By Michael Prats, MD on 01/21/19 06:00 AM
Chest pain is fun, right? Maybe add in some shortness of breath? It can be hard to sort through the potentially sick from the okay to go home. We know that point of care ultrasound (POCUS) can be helpful in making or excluding many cardiothoracic pathologies, but we don't even know if it really makes a difference! This article takes the first step by asking, "when you use POCUS, does it help lower the diagnostic uncertainty about that patient?" Secondly, it takes on an old rivalry by comparing POCUS to chest xray in these patients. https://www.ncbi.nlm.nih.gov/pubmed/30413369
By Michael Prats, MD on 01/07/19 06:00 AM
Fluid responsiveness has been all the rage in emergency and critical care medicine. Trying to determine which patients will benefit from fluids or how much fluids is a daily struggle for providers. However, every new measurement or technique to quantify a patients possible responsiveness to fluids has been riddled with problems. Is carotid flow time, the holy grail that we have been waiting for? This study dives into the use of carotid flow time in an ICU patient population and attempts to answer if flow time can predict fluid responsiveness.
By Michael Prats, MD on 12/10/18 06:00 AM
The FAST exam is tried and true for trauma, but in the past it hasn't been super useful for patients with isolated pelvic fractures. This study teases out a very sick subset of this population - patient who have significant hemorrhage associated with their fracture. The question is how well can the FAST identify intraabdominal hemorrhage in these people. The authors' idea is that if the FAST can find intraperitoneal blood, it might help determine who would benefit from REBOA instead of laparotomy.