POCUS can be used to visualize small bowel obstruction (SBO) fairly easily. It has proven itself superior to xrays and has some advantages over CT, which for most people is the standard for diagnosis. Although initial work was quite promising, there were no large studies done confirming the accuracy of ultrasound for this purpose. In this podcast we examine the latest study (plus discuss a bonus similar one) that reveals maybe this is not as good as we thought! https://www.ncbi.nlm.nih.gov/pubmed/30762916

There are many ways that TEE can help you in cardiac arrest. One of these is to monitor your chest compressions to make sure they are actually doing what you want. Although this makes sense intuitively and is supported by animal models, there has not been a lot of evidence to date. This article takes a step in that direction by showing some data on outcomes in humans. https://www.ncbi.nlm.nih.gov/pubmed/30825552

We know that the carotid arteries are easily seen on ultrasound, but usually we think of this scan in the context of comprehensive sonography. Certainly, it is not hard to believe that having increased atherosclerotic build up would put someone at increased risk for coronary artery disease, but what can we do with that in the acute setting? These authors had an idea - maybe measuring the Carotid Intima-Media Thickness (CIMT), could be a predictor of the outcomes of a cardiac stress test. Is this brilliance or craziness? Decide for yourself! https://www.ncbi.nlm.nih.gov/pubmed/30612781/

Necrotizing fasciitis (NF) is a real bad deal. We usually rely on clinical exam (which can be misleading) or other imaging studies (which can take forever) to make the diagnosis. POCUS would be an awesome solution in helping to make this time-sensitive determination. We know it can pick up fascial fluid, air, subcutaneous changes...but really how good is it when it comes down to diagnosing this deadly disease? https://www.ncbi.nlm.nih.gov/pubmed/31031033

Exploring the significance of wall motion abnormalities in acute myocardial infarction, challenges of variability in emergency ultrasound operators, limitations of bedside echocardiograms, and ways to enhance point-of-care ultrasound accuracy.

In part 2 (and the finale) of the series from the IAEM conference, the discussion heats up even more! The same star-studded international band of wisdom and wizardry tackles POCUS in cardiac arrest. They discuss the CASA exam and other pointers for using POCUS in the pulseless patient. A must listen!

In October 2018, an all-star group met during the Irish Association for Emergency Medicine annual conference to talk about point-of-care ultrasound. The result was a convivial discussion of a few key papers and topics, packed with pearls and perspectives. In part 1 of 2, the group talks about the landmark original SHoC-ED trial and performing the erector spinae plane block for rib fractures.

It is great to see more and more research on ultrasound in cardiac arrest. Although many people are already using this, there is still much work to be done to tease out the details of how exactly POCUS should affect our decision making. Here is a nice study that looks to see if ultrasound is associated with increased resuscitation efforts or better survival outcomes. https://www.ncbi.nlm.nih.gov/pubmed/31205842

They say seeing is believing...what about seeing a study about a machine that listens in order to see an organ that itself is used to see? Most scholars agree this too is believing. Of course, we are (in a convoluted way) referring to ocular ultrasound. Historically a great party trick, can this modality accurately diagnose visual problems in the emergency department? It's been done before, but it hasn't been done to this degree. Sit back, relax, and visualize the latest in ocular POCUS research. https://www.ncbi.nlm.nih.gov/pubmed/30977855

The annual conference of the Society of Clinical Ultrasound Fellowships (SCUF) is an incredible opportunity to converse and interact with many leaders in point-of-care ultrasound education and research. We took advantage of having so many brilliant people in one place to ask them all a few question about what they think are the next steps in POCUS research.