Ultrasound GEL

In our second in the series of Bonus Cuts, Zach and Mike interview the illustrious Ryan Gibbons for his take on arthrocentesis and a discussion of his research in the field. What an exciting joint venture! https://www.ultrasoundgel.org/133

What do we do with IVC's in kids?! The GEL Jr squad tackles a fascinating article that might have the answer. These authors looked at the Inferior Vena Cava collapse duration in children with dehydration. Will this novel measurement help with figuring out who needs IV fluids? https://www.ultrasoundgel.org/132 https://pubmed.ncbi.nlm.nih.gov/32530838/

Part 2 of this Special Edition episode with Larry Istrail, author of the POCUS Manifesto. More great talk about POCUS, the physical exam, and ultrasound research. https://www.ultrasoundgel.org/131

In this Special Edition episode, Mike and Creagh interview physician, entrepreneur, and author Larry Istrail discussing his recent book The POCUS Manifesto! Awesome discussion of the ups and downs of implementing, teaching, and researching POCUS. Part 1 of 2. https://www.ultrasoundgel.org/130

If you take care of neonates, the last thing you need to worry about is vascular access! In this episode the GEL Jr. team discusses an article on using POCUS to confirm central catheter placement. Can it save these babies a few xrays? https://www.ultrasoundgel.org/129 https://pubmed.ncbi.nlm.nih.gov/35152306/

This clever study questions which cardiac view is best to obtain during a cardiac arrest. By using a simulated arrest scenario on living non-cardiac arrest patients, they compare the subxiphoid window and the parasternal long axis view in terms of speed and image quality. https://www.ultrasoundgel.org/128 https://pubmed.ncbi.nlm.nih.gov/35065867/

Jugular venous distention (JVD) is a classic physical exam finding taught for ages, but assessing it can be a challenge. Can ultrasound do a better job and therefore offer a non-invasive evaluation of the patient’s right heart pressures? This goal has been the pursuit of many ultrasounds before. This time we have a new vessel to assess and a nice reference standard (right heart cath)! https://www....

This is a Special Edition podcast which features the winner of a competition at the recent SAEM Sonogames! The challenge was to create the best infographic for a POCUS article of the team's choice. The winning team was from Boston Medical Center. This podcast is a brief discussion of the article and the graphic this talented team created. https://www.ultrasoundgel.org/126 https://pubmed.ncbi.nlm.n...

In the first of our new series of author interviews, hosts Zach Risler and Mike Prats interview the illustrious Felipe Teran. They discuss Felipe's take on our coverage of the Quantitative LV Function in PEA article (ep 119) as well as thoughts on ultrasound and cardiac arrest research in general. https://www.ultrasoundgel.org/125

In this episode, Mike and Jacob dive into an important intersection of musculoskeletal and procedural ultrasound - the ultrasound-guided arthrocentesis. People have been doing arthrocentesis without the help of ultrasound for a while, and most would agree it is feasible. BUT what about those smaller joints - like the wrist, elbow, and ankle? Perhaps that is where the greatest benefit would be in m...

Intussusception is a big deal and an area where POCUS can potentially make a difference. The literature has been promising, but there hasn't been any definitive studies...until now? The GEL Jr hosts dive into this impressive prospective, multicenter, non-inferiority study and (much like an air enema) they try to get to the bottom of this question to reduce our impacted uncertainty. https://www.ult...

Ultrasound has been a friend to central venous catheter placement for a long time. It's always there to make sure you are putting that line in the right place without causing problems. While this has been standard for internal jugular lines for years, it is only more recently that this has been proposed for subclavian lines. There is now ample literature supporting this latter practice, although a...

If you have listened to this podcast for any amount of time, you know how POCUS studies usually go. Someone does an ultrasound on something cool and then compares it to another test to see how good it is. Well this study is different. In this case, we are taking a tried and true application of POCUS (undifferentiated dyspnea) and comparing a dedicated ultrasound team's POCUS to the treating emerge...

