A letter to the editor in the Canadian Journal of Emergency Medicine calling for Canadian healthcare systems to invest more resources in digital archiving systems for POCUS. As we say, “there needs to be advocacy for hospitals to provide appropriate IT funding and resources to implement digital archiving systems, and alternate avenues such as the crowdsourcing of low-cost workflow solutions needs to be explored”.
VanPOCUS’s Dan Kim moderated a POCUS-focused Canadian Association of Emergency Physicians (CAEP) National Grand Rounds session on November 3rd. He was joined by a fantastic panel of speakers: Gillian Sheppard spoke about ocular ultrasound, Colin Bell described the PENG and ESP blocks and their indications in the emergency department, and Talia Burwash-Brennan reviewed the ultrasound-guided approach to musculoskeletal complaints. If you missed these rounds, you can watch a recording on CAEP’s website.
Neil Long, one of our former fellows, published a unique case of hemorrhagic cholecystitis identified on point of care ultrasound in the Canadian Medical Association Journal. It’s freely accessible as a “Clinical Images” case, so access the paper to learn more about this uncommon diagnosis.
We kicked off the new fellowship year by having our fellows, Justin Burton (left) and Nik Humniski (model), teach in the annual UBC Medical Student Ultrasound Symposium. There was enthusiastic turnout from members of the UBC Ultrasound Club, and we had teaching help from Tracy Morton (POCUS lead for the Rural Coordination Centre of BC) and Xin Liu (one of the R3 UBC emergency medicine residents).
Matthew Douglas-Vail, one of the R4 UBC emergency medicine residents, just published this case report of a clot in transit in the Visual Journal of Emergency Medicine. His point of care echo images are impressive!
Our recent fellowship grad, Zafrina Poonja, just had this CJEM “Just the Facts” paper published on ultrasound guided arthrocentesis. It provides a concise review of the rationale for using ultrasound guidance and describes the technique. It is accompanied by this handy infographic you can refer to at the bedside.
Riley Golby, one of the R5 UBC emergency medicine residents, just published this Annals of Emergency Medicine “Images” case of a patient with ischemic ventricular septal rupture. It’s freely available as an open access article, so check it out!
We brought the old ultrasound crew back together again to run the R1 POCUS FUNdamentals workshop. Thanks to former fellows Tommy Merth, Jen Chao, and Abdullah Hammad for providing excellent bedside instruction!
Former fellow Véronique Dion published her first 1st-author study in the American Journal of Emergency Medicine. We performed a prospective observational study of 20 PEM physicians examining 71 children aged 4 to 10 years old. We compared the PEM physician’s identification of the distal fibular physis based on physical exam compared to the position of the distal fibular physis on ultrasound (the criterion standard). Their ability to identify the distal fibular physis by physical exam was poor - only 34%. This should call into question the diagnosis of Salter-Harris type 1 fractures.
VanPOCUS’s Dan Kim is the new chair of the Canadian Association of Emergency Physicians (CAEP) Emergency Ultrasound Committee (EUC). The CAEP EUC aims to promote emergency POCUS in Canada, especially in the domains of education, clinical practice, and research. To learn more, check out the CAEP EUC website If you want to connect with us, email us at firstname.lastname@example.org or communicate with us via Twitter @CAEP_EUC.
The UBC POCUS Fellowship wrapped up the academic year in style with some competitive 5-pin bowling. Zafrina Poonja is sticking around Vancouver and will take on a position as VGH ED ultrasound co-director. Abdullah Hammad is going back to Jeddah, Saudi Arabia. Jason Freder is returning to Montreal to work at St. Mary’s Hospital and has taken on a POCUS medical student education position at McGill. And David Smith is moving to Victoria. Wishing our fellows all the best with their future endeavors!
EM:RAP’s Emergency Medical Abstracts reviewed our cricothyroid membrane landmarking paper in their most recent May 2021 issue. Despite the reviewer’s concerns about the limitations of the study (single center, patients did not need airway management), they liked the take home point that the position of the cricothyroid membrane moves with a change in the patient’s position.
