Comments for Takeokun.com http://takeokun.com A blog about Medical Education, Point of Care Ultrasound, Technology, and Miscellaneous Topics. Fri, 19 Aug 2011 21:35:42 +0000 hourly 1 http://wordpress.org/?v=3.2.1 Comment on Long vs Short Axis for US Guided Central Venous Access, Review of a Study by Todd Crum http://takeokun.com/2011/08/long-vs-short-axis-for-central-venous-access-review-of-a-study/comment-page-1/#comment-1323 Todd Crum Fri, 19 Aug 2011 21:35:42 +0000 http://takeokun.com/?p=213#comment-1323 I completely agree with you. What good is this study if they admit that they have less experience with the long axis? A direct comparison cannot be made in this case. Perhaps the part that is most disturbing, is the emphasis that both arterial punctures were in the long axis group. This can only happen for two reasons in the long axis: either they were not visualizing the needle on the screen at the time of puncture, or they were visualizing the needle enter the artery (i.e. they were looking at the wrong vessel). Because, as you state, success in the long access was defined as visualizing the needle enter the vein, one must assume that they made the second error -- visualizing the artery at time of puncture. Not being able to identify artery vs. vein speaks more to their comfort with the technique than it does the technique itself. I completely agree with you. What good is this study if they admit that they have less experience with the long axis? A direct comparison cannot be made in this case.

Perhaps the part that is most disturbing, is the emphasis that both arterial punctures were in the long axis group. This can only happen for two reasons in the long axis: either they were not visualizing the needle on the screen at the time of puncture, or they were visualizing the needle enter the artery (i.e. they were looking at the wrong vessel). Because, as you state, success in the long access was defined as visualizing the needle enter the vein, one must assume that they made the second error — visualizing the artery at time of puncture. Not being able to identify artery vs. vein speaks more to their comfort with the technique than it does the technique itself.

]]> Comment on How timed Tweets can distract from your message. by Joe Bulkin http://takeokun.com/2010/09/how-timed-tweets-can-distract-from-your-message/comment-page-1/#comment-729 Joe Bulkin Wed, 18 May 2011 17:11:14 +0000 http://takeokun.com/?p=124#comment-729 Dear Dr. Nomura, I’m happy to share with you that your site, Takeokun, has been awarded the “Sermo Selected Site” distinguished honor. We’ll be announcing to our 120,000 physician members the list of sites that are receiving this recognition from us. Recommended sites such as yours will also be featured in our new Sermo Selected microsite. In addition to increasing the online resources for our members, we look forward to driving traffic and brand awareness to your site. We would like to send you a badge that you can place on your site to share with your readers that you have received this distinction from Sermo. I would be happy to discuss additional opportunities for us to work together. I’ll reach out to you soon if I don’t hear from you first. Thanks again and congrats! Joe Bulkin Marketing Manager, Sermo ------------------------------------------------------- Sermo is the largest online physician-only network in the US, where 120,000 practicing physicians discuss a wide range of topics from clinical cases to advice about drugs, practice management, healthcare reform and more. If you are not familiar with our website or membership, I invite you to take a quick look: www.sermo.com. Dear Dr. Nomura,

I’m happy to share with you that your site, Takeokun, has been awarded the “Sermo Selected Site” distinguished honor.

We’ll be announcing to our 120,000 physician members the list of sites that are receiving this recognition from us. Recommended sites such as yours will also be featured in our new Sermo Selected microsite. In addition to increasing the online resources for our members, we look forward to driving traffic and brand awareness to your site.

We would like to send you a badge that you can place on your site to share with your readers that you have received this distinction from Sermo.

I would be happy to discuss additional opportunities for us to work together. I’ll reach out to you soon if I don’t hear from you first.

Thanks again and congrats!

Joe Bulkin
Marketing Manager, Sermo

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Sermo is the largest online physician-only network in the US, where 120,000 practicing physicians discuss a wide range of topics from clinical cases to advice about drugs, practice management, healthcare reform and more. If you are not familiar with our website or membership, I invite you to take a quick look: http://www.sermo.com.

]]> Comment on Single Operator Sterile Sheathing of an Ultrasound Probe for an Ultrasound Guided Procedure by Ruby Osorio http://takeokun.com/2011/03/single-operator-sterile-sheathing-of-an-ultrasound-probe-for-an-ultrasound-guided-procedure/comment-page-1/#comment-557 Ruby Osorio Wed, 06 Apr 2011 05:07:29 +0000 http://takeokun.com/?p=182#comment-557 Thank you for your valuable post. We have decided to share it with our global physician audience at PhysicianNexus.com: http://physiciannexus.com/forum/topics/single-operator-sterile Ruby Team Member www.PhysicianNexus.com Physicians connecting worldwide Thank you for your valuable post.

We have decided to share it with our global physician audience at PhysicianNexus.com: http://physiciannexus.com/forum/topics/single-operator-sterile

Ruby
Team Member
http://www.PhysicianNexus.com
Physicians connecting worldwide

]]> Comment on Tips and Tricks for Placement Confirmation of IJ CVCs by healthy living http://takeokun.com/2011/01/tips-and-tricks-for-placement-confirmation-of-ij-cvcs/comment-page-1/#comment-408 healthy living Sat, 05 Mar 2011 01:48:22 +0000 http://takeokun.com/?p=176#comment-408 Great article Doc. Looking forward to more ultrasound tricks for newbies like me. Great article Doc. Looking forward to more ultrasound tricks for newbies like me.

