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: Phantom model was provided by Kyoto Kagaku for evaluation.

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.

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.

Practical Tips on Emergent Transcutaneous and Transvenous Pacing

Originally Published; 2013-Mar-01

Was one of the faculty for a simulation day with some lecture stations.  The station I had was a short lecture on the setting up of emergent transcutaneous and transvenous pacing followed by some hands on.  Figured I would record the lecture and post it up for whoever was interested.  I did have to put in some echo guided pacemaker insertion clips since I was giving the presentation.

As a side note some of the discussion points may not be applicable depending on what kind of equipment your facility regularly stocks.

Clearing the Memory on a SonoSite Turbo

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:

Central Line Kit Walkthrough and Line Placement

Originally Published: 2013-Jul-02

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.

Twitter Use During Emergency Medicine Conferences

Originally Published: 2012-Apr-26

This research letter is published online ahead of print in the American Journal of Emergency Medicine.  It reviews some of the Twitter statistics from the American College of Emergency Physicians 2010 Scientific Assembly and the Society for Academic Emergency Medicine 2011 Annual meeting.

It also raises the idea of the metric of individual user, original tweets, and original tweet per individual user for evaluating Twitter volume during conferences.

The citation and a pre-production pdf version for those who do not have journal access is: Nomura JT, Genes N, Bollinger HR, Bollinger M, Reed JF 3rd. Twitter Use During Emergency Medicine Conferences. Am J Emerg Med. Epub ahead of print. PMID 22424992.