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

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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

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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

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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
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@ CMGrffn

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AirRescue Volume 2, 2012

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  • 1st – you must know anatomy
  • 2nd - Probe marker – R or Head
  • Slice of Glass
  • Study & Label images
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Hemoperitoneum Sns 46% , Spc 94.1% PTX Sns 18.7%, Spc 99.5% RN/EMT Crew w N=293 pts w 211 FAST

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  • 3rd rock us
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RUSH Protocol

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HIMAP

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Simple 90° turn

  • f the probe
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S/S Cardiac Tamponade on bedside ECHO: RA diastolic collapse RV diastolic collapse Dilated non-collapsing IVC

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100mL

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Other Exams w POCUS

  • Intubation: Direct or Static
  • Ocular: ONSD, Blowout
  • Wall motion abnormalities
  • Fxs
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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
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Tube confirmation

40 s = US 48 s = Auscultation + ETCO2

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POCUS = 30 s

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↑ICP

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Fx

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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?
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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?
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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?
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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?
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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

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Thanks for your attention…

  • Discussion & Questions
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Great Refrences for US teaching

  • http://www.emergencyultrasoundteaching.co

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  • More references to follow