We had an amazing Virtual Vancouver POCUS21 Symposium yesterday morning. The “king of puns” Ross Prager did a phenomenal job of moderating, and we had fantastic talks from all our speakers. Thank you to everyone who joined us, and if you registered but were unable to join us live yesterday morning, the videos will be made available to you shortly. If you missed out all together, here’s a brief review of the "Top 10 POCUS Papers of 2020” talk.
A new CJEM Just the Facts publication about the role of POCUS for skin and soft tissue infections specifically cellulitis, abscess, and necrotizing fasciitis. It provides guidance about how to perform the scan, as well as how POCUS can be used to assist with incision and drainage of abscesses.
VanPOCUS’s Dan Kim will be speaking at SaskSono21 on Saturday, April 17, 2021 about continuing medical education in POCUS, as well as facilitating workshops on how to give a good POCUS lecture and how to run a scanning course/ultrasound boot camp. If you haven’t yet registered, it’s not too late: https://cmelearning.usask.ca/current-courses/sasksono_21.php.
VanPOCUS’s Dan Kim was part of the team behind this new meta-research study of systematic reviews assessing the diagnostic accuracy of POCUS applications. This study attempted to characterize the completeness of reporting using the PRISMA-DTA checklist. Overall, systematic reviews of POCUS diagnostic accuracy were moderately reported, but the main areas of deficiency were systematic review registration and the identification of a minimally acceptable test accuracy threshold.
Save the date! The 2nd annual Vancouver Point of Care Ultrasound (POCUS) Symposium will be coming back as a virtual conference. The symposium will provide an update on the most recent trends in resuscitative, diagnostic, and procedural POCUS and will feature a panel discussion on POCUS and standard of care with experts from anesthesia, critical care, emergency medicine, and internal medicine.
The Imaging Wire recently summarized the POCUS community’s dissatisfaction with the European Society of Pediatric Radiology’s recently published position statement on POCUS This was prompted by a tweet from VanPOCUS’s Dan Kim, categorically rejecting the idea of a radiology society imposing its control over an imaging modality that is used by clinicians from across all specialties in medicine.
VanPOCUS is presenting a virtual poster at ACEP20 If you’re registered for the conference, check it out - abstract #349: "The Physical Examination is Unreliable in Determining the Location of the Ankle Physis in Healthy Children”. The full abstract is available in the November supplement of Annals of Emergency Medicine.
A new publication from the VanPOCUS group where we assessed the change in the position of the cricothyroid membrane ultrasound landmark from 0° head of bed elevation to 30° and 90°. Check out the full manuscript in the Canadian Journal of Anesthesia.
VanPOCUS ran the UBC R1 ultrasound course in a physically distanced manner, given the current COVID-19 pandemic. The R1 cohort had to be separated into smaller groups and had to act as their own models. We had help from former fellow Neil Long and current fellow Zafrina Poonja.
Neil Long and Justin Ahn are featured in a video by the Burnaby Hospital and the Royal Columbian Hospital Foundations where they describe their participation in Microsoft Philanthropies’ Hack for Good program. They have partnered with Microsoft’s team to develop a low cost pericardiocentesis trainer, using 3D printing and cheap, easily accesible materials like gelatine and balloons.
The Canadian Association of Emergency Physicians (CAEP) Emergency Ultrasound Committee has published recommendations on the use of POCUS in the management of patients with suspected COVID-19. Key recomendations focus on the clinical indications for using POCUS, typical lung ultrasound findings, infection control strategies, and a protocol for safely cleaning an ultrasound machine. Check out the full manuscript in the Canadian Journal of Emergency Medicine.
Given the current situation with COVID-19 and recommendations from Vancouver Coastal Health about cancelling all non-essential group meetings and events, the organizing committee has made the decision to cancel our April 18th Vancouver POCUS Symposium and to postpone the event to the fall. This is in keeping with both health authority and provincial recommendations, and at the end of the day, we believe this is the right thing to do. While we're disappointed about this, we hope that all of you will be able to join us for a rescheduled symposium in the fall.
Our fellow Neil Long has worked with Life in the Fastlane to get our VanPOCUS video tutorials on to the Life in the Fastlane blog! Check it out at: https://litfl.com/ultrasound-library/vancouver-pocus/