Hemodynamically unstable, sick patient have high mortality and morbidity. Their physical exam findings can be misleading and the diagnosis still broad or unclear even after examination. When time counts and your patient is sick, bedside ultrasound can quickly make the diagnosis to help you provide appropriate and definitive care when it matters most. This is the basis for the SonoSave series, which examines ultrasound saves and the critically ill patients alive today because of point of care ultrasound.
Intro
Ultrasound is a lifesaver and luckily for a recent patient I mean this literally. Thanks to the early use of ultrasound a life was saved that would have been lost. A critical diagnosis was made within 5 minutes of arrival, preventing investment of precious time in ineffective treatments or delaying definitive care and making me look real slick in the process. The patient was successfully treated and admitted to the ICU. When I walk into work the next day, I find out the patient is not only alive but sitting up in bed talking to the team! With some simple ultrasound views and less than 2 minutes, the direction of our treatment completely changed and a man lived to see his family that I doubt would have otherwise. Two minutes to save a life… that’s some good stuff and even better ultrasound! These are the moments that make medicine worth it.
That Feeling When You Walk Out of Your Shift After A Good Save Continue reading SonoSave – It’s Just Sepsis →
The Case
There are a few cases I could talk about… Ultrasound guided LPs have turned out to be a surprisingly useful skill. Lucky for you, I’ve restrained myself.
The first time I heard about ultrasound guided LPs was during a spectacular yearlong ultrasound elective in medical school. I was sitting in the doctor’s pod with THE ultrasound attending of ultrasound attendings. He casually asked “Have you ever heard of ultrasound guided LPs?” Never. “Do you want to see one?” Obviously. He explained how ultrasound guided LPs follow the principle of “Measure twice. Cut once.” He spent a minute (and I mean literally just one minute) visualizing the spinal landmarks and marking them on a somewhat altered, seriously chunky patient. He proceeded to get the LP in one stick! I remember thinking he was a wizard in that moment, a wizard who uses ultrasound to elevate patient care to another level; and that I want to be the badass attending that gets LPs on obese, altered patients in one stick. I had to learn this skill… Continue reading Getting to the Point of Ultrasound Assisted Lumbar Punctures →
I’m an emergency ultrasound fellow and emergency medicine physician who loves bedside ultrasound. While I’m a California native, I enjoyed life in the Southeastern US for medical school, the good life in Ohio for residency, and now an ultrasound fellowship back out West. When I started SonoMojo, I was a medical student. As my career has grown, so has the site! My specific interests are now ultrasound education, bowel ultrasound, and resuscitation ultrasound.
No matter how far I get in my training, I will always have a love for ultrasound education because of my experiences as a medical student. At the start of medical school we had NO ultrasound education available to students and definitely no ultrasound in our curriculum. I stumbled upon ultrasound by complete accident at the start of my 2nd year. With the guidance of a WONDERFUL ultrasound faculty adviser I discovered the wealth of FOAMed ultrasound resources available to ultrasound learners and navigated through these resources to developed a FOAMed based ultrasound curriculum. I also started an ultrasound student group without any financial support or ultrasounds, which forced us to develop our own resources from scratch. A couple years later our school had a large student organization that teaches bedside ultrasound to our fellow students (and sometimes faculty), official ultrasound electives, and ultrasound labs in our physical exam and anatomy curriculum. This has largely been the result of a student-driven model of ultrasound curriculum integration and the support of one amazing ultrasound faculty member. I’ve shared our experiences in developing our own ultrasound education and some resources to help you do the same. Happy ultrasounding! Please enjoy the site!
Dr. Jennifer Cotton, MD RDMS
(Oh and my opinions are my own… They do not represent my former medical school , residency program, or current fellowship program.)
