Rahim Manji generously hosted the UBC POCUS Fellowship's fall journal club. This journal club evening focused on biliary POCUS, and we reviewed two papers: Hilsden’s "Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions” in Trauma Surgery & Acute Care Open and Zitek’s "The use of additional imaging studies after biliary point-of-care ultrasound in the emergency department” in Emergency Radiology. The take home is that biliary POCUS is highly accurate for cholelithiasis and is highly predictive of surgical decision making. However, this is only the case in systems where you have buy-in from your surgical colleagues and where you have image archiving so all members of the treating team can review the point of care imaging.
VanPOCUS’s Dan Kim was part of an international effort led by Bob Jarman, Anna Colclough, and Cian McDermott to provide recommendations on commonly used heart and lung POCUS applications, including the assignment of levels of evidence (LoE) and grading of the recommendations (using the GRADE framework). These clinical practice guidelines were supported by the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB).
The latest VanPOCUS publication is a new paper in Cureus where we used a modified Delphi method to identify the top 5 most influential papers on FAST and E-FAST. This was a national collaborative effort, and best of all, the paper is open access and freely available to all!
The UBC POCUS fellowship kicked off the new academic year with our new fellow Torey Lau. Torey impressed us with his disc golf skills - hopefully his ultrasound skills are even better! Torey joins us after completing his CCFP-EM training at UBC’s St. Paul’s site.
VanPOCUS’s Dan Kim spoke about “POCUS in the ER” today at UBC Radiology’s Vancouver Imaging Review (VIR) 2022. It was a great opportunity to discuss the clinical impactfulness of POCUS with radiologists who may not have the perspective of the clinician at the bedside. A summary of the take home points from this talk can be found here.
A new academic year means reprising the R1 POCUS FUNdamentals workshop and welcoming a new group of R1s to the program. We had an awesome group of instructors, including Melissa Skaugset, Karine Badra, Zafrina Poonja, new POCUS fellow Torey Lau, and UBC emergency medicine residents Kate Eppler and Matt Douglas-Vail.
Congratulations to our graduating POCUS fellows, Nik Humniski and Justin Burton! Regrettably, Justin Burton was unable to attend due to illness, but we celebrated with Nik Humniski at CRAFT English Bay. We’re delighted that both of our fellows will be sticking around the lower mainland. Nik will be the new ultrasound director for the Richmond Hospital emergency medicine group, and Justin is joining the Langley Memorial Hospital emergency medicine group. Wishing our fellows all the best with their future endeavors!
VanPOCUS held the first iteration of the CRASH course this past weeked - Cardio Respiratory and Abdominal Sonography for Hospitalists. We had a great group of attendees, including hospitalists from Vancouver General Hospital, Royal Columbian Hospital, Eagle Ridge Hospital, and even as far away as Mackenzie Hospital in Northern BC! We were joined by an excellent group of instructors, including our fellow Nik Humniski, Rahim Manji, and Maja Stachura.
The May edition of the ACEP-SAEM “Probing the Literature” Ultrasound Journal Club reviewed Dan Kim's 2019 paper from Academic Emergency Medicine, "Test Characteristics of Point-of-care Ultrasound for the Diagnosis of Retinal Detachment in the Emergency Department”. If you missed it, you can catch all the lively discussion on the ACEP Emergency Ultrasound Section YouTube channel.
Dan Kim chaired a track on “POCUS in Resuscitation" at the annual CAEP 2022 conference today in Quebec City. Speakers included Tom Jelic, Frank Myslik, Laurie Robichaud, and Elizabeth Lalande. If you missed it, you can find a Twitter thread on the talk “5 POCUS Resuscitation Papers You Should Know”.
VanPOCUS’s Dan Kim was the invited guest speaker at this month’s ACEP-SAEM “Probing the Literature” Ultrasound Journal Club. He presented his 2019 paper from Academic Emergency Medicine, "Test Characteristics of Point-of-care Ultrasound for the Diagnosis of Retinal Detachment in the Emergency Department”. There was excellent discussion, and if you missed it, you’ll be able to catch it on the ACEP Emergency Ultrasound Section YouTube channel soon.
