Academy with @emcrit & @CriticalCareNow

Ok, now let’s finish it off.  We’re about to get a little more controversial that the last post.  But seriously, what do you trust more, your finger or the echo probe in an arrest.  It’s time we just admit how badly we suck at palpation for pulse and use a better tool if we have it.  Of course, as soon as your finger gets better than all the evidence would suggest it is, then fine, trust it. Until then, watch this.
If you really want to get nuts and deliver seriously next level care, at least consider the TEE stuff we’re gonna throw at you in the last part of this podcast.
 
Also, at the very beginning we’re gonna tell you about a new project we’ve created with Scott Weingart and Haney Mallemat.  If you’re interested, sign up at www.resuscitationleadershipacademy.com.  It’s gonna be incredible.
 
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Ultrasound guided CPR Part 1.  How we’re doing it wrong.  #foamed

So listen up people!  You’re doing cardiac arrest resuscitation all wrong!  What’s wrong with you?!?!  Ok, that’s a little harsh.  We’re not really saying that at all.  We just think, based on recent evidence and new technology, that it could be done a little better and we’re gonna explain what we mean.  Accept our humble apologies for the rude beginning.

Also, BIG change to SonoNorway.com.  You all were rather adamant, and you’re getting your way.  The course is being moved from the boat to an incredible location in Oslo.  Go to Sononorway.com for more information.  There are a few spots left, but this is what people asked for, so those spots will be gone super quick.
We’ll have part 2 of this ultrasound guided resuscitation podcast up for you in no time.  Check back soon!
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Quit Mainstemming kids 30% of the time!  #foamed Airway Ultrasound with @pempocus.

We know you’re awesome and you never mainstem intubate children or adults.  Of course, the literature says even the best peds EM trained docs mainstem about 30% of the time, but you’re best of the best.  However, if others are doing this, you should at least watch this so you can “help them”……right?
Enjoy…..
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Endomyometrial Thickness Measurement for Interstitial Ectopic Pregnancy with @ultrasoundREL.  #FOAMED

Wow, that is a mouth full.  Luckily, we have Resa Lewiss, the current chair of the ACEP ultrasound section, to go over this with us.  It came to our attention based on an article that Resa was the lead author on, and to be honest we didn’t know what to do with it.  So we decided we better figure that out.

Also, at the very bottom of this are some show notes for you that you can refer to while listening or afterwards…..whatever floats your boat (does anyone know what that means?).

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Learn with us:  www.ultrasoundleadershipacademy.com
Register:  Cabo Course or Yellowstone Course or Norway

Inkling.com eBook  

iTunes versions if you prefer the iBooks Textbook format:

Volume 1
Volume 2

One Minute Ultrasound Smartphone App for iOS
One Minute Ultrasound Smartphone App for Android

Discussed on this podcast:

Dr Resa Lewiss tells us about interstitial ectopics and how to measure the myometrial mantle to help diagnose this rare disease.

Interstitial ectopics – higher risk for morbidity and mortality but rare.

Risk of interstitial ectopic in 2-4% of all ectopics.

Risk of ectopics 2% of all pregnancies, but  6-16%% of all 1st trimester pregnancies presenting to the emergency department.

Thus risk of interstitial ectopic ~2-3/500 1st trimester pregnancy patients (ish) no prospective studies – so who knows!

<5mm myometrial mantle – call somebody
5-8mm grey area – maybe call somebody – patient specific
>8mm – no worries playa

J Ultrasound Med. 2014 Jul;33(7):1143-6.
Obstet Gynecol Surv. 2013 Aug;68(8):571-8

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