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ACEP Ultrasound Section

  • December 2016 Newsletter Highlight

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    Tips & Tricks: Volume Status - Using the Internal Jugular Vein 

    Central venous pressure (CVP) is crucial for evaluating the patient’s intravascular volume and hemodynamics, which has important indications on management for sepsis, congestive heart failure, pulmonary edema, trauma, and surgery.1-5 Over or under fluid resuscitation can both be detrimental to critically ill patients or those with cardiovascular diseases.1-3 The gold standard was invasive monitoring with a central venous catheter, but due to the procedure’s inherent risks and potential to delay resuscitation, there has been ongoing research for noninvasive methods.1,4,6,7 Sonographic measurement of the inferior vena cava (IVC) has been widely studied and accepted as a tool to assess intravascular volume status.2,8-10 Multiple studies have demonstrated that respiratory variations of IVC measurements at 2cm from the right atrial-caval junction reliably reflects the central venous pressure.2,8-10 However, this technique is limited by body habitus, bowel gas, ascites, surgical scars, and wound dressing, thus providers have been searching for alternatives.3,6,8

     

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    Point-of-Care OB Ultrasound iBook 

    A product of an ACEP ultrasound section grant, the new ACEP Point-of-Care OB ultrasound book is bursting with crucial information that will be a huge aid to any bedside provider. This book bypasses the traditional method of book publishing by being available exclusively in iBook format. Besides the rapid dissemination and the price tag of $0, another asset of the book is its abundant multimedia. The authors report that their book contains 967 illustrations and 10 hrs of mini-lectures, which function to help augment the stellar literature review and instructional content already present. This iBook is available on Apple devices, is free to download, and will make an excellent addition to the bedside sonographer’s armamentarium. 

    Ultrasound GEL podcast

    Ultrasound G.E.L. (Gathering Evidence from the Literature) is a new medical podcast featuring reviews of recent studies in point-of-care ultrasound (POCUS). Especially as more and more indications for ultrasound are discovered, it is important to keep abreast of the available literature so we can use ultrasound safely and appropriately to help our patients. The goal of the podcast is to disseminate an evidence basis for POCUS. The podcast reviews a single article every two weeks and attempts to briefly summarize the study and provide take-home points that you can bring to the bedside. The podcast is available on iTunes, and summary notes and infographics can be found on the website: www.ultrasoundgel.org. While there are many high quality ultrasound podcasts out there, most require your attention to images and videos. Here is one that you can (safely) listen to on the way to work.

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