Can you believe we have never talked about ectopic pregnancy on this podcast?? Fortunately for you, a new research article allows our faithful hosts to dive into this core application of POCUS. These authors ask the practical question of whether or not a POCUS saves time in patients with ectopic pregnancy requiring an operation. The results may not be too surprising, but there are many twists and...

Ultrasound in cardiac arrest is a favorite topic of the GEL Team and thus, we are back to crack open a radical new concept in the field. Does the left ventricular function actually matter in patients that are arresting?? Current practice for many is to assess for the binary presence or absence of cardiac activity, but these audacious authors suggest that a higher LV systolic function could be asso...

The FAST exam has been used in trauma for decades - so why is there still confusion on how to use it in pediatrics? Because kids are different than adults! This article takes a look at the associations between intraabdominal injury and the FAST, physical exam, and labs. The authors then combine the FAST with physical exam findings to create the exFAST, the FAST-enhanced physical exam! Our GEL Jr h...

Do you use ultrasound for suspected peritonsillar abscess (PTA)? Some of us probably do, some don't - but what does the evidence say?? Does it help the clinician? and (dare we ask) does it help the patient? This paper is potentially the best data we currently have on the topic. Mike and special guest Kim Fender dive straight into the purulence of this fluctuant topic.   https://www.ultrasoundgel.o...

GEL Jr coming in hot with the latest in neuro-ocular sonography - optic disc elevation! That's right - not optic nerve sheath diameter (ONSD), the actual elevation of the disc as seen on ocular ultrasound. Super cool new idea - lets how how it pans out in this pilot study!   https://www.ultrasoundgel.org/116 https://pubmed.ncbi.nlm.nih.gov/34051397/

Everyone's new favorite doppler marker for pulmonary embolism is back! We discussed the ESN (early systolic notching) when this concept was first introduced as a marker for large PEs, but now we have a prospective study that improves upon some of the limitations of the past article...or does it? https://www.ultrasoundgel.org/115 https://pubmed.ncbi.nlm.nih.gov/33987920/

One of the gang's favorite topics - ultrasound in cardiac arrest! This article delves into the importance of "pre-pause imaging", getting that picture of the heart ready even before the compressions are stopped! This seems like an important part of minimizing pauses in CPR, but how convincing is this data? https://www.ultrasoundgel.org/114 https://pubmed.ncbi.nlm.nih.gov/34223359/

The GEL Jr. team is back with another great use for pediatric POCUS! You might not have known that you can actually use ultrasound to confirm that your endotracheal tube is in the right place! But how good is it?? https://www.ultrasoundgel.org/113 https://pubmed.ncbi.nlm.nih.gov/32168296/

This Special Edition podcast covers not one - but 7 really important POCUS articles! These articles were selected by the Academy of Emergency Ultrasound (an academy of the Society of Academic Emergency Medicine) as the top articles from the past year. Here we briefly discuss the winningest articles from each of the categories! https://www.ultrasoundgel.org/112

We have talked about ocular ultrasound many times before - it certainly can be useful in identifying many acute ophthalmologic pathologies. But what about papilledema? We know that POCUS can be used to measure the optic nerve sheath diameter (ONSD), which dilates with increased intracranial pressure. So theoretically this should work well in patients with suspected increased intracranial pressure,...

We have been ultrasounding hips for a while now. We know this modality is accurate for finding effusions. This can really help in cases of suspected septic arthritis. Unlike patients with this disease, this study takes multiple steps forward. First it asks the question - "Does point-of-care ultrasound (POCUS) in the emergency department lead to a faster diagnosis?". Then it goes further by trying...

In this Special Edition podcast, Mike is joined by POCUS leaders and educators Nova Panebianco and Cameron Baston to discuss their recent publication on interdepartmental collaboration with ultrasound. They discuss their process for creating a combined fellowship and share additional pointers in achieving mutually beneficial relationships between departments. https://www.ultrasoundgel.org/109 http...