All posts by Velia Antonini

Diagnosing pneumothorax and lung effusion on Lung Ultrasound

Here a couple of infographics on bedside lung ultrasound…                                                                  first one refers to diagnosing pneumothorax, with an introduction of basic definitions on lung ultrasound (ie pleural line, pleural sliding, A/B lines, lung pulse):

1  suspecting pneumothorax in the absence of lung sliding

2 signs which confirm or rule out PTX diagnosis

3 how to look for lung point

Second infographics relates to pleural effusion:

1 diagnosing effusion on 2D and M-mode lung ultrasound

2 localize effusion & define its expected nature

3 easily & quickly quantify pleural effusion to understand if it has to be evacuated

4 if drainage is needed, POCUS could assist or guide chest tube insertion, and support continuous monitoring of the effusion, to evaluate drain effectiveness.

At the end, some tips to choose the right probe for LU & some suggested readings, enjoy!

graphics by Marta Velia Antonini @FOAMecmo                                                                                    content based on Belaïd Bouhemad masterclass at #LIVES2019

Polytrauma management

Pitfalls in the trauma case management:

intubation 

hemorrhagic shock

thoraco-abdominal penetrating injuries

pelvic circumferential fractures

posterior dislocation of the hip

retro-orbital hematoma

older patients

Be careful to avoid common cognitive errors,  premature diagnosis, over-reliance upon early negative results, attributing abnormal findings to benign causes, early grading injury severity based on signs in young healthy adults, distractions due to focus on main/obvious injuries and on performing a critical procedure. Also consider lot of potential communications error, lack of situational awareness & errors in staffing or workload distribution.

PS do not forget analgesia & sedation!

infographic based on the talk given by Sharon Einav, Shaare Zedek Medical Center, Hebrew University Faculty of Medicine, Jerusalem, Israel during the Trauma & surgery session  of the EDIC I Refresher Course at LIVES2019

graphics by M Velia Antonini @FOAMecmo

Basic Echocardiography Masterclass at LIVES2019

Basic Echocardiography Masterclass at LIVES3019

Here an infographic with some tips about running a (basic) point-of-care cardiac ultrasound study in the critical care patient. The 5 main views:

parasternal long axis – PLAX

parasternal short axis – PSAX (mitral valve, papillary muscles, apex & great vessels level)

apical 4 chambers – A4C

apical 2 chambers – A2C

subcostal (4 chambers and vena cava views)

are summarised with advices in probe positioning in order to find the acoustic window, and some notes about the data potentially achievable, regarding LV, RV, pericardial fluid, volume status & others. Enjoy and follow #LIVES2019 hashtag on twitter for full virtual access to the annual ESICM congress.

graphics Marta Velia Antonini @FOAMecmo
echocardiographic scans Jonny Wilkinson @Wilkinsonjonny criticalcarenorthampton.com
content based on A. McLean & Y. Beaulieu class at #LIVES2019