]]> Comment on Tips and Tricks for Placement Confirmation of IJ CVCs by Michael Cromeans, M.D. http://takeokun.com/2011/01/tips-and-tricks-for-placement-confirmation-of-ij-cvcs/comment-page-1/#comment-331 Michael Cromeans, M.D. Sun, 30 Jan 2011 06:10:17 +0000 http://takeokun.com/?p=176#comment-331 Thanks! Thanks!

]]> Comment on Tips and Tricks for Placement Confirmation of IJ CVCs by Jason Nomura http://takeokun.com/2011/01/tips-and-tricks-for-placement-confirmation-of-ij-cvcs/comment-page-1/#comment-321 Jason Nomura Thu, 27 Jan 2011 18:37:13 +0000 http://takeokun.com/?p=176#comment-321 This is a view from <strong>superior</strong> to the clavicle and distal to the lateral head of the sternocleidomastoid muscle insertion, not where you would cannluate. This is distal to where you would puncture for a supraclavicular insertion and proximal to where you would puncture for a infraclavicular approach. I would not stick in this spot for cannulation of the subclavian as you can tell from the image it is less then ideal. The approach for an infraclavicular subclavian cannulation is after the vein will dive under the clavicle, distal to where this image is obtained. This is a view from superior to the clavicle and distal to the lateral head of the sternocleidomastoid muscle insertion, not where you would cannluate. This is distal to where you would puncture for a supraclavicular insertion and proximal to where you would puncture for a infraclavicular approach. I would not stick in this spot for cannulation of the subclavian as you can tell from the image it is less then ideal.

The approach for an infraclavicular subclavian cannulation is after the vein will dive under the clavicle, distal to where this image is obtained.

]]> Comment on Tips and Tricks for Placement Confirmation of IJ CVCs by Michael Cromeans, M.D. http://takeokun.com/2011/01/tips-and-tricks-for-placement-confirmation-of-ij-cvcs/comment-page-1/#comment-320 Michael Cromeans, M.D. Thu, 27 Jan 2011 13:07:08 +0000 http://takeokun.com/?p=176#comment-320 I'm an US novice. When I look at the second image, I hope it is labeled wrong. You've labeled the vessel abutting the clavicle the artery, and the vessel further away the vein. If this is accurate, I'll never attempt another subclavian line. Please clarify this for me. Thanks. I’m an US novice. When I look at the second image, I hope it is labeled wrong. You’ve labeled the vessel abutting the clavicle the artery, and the vessel further away the vein. If this is accurate, I’ll never attempt another subclavian line. Please clarify this for me. Thanks.

]]> Comment on Tips and Tricks for Placement Confirmation of IJ CVCs by The LITFL Review 003 - Life in the FastLane Medical Blog http://takeokun.com/2011/01/tips-and-tricks-for-placement-confirmation-of-ij-cvcs/comment-page-1/#comment-309 The LITFL Review 003 - Life in the FastLane Medical Blog Mon, 24 Jan 2011 03:56:20 +0000 http://takeokun.com/?p=176#comment-309 [...] Jason Nomura, an ED ultrasound guru, makes his LITFL Review debut with some slick Tips and Tricks for Placement Confirmation of IJ CVCs. [...] [...] Jason Nomura, an ED ultrasound guru, makes his LITFL Review debut with some slick Tips and Tricks for Placement Confirmation of IJ CVCs. [...]

]]> Comment on Tips and Tricks for Placement Confirmation of IJ CVCs by Tweets that mention Tips and Tricks for Placement Confirmation of IJ CVCs | Takeokun.com -- Topsy.com http://takeokun.com/2011/01/tips-and-tricks-for-placement-confirmation-of-ij-cvcs/comment-page-1/#comment-306 Tweets that mention Tips and Tricks for Placement Confirmation of IJ CVCs | Takeokun.com -- Topsy.com Sat, 22 Jan 2011 15:58:57 +0000 http://takeokun.com/?p=176#comment-306 [...] This post was mentioned on Twitter by precordialthump and Foobirds, Jason T Nomura MD. Jason T Nomura MD said: New blog post on a trick for wire confirmation for central line placement http://takeokun.com/?p=176 [...] [...] This post was mentioned on Twitter by precordialthump and Foobirds, Jason T Nomura MD. Jason T Nomura MD said: New blog post on a trick for wire confirmation for central line placement http://takeokun.com/?p=176 [...]

]]> Comment on Why Takeokun.com and what is that logo about? by ZDoggMD http://takeokun.com/2011/01/why-takeokun-com-and-what-is-that-logo-about/comment-page-1/#comment-278 ZDoggMD Tue, 11 Jan 2011 17:05:43 +0000 http://takeokun.com/?p=165#comment-278 Kick-ass logo Jason! Kick-ass logo Jason!

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