In this Bonus Cut author interview, Zack and Mike go off the rails by interviewing the author of a case series describing a fascinating and mysterious procedure - the transgluteal hydrodissection! Guest Gabe Rose gives us the low down of how this nerve block alternative might be the way to go to help a radicu-lous amount of patients. https://www.ultrasoundgel.org/164 https://pubmed.ncbi.nlm.nih.gov/36933988/

The GEL Jr team strikes back with a fascinating topic - using POCUS to guide response in the treatment of Crohn's disease! Join the gang as they peristalse their way through an article describing this inflammatory idea. https://www.ultrasoundgel.org/163  https://pubmed.ncbi.nlm.nih.gov/32453126/

In September 2023, the GEL crew traveled to Portland, Maine to do some on-the-street reporting at the annual conference for the Society of Clinical Ultrasound Fellowships (SCUF).  What evolved was a series of incredible mini-interviews focusing on the different paths to ultrasound and the exciting new frontiers of ultrasound technology. This is Part 1 of 2. https://www.ultrasoundgel.org/154 https://www.awakeandawarebend.com/a/2147793147/QULTuhF9

Have you been PENG attention? This block is everywhere! In this episode, we talk about the preliminary data for the PEricapsular Nerve Group (PENG) block used for analgesia of acute hip fractures in the emergency department. https://www.ultrasoundgel.org/153 https://pubmed.ncbi.nlm.nih.gov/35652877/

Bonus Cuts back again! Zack and Mike talk with guest Yale Tung-Chen about the POCUS vibe in Spain and his recently reviewed study on using doppler flow as a measure of right ventricular dysfunction in heart failure. https://www.ultrasoundgel.org/152

Mike flies solo and ventures into the wily world of artificial intelligence in clinical ultrasound. How well does the machine measure up to the expert when it comes to hemodynamic measurements with echo? https://www.ultrasoundgel.org/151 https://pubmed.ncbi.nlm.nih.gov/36835888/

To celebrate 150 episodes we are doing a deep dive into one of POCUS's most beloved applications - acute heart failure. We bring in echo expert Sean Hickey to help delve into the ins and outs of the hearts, the lungs, and the IVCs. https://www.ultrasoundgel.org/150

Another author-focused Bonus Cuts episode with Zack and Mike joined by the one and only Rob Farrow! Rob represents the research team behind the recently discussed US-guided trigger point article. Discussion ensues regarding the methodology, procedural pearls, and a strained Bob Dylan reference. https://www.ultrasoundgel.org/149

Another cutting edge topic! These insatiable investigators propose to use doppler waveforms from the common femoral vein as a marker of right heart dysfunction in heart failure patients. Novel? Certainly. Useful? We shall see! https://www.ultrasoundgel.org/148 https://pubmed.ncbi.nlm.nih.gov/37088380/

What if I told you that you could use ultrasound to find traumatic injuries to the vertebral arteries? I am not telling you that...yet. The team has some thoughts on this novel idea. https://www.ultrasoundgel.org/147 https://pubmed.ncbi.nlm.nih.gov/37087444/

The GEL Jr crew sets up shop at the 2023 P2 Convention in Washington, D.C. and interviews the leaders of this organization about its history, purpose, and future. https://www.ultrasoundgel.org/146 https://p2network.com

Hold onto your hats - the latest episode discusses an application for ultrasound that you have probably never even thought about doing! Ultrasound-guided trigger point injections - do they work?! https://www.ultrasoundgel.org/145 https://pubmed.ncbi.nlm.nih.gov/36214230/

In this Father's Day Special, Mike interviews his old man about the state of point-of-care ultrasound in general surgery. All sorts of learning ensues. https://www.ultrasoundgel.org/162

Virtual reality ultrasound?! It is here, and it might be a valuable educational tool. Special host Shawn Sethi, usual but still somewhat special host Mike, and definitely special guest ultrasound educator Suean Pascoe discuss the available evidence and their own perspectives on this innovative technology. https://www.ultrasoundgel.org/144

Can looking at the diaphragm with ultrasound help us understand a patient's respiratory status? This is one of the first papers to look at this question in an emergency department population. https://www.ultrasoundgel.org/143 https://pubmed.ncbi.nlm.nih.gov/36680779/

This is the second and final part of our episode on diversity, equity, and inclusion within the point-of-care ultrasound community. Guests Almaz Dessie and Javier Rosario lend their insights to the discussion of their articles and practical next steps. https://www.ultrasoundgel.org/142

Special guests Almaz Dessie and Javier Rosario join Mike, Creagh, and Jai to discuss diversity, equity, and inclusion specifically in the point-of-care ultrasound community. This is the first of a two part discussion that covers the recently published articles on this topic and what you can do to help these efforts. https://www.ultrasoundgel.org/141

