Kyoto Kagaku US Guided PICC Phantom: Hands On

I got the chance to use and evaluate the Kyoto Kagaku Ultrasound guided Peripherally Inserted Central Catheter procedure phantom.  The phantom consists of a torso and an arm that articulates at the shoulder to be able to place the arm in different positions.

The upper arm has a replaceable area that can be ultrasounded and cannulated.  The targets are the cephalic and basilic veins.  The vessels outside of the insert are clear so you can see the wire and/or catheter threading. There is the ability to place the wire in to the SVC and the IJ.  There is a vessel that is used to fill the model and could be considered an azygos vein, but its take off is a little odd.

The video goes over the phantom’s parts and images along with demonstration of access and wire threading.

Disclosure:  PICC Phantom was provided by Kyoto Kagaku for review.

Posted in US Procedures | Tagged , , , , , , , | 1 Comment

Twitter Transcript from SAEM14

Here is the Twitter transcript from the Society for Academic Emergency Medicine 2014 Annual meeting, #SAEM14.  During the conference we became a world wide trending topic thanks to the discussions and retweets.

 

We also had a record number of attendees at the conference along with an increased number of people on Twitter and number of tweets.  Nowhere near the numbers that we get for ACEP but growing.  The Symplur graph shows the volume over the conference.

Download the Twitter Transcript pulled from Hootsuite.

Posted in Social Media | Tagged , , , , | Leave a comment

From Twitter to Tenure: SAEM 2014 Annual Meeting

At the 2014 Society for Academic Emergency Medicine Annual meeting Michelle Lin (M_Lin), Nicholas Genes (@NickGenes), Robert Cooney (@EMEducation), and myself (@takeokun) give a didactic session entitled “Twitter to Tenure: Use of Social Media to Advance Your Academic Career”.

We discussed the relationship of social media and #FOAMed to scholarship, the traditional markers of academic scholarly activity in the setting of US Graduate Medical Education, and our experience in social media over the years.  Here is a recording of our lecture presentation and the questions from the audience.  The audio is limited due to some technical difficulties while traveling.

I would also pay attention to the discussion from Ed Panacek at about 57:24.  Ed has some very important things to say about social media and academic careers/advancement, Michelle may have also let a little surprise slip.

This video was in collaboration with:

Michelle Lin MD   @M_Lin   http://academiclifeinem.com

Nicholas Genes MD PhD   @NickGenes   http://blogborygmi.blogspot.com

Robert Cooney MD RDMS   @EMEducation   http://flippedem.com

Hope you all enjoy.

Posted in Education, Social Media | Tagged , , , , , | Leave a comment

SAEM 2014 Poster on Swallow Screening for Acute Stroke Patients

At the Society for Academic Emergency Medicine Annual Meeting at Dallas Texas I had the opportunity to present a poster on a project I had worked on. The project was entitled:

Customized Swallow Screening Tool to Exclude Aspiration Pneumonia Risk in Acute Stroke Patients

Unfortunately there were concurrent events at the meeting and I could not stay at the poster session the entire time.  Below is  a short video discussing the poster and our team’s findings.

The abstract can be downloaded in the Academic Emergency Medicine Supplement issue, abstract 622.

Posted in General | Leave a comment

AIUM 2014 Twitter Transcript

The American Institute of Ultrasound in Medicine Annual Convention was held March 2013 at Las Vegas.  It was a great conference with lots of social media coverage and information broadcast.

At the conference there were the expected ebb and flow of tweets based on session times as shown by the graphic from Symplur.

The full transcript can be downloaded as a pdf at:  http://takeokun.com/Media/2014/aium14-tweet.pdf

Posted in General | Leave a comment

Resident Education in Ultrasound Using Simulation and Social Media AIUM14

There was a session at the American Institute of Ultrasound in Medicine 2014 Annual Meeting focusing on education in Point of Care Ultrasound.  There were several speakers and I was asked to speak on resident education, particularly to focus on simulation and social media and how it fits with EM Resident ultrasound education.  This is a fairly large and broad area to cover in 15 minutes or less.

I chose to focus on how to simulation and social media can assist in education and deliberate practice to get learners to an “expert performance” level.  The information may not be new to people who are familiar with simulation or social media. My goal was to show how these things can be helpful from a conceptual and design view for education.  Also to provide information that you can use if you have to justify to others why social media or simulation is important to your educational program and why it should be supported.

This is a recording of the presentation, sorry the audio is not as clear but did not have the external microphone for the recording.

 

Posted in Education, Social Media | Tagged , , , , , , , | Leave a comment

Twitter Feed from #ACEP13 Scientific Assembly

Another Emergency Medicine conference has come and gone.  Twitter was extremely active during the ACEP 2013 Scientific Assembly in Seattle.  There were meet ups organized all over the place, including the exhibitor floor booths.  I pulled the tweets with #ACEP13 and compiled them to the attached pdf document so you can search the tweets.  Be warned it is a large file 1,576 pages and 5 Mb.

A graph of twitter activity via Symplur’s healthcare hashtag project.  You can see the activity is during the conference but also the peaks are during the educational sessions.  This leads us to the thought that the tweets are about the sessions and conference more so then the social aspects of the gathering.  If you were following the hashtag you know this is true, at least in an unscientifically rigorous sampling anyway.

