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TAPSE to Diagnose Pulmonary Embolism

Feasible and/or useful?

By Michael Prats, MD on 08/28/17 02:00 AM

Alright, we all know that TAPSE (tricuspid annular plane systolic excursion) is a fun word to say, but the question is whether or not it can be used in the emergency department to help diagnose someone with a pulmonary embolism. The TAPSE is a marker of right heart strain, and we know that PEs can cause right heart strain - so...it seems like a reasonable idea, right? Well this article takes a look to see if this is something that can be done in the ED and whether or not it is accurate for the diagnosis.


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Ultrasound Associated with Delays in Chest Compressions

Don't throw the baby out

By Michael Prats, MD on 08/14/17 02:00 AM

Ultrasound is commonly used in the resuscitations of patients in cardiac arrest. It can help to determine cardiac activity and etiologies of the arrest. Usually the ultrasound evaluation is performed during a pulse check. We know that we need to minimize pulse checks to maintain good perfusion - so is it possible that ultrasound causes further delays between chest compressions? This article says yes.


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Inferior Vena Cava Collapsibility for Fluid Responsiveness

yes or no?

By Michael Prats, MD on 07/31/17 02:00 AM

Ultrasound of the IVC is the people's volume responsiveness test. The idea is that you can non-invasively tell if a patient will benefit from getting more IV fluids. Everybody wants this to work so we can have a simple test to help us in critical situations. It is more reliable in mechanically ventilated patients with a fixed tidal volume but how about the non-intubated patient? Can we trust it?


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