The American Institute of Ultrasound in Medicine had their 2013 Annual Meeting in New York.  Several sessions were live tweeted by myself and others.  It was an interesting meeting for several reasons.  I was able to sit in on the Bioeffects committee meeting and participate in several interesting discussions.

A pre-convention session on education in ultrasound during medical schools was created and used to discuss the topic, @SonoMedEd.  This was coordinated in part by @EDUltrasound. Also during the meeting I had the chance to meet @MarcoAlvarez in real life.

There was a hands on workshop on Ultrasound Guided Vascular Access co-sponsored by the Emergency Medicine-Critical Care and Interventional Radiology Communities of Practice (AIUM’s version of interest groups/sections).  The short voiced over lecture will be voiced over and posted later.

Here is a transcript of the Twitter feed for #AIUM13 with some informational graphics from Symplur.

Here is a transcript of the

Was one of the faculty for a simulation day with some lecture stations.  The station I had was a short lecture on the setting up of emergent transcutaneous and transvenous pacing followed by some hands on.  Figured I would record the lecture and post it up for whoever was interested.  I did have to put in some echo guided pacemaker insertion clips since I was giving the presentation.

A side note some of the discussion points may not be applicable depending on what kind of equipment your facility regularly stocks.

I recently had the chance to attend the American Institute of Ultrasound in Medicine’s Ultrasound First Forum.  This was held on November 12, 2012 in New York.  In full disclosure I did attend as a representative of the AIUM as an invitee.

Members from different societies and groups attended this forum to discuss medical ultrasound and how it can be promoted as a first line diagnostic therapy when appropriate. The thought of ultrasound first is to use a dynamic imaging modality that has no ionizing radiation and can provide the diagnostic information in many cases.

The discussion focuses on using ultrasound rather CT scans or MRI in cases where appropriate.  Examples were given of female pelvis pain where ultrasound was more diagnostically appropriate and informative then CT scanning.  Musculoskeletal complaints that could be evaluated dynamically, more thoroughly, and with better resolution with ultrasound compared to the static MRI were also given.  These discussions all had merits and we heard from medical organizations, patient advocacy groups, and practitioners about why ultrasound should be considered before some other imaging modalities.

I agree that we should consider ultrasound before other imaging modalities such as CT and MRI when appropriate and available.  That is the key point that has to be kept in mind.  When ultrasound is an appropriate test it should be considered first.  It does not mean it always has to be the first test, but considered and if appropriate be the first test.

It also depends if you have the equipment and personnel to perform and interpret ultrasound in some of these situations.  We are leaders in our areas of medical expertise; but there is a variability in ability and resources across the country and the world.  Not every hospital in every corner of the world can provide ultrasound in all its myriad forms and applications.  In some areas ultrasound may not be the best first choice due to limitations in equipment, skill, personnel or other factors.

While I am an ultrasound evangelist and firmly believe in the technology and its role in patient care I also do recognize that there can be limitations in making ultrasound first even when appropriate, at least for today.

Here are links to the Ultrasound First site with the Sound Judgement series from JUM and AIUM.

Here is the collection of the tweets using the #US1st hashtag during the forum.

PS: As a side note ultrasound guidance for vascular access was also discussed at the forum. The AIUM Practice Guideline on US guidance for vascular access is forthcoming, I was able to see a draft at the forum.  If you have ultrasound and are performing an non-crash IJ there is no reason to not use ultrasound.

A recent article was published in the Journal of Ultrasound in Medicine regarding non-pathologic abdominal free fluid in males.  If you read only the abstract and don’t delve into the study the wrong conclusions can be drawn.

Short video reviewing the key points of the article and some example images to highlight key points.

Trying a little something different with the video posted on YouTube to see if this makes it easier for people to view the videos.  Let me know what you think in the comments.

The article is online at the Journal of Ultrasound in Medicine at http://www.jultrasoundmed.org/content/31/10/1527.abstract

This is a short video recording about the Ultrasound education research that I am presenting at the American College of Emergency Physicians 2012 Research Forum. Click on the image to play the video.

There was a recent letter published by Reusz G et al in the Canadian Journal of Anaesthesiology about the appearance of the needle tip during ultrasound guided vascular access.  I agree with some of their points; not earth shattering findings.  But I do think they missed an important point when it comes to peripheral vascular access.

This short video discusses the findings of the paper, my thoughts, and some examples. Click on the image to play.