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HEMS US Cynthia Griffin D.O., EMT-P University of Wisconsin - PowerPoint PPT Presentation

Mar 13, 2023 •454 likes •940 views

HEMS US Cynthia Griffin D.O., EMT-P University of Wisconsin Hospital & Clinics MedFlight Fellow 2014 VCU EM Residency Trained Virginia College of Osteopathic Medicine April 22, 2015 CCTMC, Charlotte NC Objectives To make you & US

  1. HEMS US Cynthia Griffin D.O., EMT-P University of Wisconsin Hospital & Clinics MedFlight Fellow 2014 VCU EM Residency Trained Virginia College of Osteopathic Medicine April 22, 2015 CCTMC, Charlotte NC

  2. Objectives • To make you & US BFFs • To review the “Cut by glass method” • To explain the RUSH exam • To review ETT Confirmation using US • To discuss using ONSD for ICP eval • To go over abnormalities in ECHO

  4. @ CMGrffn

  5. AirRescue Volume 2, 2012

  7. • 1 st – you must know anatomy • 2 nd - Probe marker – R or Head • Slice of Glass • Study & Label images

  8. Hemoperitoneum Sns 46% , Spc 94.1% PTX Sns 18.7%, Spc 99.5% RN/EMT Crew w N=293 pts w 211 FAST

  9. • 3 rd rock us

  11. RUSH Protocol

  12. HIMAP

  13. 8 9 1 2 3 4 7 5 7 7 6

  15. Simple 90° turn of the probe

  17. S/S Cardiac Tamponade on bedside ECHO: RA diastolic collapse RV diastolic collapse Dilated non-collapsing IVC

  20. 100mL

  26. Other Exams w POCUS • Intubation: Direct or Static • Ocular: ONSD, Blowout • Wall motion abnormalities • Fxs

  27. 11 studies  969 intubations Sensitivity: 98% (95% C.I. 97-99%) Specificity: 98% (95% C.I. 95-99%) Positive Predictive Value: 99.5% Negative Predictive Value: 93.8% + Likelihood Ratio: 46 - Likelihood Ratio: 0.0157

  29. Tube confirmation 40 s = US 48 s = Auscultation + ETCO2

  31. POCUS = 30 s

  32. ↑ ICP

  36. Fx

  37. Case 1 • EMS “ Pt breathing hard all night” • 50 yo M diaphoretic, breathless, confused • HR 120 RR28 BP 88/50 SaO2 90% • What do we do Doctor?

  39. Case 2 • EMS “ Pt breathing hard all night” • 50 yo M diaphoretic, breathless, confused • HR 120 RR28 BP 88/50 SaO2 90% • What do we do Doctor?

  41. Case 3 • EMS “ Pt breathing hard all night” • 50 yo M diaphoretic, breathless, confused • HR 120 RR28 BP 88/50 SaO2 91% • What do we do Doctor?

  43. Case 4 • EMS “ Pt breathing hard all night” • 50 yo M diaphoretic, breathless, confused • HR 120 RR28 BP 88/50 SaO2 90% • What do we do Doctor?

  45. Summary Ultrasound is changing what we do in the ED and the data supports that US should be used in the prehosp environment There are a bunch of websites to help w US edu It takes time, but if you stick with it, it will blow your mind

  46. Thanks for your attention… • Discussion & Questions

  47. Great Refrences for US teaching • http://www.emergencyultrasoundteaching.co m/ • More references to follow

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