Ultrasound Podcast

Latest Episodes:

RV enlargement in arrest, and how it’s not always a PE Aug 20, 2019

Show notes

While preparing for a recent grand rounds lecture, I uncovered something rather interesting: The fact that the RV can enlarge during cardiac arrest independently of the presence of a pulmonary embolism. It turns out that the data showing RV enlargement as a marker of a pulmonary embolism is actually mostly extrapolated from alive patients (in which it has been shown to be a pretty good marker of submassive and massive PE). There is very minimal data on RV enlargement in arrest in humans, but there are some animal studies that suggest that the RV enlarges in many causes of arrest, including hypoxia and arrhythmias.
Check out the podcast, and the summary of the literature on the PDF below:

PDF Summary Download

This week we talk with @probeme and @ER_Dr_ummer and discuss best practices for US-guided vascular access and cardiac arrest. Recorded live at #Bendfest19! Aug 14, 2019

Show notes

The last day of Bendfest 2019 was bittersweet. I was a phenomenal day of education, idea exchanges and friendship, but also it was the last day. In this summary, I sit down with Justin Cook to talk about his top tips for being a master of the ultrasound-guided vascular access, and I give you a sneak peek of Patrick Ockerse’s phenomenal talk on ultrasound in cardiac arrest. Check it out!

Check out our other ventures:

www.ultrasoundleadershipacademy.com – Online ultrasound fellowship

www.5minsono.com – Short videos on how to perform exams

www.ultrasoundGEL.org – Audio ultrasound journal club

www.ultrasoundoftheweek.com/tools – If you want to learn to create content, definitely check this out.

Jacob sits down w/ @CreaghB & @SonoMojo to talk about #POCUS in shock and pregnancy Aug 07, 2019

Show notes

Day 2 of Bendfest 2019 is drifting further in the past, but that doesn’t mean we can’t relive it! In this interview summary, Jacob sits down with Creagh Boulger and Jenn Cotton and they talk about ultrasound in shock and pregnancy. Here are the salient points:

Creagh Boulger (Ultrasound in Shock)

Mnemonics can be helpful, but not every patient needs the same exam every time.
First step for Dr. Boulger: Is it the pump (cardiac contractility) and/or is it the pipes (Preload)?
Other things can cause shock that aren’t in the typical hypotensive algorithm (Gallbladder, Soft tissue, etc)

Jenn Cotton (Pregnancy)

Don’t get tricked by the hCG! You can have ruptured ectopics at hCG = 0. Additionally, viable pregnancies with hCG levels above the “discriminatory zone” and not visualized on US can still be viable
Our job is to RULE IN uterine pregnancies, not RULE OUT ectopics.
Fertility treatments increase risk of heterotopic ultrasounds
Don’t be scared of performing a transvaginal ultrasound.

Day 3’s summary will be out soon!
If you’re interested in an online ultrasound fellowship, check out www.ultrasoundleadershipacademy.com

Jacob sits down with @jchristianfox to talk about his journey integrating #POCUS into #Medschool Jul 30, 2019

Show notes

Dr. Chris Fox is one of the trailblazers in integrating ultrasound into medical school education. This week, I got the opportunity to interview him and hear a bit of his story, get some tips and talk about the 7th Annual World Congress of Ultrasound in Medical Education. If you want to see a video of the interview, check out our youtube page!
Interested in an online ultrasound fellowship? Check out ultrasoundleadershipacademy.com

Bendfest 2019 Day 1 Summary! Jul 22, 2019

Show notes

A few weeks ago we had a wonderful time in Bend, Oregon during Bendfest 2019. We got some mountain biking in, some hiking in, some river floating in and ate some great food! We wanted to share the choicest pearls from our phenomenal lecturers on some of the topics they covered. Check out the summary of day 1!

Peter Weimersheimer (Cardiac):

Find the beating thing first.
Use lots of gel, and lot of pressure to get your view.
Get your ultrasound beam parallel with the heart.
Start your exam with your patient in the left lateral decubitus position.
Do one maneuver at a time (rotate, fan, rock, etc).
Start with the probe at the clavicle/sternal interface, slide down until you see the heart.
You don’t always need all the 4 views of the heart.
If ventricle is round, subtle hand rotations will fix.
#1 point – Just use bedside echo.

Ben Smith (Aorta, renal)

If you think you see mild hydro, use color flow to differentiate between mild hydro and prominent renal vessels
Scan from the back; the ribs are farther away from each other back there so may get better windows.
We aren’t good at finding the actual ureteral stone, but were pretty good at hydro
For getting past bowel gas when looking at the aorta – start up high where there is less gas (epigastric). Then when you come up on gas, use other hand to apply steady pressure (often 30-60 seconds). Use curvilinear probe, hurts less than the phased array.
Transhepatic view of aorta – not bad for aneurysm, but not great for dissection
We are good at looking at the aorta as long as we can actually see the aorta. Research that show great accuracy of bedside sonographic aorta exam only included studies where the aorta was able to be visualized.

If you are interested in an online ultrasound fellowship, please check out ultrasoundleadershipacademy.com!