Some highlights include (estimates from aggregators and word counts not by hand):

  • In 12 pt font 1,576 pages
  • 10,842 tweets with the hashtag #ACEP13
  • 4,928 Original tweets (estimated)
  • 3,692 mentions
  • 5,914 retweets
  • @srrezaie leading with 656 mentions followed by @gruntdoc with 523 mentions
  • @mastinmd (485 tweets), @kasiahamptonmd (454 tweets) and @gruntdoc (@444 tweets)

#ACEP13 Twitter Archive

Posted in Social Media | Tagged , , , , | Leave a comment

Clearing the SonoSite M-Turbo Memory

It is that time of year again with new residents and fellows for ultrasound programs.  Many Emergency Medicine programs are now using digital arching solutions for their ultrasound studies.  Also becoming popular are the use of middleware and/or PACS systems for quality assurance and education/feedback.

One problem that occurs if you are using a SonoSite system is that the studies are saved to the hard drive or internal memory before transmission to the middleware system, such as Q-Path.  Eventually the internal memory of the ultrasound unit will fill up.  When the memory is full the boot time can be longer and performance may suffer.  Most importantly you will NOT be able to save further studies to the hard drive in order to transmit to the arching solution you use.

Someone has to clear the memory periodically.  Unfortunately if you have several sites this could become a problem with schedules and new people in the program.  This short video is a walk through of how to clear the memory on the M-Turbo system from SonoSite, it also works for the Edge system.  Feel free to distribute the link to you people in your program or if you get that late night call asking how to clear the memory.

To make things easier to distribute you can also use this shortened link that will take you directly to the YouTube video:  http://bit.ly/clearturbo and is easier to remember.  Or you can use this QR Code:

clearturbo

 

Posted in Ultrasound System | Tagged , , , , , , , , | Leave a comment

Ultrasound and the Emergency Medicine Milestones

If you are involved in Emergency Medicine education in the United States you have heard about the new evaluation process for residents known as the Milestones project. As a quick summary the ACGME and the RRC for EM has developed several key areas residents should be evaluated in during their residency education with milestones they should reach before graduation. Now there are discussions back and forth over the utility of the milestones, how they correlate or don’t correlate with competency, why these particular items and milestones were picked and many other topics. In the end the Milestones are here and being implemented.

One of the Milestones is PC-12 which involves Emergency Ultrasound. Not every residency program has a ultrasound fellowship trained faculty (not that every program needs one). So there was a lot of discussion on how to meet this milestone.  A joint taskforce was convened with the Academy of Emergency Ultrasound (AEUS), an Academy of the Society for Academic Emergency Medicine and the Council of Residency Directors in Emergency Medicine (CORD). There were also representatives from ACEP and EMRA.

In the July 2013 issue of Academic Emergency Medicine the consensus document was published to serve as a resource to programs. It is available at the journal website.

Lewis RE, Pearl M, Nomura JT, Baty G, Bengiamin R, Duprey K, Stone M, Theodoro D, Akhtar S, CORD-AEUS: Consensus Document for the Emergency Ultrasound Milestone Project. Acad Emerg Med:20;740-745.

The document discusses how the Milestone project relates to Emergency Ultrasound and brings some important topics and information. There are several data supplements that go along with the document which is what I wanted to mention and serve as resources.

One key area is the differentiation between what is basic and what is advanced emergency ultrasound applications. This list was developed through a modified Delphi method that also allowed input from educators and ultrasound practitioner from the involved groups (ACEP, SAEM, CORD). Now the differentiation was a consensus, so you may not agree with everything. The table of core vs advanced topics can be downloaded. Also to be clear this was to help define the educational base for an EM residency graduate; not to define Emergency Ultrasound as a whole.

The other supplement is the list of assessment methods and how they integrate in to the milestone. Programs currently have assessment  methods in place and there is no single way to meet each milestone or evaluate competency. This assessment table lists different methods, what they assess, limitations, and which milestones they can evaluate.

Residents will perform many ultrasounds during their residency, at least 150 per the milestones, and the assessment of progress through the milestones could be done differently. One method is to evaluate ultrasound performed by the resident individually for education, feedback, and performance improvement. This could be done using the CORD US-SDOT forms.

Then the resident’s progress in the US milestone could be evaluated over time by examining their ultrasound performance in aggregate. This was the approach for the evaluation document by the Joint Milestone Task Force (they have a wiki) from CORD.  The form that was created is available on the wiki and I have adapted it as a New Innovations questionnaire or evaluation form.  The JMTF form allows you to add ultrasound studies to evaluate in addition to the FAST exam, in the example these are multi-view echo and abdominal aorta, but you can customize this to fit your program.

Downloadables:

  1. Core vs Advanced Emergency Ultrasound for Residents
  2. Assessment methods with skills tested, limitations, and associated milestones
  3. CORD US-SDOT Forms
  4. New Innovations version of the JMTF US milestone evaluation form

As a disclaimer I was an author on the consensus document and served on the CORD-AEUS Task Force and the CORD JMTF.

Posted in Education, Ultrasound Education | Tagged , , , , , , , , , | 1 Comment

Central Line Kit Walk Through and Line Placement

This video is a walk through of placing an ultrasound guided internal jugular central line in  a sterile fashion.  The technique and individual steps will depend on the brand of kit and how it has been customized for your institution.

This video was originally created as a review for the residents at my institution.  It focuses on the process of placing the line and less so on the ultrasound guidance.

Posted in US Procedures | Tagged , , , , , | 1 Comment