Delia and Lianne take on the topic of pediatric gastric POCUS. Is it a helpful way to assess the effect of fasting prior to procedural sedation? Is fasting itself a helpful way to empty the stomach?? https://www.ultrasoundgel.org/140 https://pubmed.ncbi.nlm.nih.gov/32769837/

Vicki Noble is a veritable legend of point of care ultrasound. Zach and Mike are lucky enough to sit down with this proverbial fountain of wisdom and scoop some razor insights into the past, present and future of the field. We discuss Vicki's origin story, multi-disciplinary collaboration, hot takes on POCUS research, and the middle-age of POCUS. https://www.ultrasoundgel.org/139

This episode has been a long time coming! We're talking ultrasound-guided subclavian central lines, and a lot of people have opinions. Are they better than landmark? What should we teach learners? The GEL team discusses through the lens of this fascinating RCT. https://www.ultrasoundgel.org/138 https://pubmed.ncbi.nlm.nih.gov/35562246/

Here's a little bit about our podcast. You can find out more at UltrasoundGEL.org.

We can only go so long without talking about cardiac arrest! Here is the latest idea - using sonographic carotid compression to help determine if a pulse is present. Can it save time compared to manual palpation and thus help our patients? https://www.ultrasoundgel.org/137 https://pubmed.ncbi.nlm.nih.gov/35792305/

Another Bonus Cuts author interview - this time with Amy Zhou, Pediatric Emergency Medicine specialist and first author of the recently reviewed article on IVC collapse duration. Zach and Mike ask the hard questions about how this paper came to be and how we should be thinking about the IVC in our pediatric patients. https://www.ultrasoundgel.org/136

It's been a while since we talked about Venous Excess Ultrasound, aka VEXUS. There is still a lot of buzz around this concept, but not a lot of honey (honey is evidence in this metaphor). Ross Prager, international friend to POCUS researchers everywhere, joins Mike to discuss what's new and where this is going. https://www.ultrasoundgel.org/161

Pneumoperitoneum is usually bad news for patients, and it would be great to have a quick way to make this diagnosis. These authors ingeniously used ultrasound contrast software (without any contrast) to boost the accuracy of ultrasound for this pathology! https://www.ultrasoundgel.org/135 https://pubmed.ncbi.nlm.nih.gov/35204492/

New idea alert! Should we be using POCUS to guide nasogastric tube placement? Crazy? Unnecessary, you say? Well listen in to the discussion of this interesting randomized controlled trial designed to answer this burning question. https://www.ultrasoundgel.org/134 https://pubmed.ncbi.nlm.nih.gov/35834792/

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.ultrasoundgel.org/127https://pubmed.ncbi.nlm.nih.gov/34958600/

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.nih.gov/33795166/

Part 2 of the discussion with Rachel Liu and Cian McDermott for Yale Emergency Medicine podcast day. Now the banter turns to a favorite topic: POCUS in cardiac arrest - is there a right or wrong way to do it? https://www.ultrasoundgel.org/160 Sponsor: Echonous

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 making sure your needle gets to the right place. These authors performed a randomized trial of this specific population to investigate this question. https://www.ultrasoundgel.org/124 https://pubmed.ncbi.nlm.nih.gov/34608713/

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.ultrasoundgel.org/123 https://pubmed.ncbi.nlm.nih.gov/34226072/

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 as far as I know, it is not yet widely adopted. This article starts off with the assumption that ultrasound is being used for subclavian lines and now asks the question, which is the safer approach - above or below the clavicle? https://www.ultrasoundgel.org/122 https://pubmed.ncbi.nlm.nih.gov/34231204/

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 emergency team's POCUS. You can imagine the important implications for how we do and define POCUS!!

 

https://www.ultrasoundgel.org/121

https://pubmed.ncbi.nlm.nih.gov/34348868/

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 turns to this discussion - not unlike the course traversed from the uterus to the adnexa! https://www.ultrasoundgel.org/120 https://pubmed.ncbi.nlm.nih.gov/34146921/

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 associated with a greater likelihood of return of spontaneous circulation!

 

https://www.ultrasoundgel.org/119

https://pubmed.ncbi.nlm.nih.gov/34087419/

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 hosts deliver great pearls for the FAST exam and how we should be using it based on the evidence to date. https://www.ultrasoundgel.org/118 https://pubmed.ncbi.nlm.nih.gov/32159909/

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.org/117 https://pubmed.ncbi.nlm.nih.gov/32826122/

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/

Creagh and Mike were invited to speak at the first ever Yale Emergency Medicine Podcast day! They join their old buddies Rachel Liu and Cian McDermott to discuss podcasting and POCUS in cardiac arrest. This is part 1 of 2.  https://www.ultrasoundgel.org/159 Sponsor: Echonous

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