Ultrasound Image Review pearls with Patrick Ockerse, MD. Jul 17, 2019

Show notes

This week, we had the pleasure of sitting down with Patrick Ockerse, MD at Bendfest 2019, a 3 day ultrasound event in Bend, Oregon. Dr. Ockerse is the ultrasound director at the University of Utah in Salt Lake City, Utah and part of his job is to review ultrasound images performed in his emergency department. Mike was formerly the ultrasound director in Utah and Jacob has a very similar job as the ultrasound director at the University of Kentucky in Lexington, Ky. This week, we sit down and talk about the errors we most commonly see when performing our image review sessions. Here are some tips:

Basics:

Depth – Make sure that the image you’re trying to see is as big as you can make it. Don’t have any wasted space in your clips or images.
Gain – Make sure your image is bright enough. But don’t over gain!
Exam type – If you’re doing a FAST exam, don’t scan in the “lung” setting.
Video clips – Be conscientious of the clips and images you take. Focus on the thing you want to record and record a long enough clip of it, but also don’t record multiple clips of subpar exams.

Specific exams:

DVT – Make sure that the vein you’re evaluating is actually a deep vein. Deep veins paired, while superficial veins may be solitary. Also, don’t confuse a lymph node for a DVT.
FAST exam – Slow sweeps of the regions your evaluating. Fast sweeps can miss subtle fluid collections. Don’t forget to look at the inferior pole of the kidney/caudal tip of the liver interface on the right side. Be careful with the seminal vesicles in the pelvis.
Intrauterine pregnancy (IUP) – Make sure that gestational sac is actually inside the uterus.
Thorax – Make sure to look at the back of the thorax when evaluating your patient with suspected pneumonia
Aorta vs IVC – To identify the IVC, first find the right atrium then look for the thing coming off of the right atrium. That’s your IVC. Know your left and your right. Most of the time, the IVC will be on the patient’s right. Also, put color flow on it. The less pulsatile one is the IVC.

General

We do quality assurance (QA) to make sure that our ultrasound examinations are the best they can be. We should aim to give negative feedback privately and commend when we see excellence!

Lateral Water bath technique for evaluation of hand infections with Jenn Cotton! Jul 09, 2019

Show notes

We love talking about super advanced ultrasound applications, but its important to make sure we understand the basics. Soft tissue ultrasound probably has a greater effect on patient dispositions and treatment than most of our other ultrasound applications due to the sheer volume of soft tissue infections we see. I recently (virtually) sat down with Jenn Cotton and discussed a technique she developed with Mike Prats for evaluating hand infections. If you need a review on how to evaluate soft tissue infections on ultrasound, check out the 5 Minute Sono abscess vs cellulitis 2019 update video and the 5 Minute Sono necrotizing soft tissue infection 2019 update and if you want to see a video on how to perform the technique we discuss with Jenn, check out our youtube page

Interested in an online ultrasound fellowship? Check out the Ultrasound Leadership Academy

Are you holding the probe correctly? Jul 02, 2019

Show notes

Sometimes we have to get back to our basics and just, make sure we’re holding the probe correctly. This is especially relevant considering we all have new residents this month (It is July, after all!). In this podcast, Cian McDermott sits down with Jacob to discuss his tips for how to hold the probe and how to position yourself to get your best images. Jacob’s favorite tip? Don’t treat the probe like a dirty sock. Check out the podcast to learn more! Interested in an online ultrasound fellowship? Check out

http://ultrasoundleadershipacademy.com/

Jacob sits down with Srikar Adhikari to talk about #ArtificialIntelligence and #POCUS. Jun 17, 2019

Show notes

Is Skynet around the corner? Remember Terminator? That was set in 2029, 10 years away. Maybe that’s a little dramatic, but AI, artificial intelligence, is already present in daily medicine and we’re starting to see it in point of care ultrasound as well. In this episode Jacob sits down with Srikar Adhikari, man, myth, legend of POCUS and they wax extensionally about AI in point of care ultrasound. Education, feedback, accuracy, and the future of AI in POCUS. Join us and learn something instead of letting the computers learn it for you. Want to come scan with us in Bend, Oregon? Go to Bendfest19.com Want to participate in an online ultrasound fellowship? Check out ultrasoundleadershipacademy.com

Current Point of Care Machines Jun 10, 2019

Show notes

This week Mike and Jacob sit down and talk about their thoughts on current point of care machines, including the cart based machines, the laptop machines, and the tablet/phone ultra-portable machines. A lot of the discussion right now is regarding Butterfly and its utility in patient care scenarios. If you want more on the comparison between the Butterfly Is and the Philip Lumify machine, check out this podcast we did a few weeks ago. Also, if you would like to see my review on the new GE Venue Go machine, check out the youtube page.

If you want hands-on time with us and some great didactics this coming July, check out Bendfest 2019! Interested in an online ultrasound fellowship? Check out the ULA!

Our TOPPODCAST Picks

Follow Us

Stay Connected

Related Podcasts

Links

Stay Connected

Our TOPPODCAST Picks

Follow Us

Stay Connected

Ultrasound Podcast

Related Podcasts

1

2

3

4

5

6