The 3rd annual Vancouver Point of Care Ultrasound (POCUS) Symposium took place on Saturday May 7, 2022 as a virtual conference. We had over 150 participants join us as our amazing faculty provided an update on the most recent trends in resuscitative, diagnostic, and clinical POCUS. Iff you missed registration and missed the conference altogether, you can now purchase Vancouver POCUS22 On Demand!
You still have time to register for Vancouver POCUS 2022! Join us tomorrow morning for an update on the most recent trends in resuscitative, diagnostic, and clinical POCUS. If you can’t join tomorrow morning, you’ll be able to access recorded versions of all the talks for the next year. Ross Prager will be back again as our host, and we have an incredible group of speakers, including Katie Wiskar, Kevin Ong, Matthew White, Tracy Morton, Lauren Arthurs, Rahim Manji, Ken Kaila, Ross Prager, Shane Arishenkoff, Virginia Robinson, Karine Badra, and Justin Ahn.
We’re delighted to announce that the UBC DEM POCUS Fellowship has received official accreditation from the Royal College as an Area of Focused Competence Program (AFC) in Acute Point of Care Ultrasonography. AFCs are areas of specialty medicine addressing a societal and patient population need that was previously unmet by traditional systems of primary and subspecialty disciplines. As POCUS is a relatively young subspecialty area, the AFC helps to establish national standards for training and specialist competence and provides fellows who complete an AFC program with credentials that are nationally and internationally recognized. More information about AFCs can be found on the Royal College website.
Less than 1 week until Vancouver POCUS 2022! Join us virtually on Saturday May 7, 2022 for an update on the most recent trends in resuscitative, diagnostic, and clinical POCUS. Go to the symposium page for the agenda and to register. As a preview of what to expect, check out Kevin Ong’s talk on ultrasound guided pericardiocentesis from last year’s Vancouver POCUS Symposium.
Check out the newest issue (April 2022) of the Canadian Journal of Emergency Medicine for 2 VanPOCUS publications:
-Point of care ultrasound training in Canadian emergency medicine residency programs
-A picture is worth a thousand words, but only if you can see it
Letter just published in the Journal of Trauma and Acute Care Surgery addressing a highly flawed study on the use of ultrasound in traumatic pneumothorax. The study in question retrospectively found a sensitivity of ultrasound for traumatic pneumothorax far lower than the current published literature on the subject. We highlight many methodologic issues with their study design that limit the applicability of their conclusions.
VanPOCUS’s Dan Kim spoke at UBC CPD’s Rural POCUS Rounds on ultrasound guided arthrocentesis. It was a well attended virtual session with great discussion after. You can catch a recording of the talk for free on the UBC CPD website. The CJEM Just the Facts paper on ultrasound guided arthrocentesis is an excellent accompaniment to this talk.
A new paper in the Canadian Journal of Emergency Medicine provides the most complete and current description of POCUS training in Canadian emergency medicine residency programs. Former fellow David Smith is amongst the authors. We demonstrate that POCUS training in Canadian emergency medicine programs is prevalent, but there is variability in support for POCUS leads, delivery of training, determination of proficiency, and presence of quality assurance.
Registration is now open for Vancouver POCUS 2022! Join us virtually on Saturday May 7, 2022 for an update on the most recent trends in resuscitative, diagnostic, and clinical POCUS. If you can’t join on the day of, you’ll be able to access recorded versions of all the talks for the next year. Agenda for the symposium can be found on the symposium page.
Announcing the 3rd annual Vancouver POCUS Symposium! It will take place on Saturday May 7, 2022 as a virtual conference. The symposium will provide an update on the most recent trends in resuscitative, diagnostic, and clinical POCUS. You can catch it all from the comfort of your own home, and you’ll be able to access recorded versions of all the talks for the next year.
We’re thrilled to have an amazing organizing committee: Katie Wiskar, Ross Prager, Tracy Morton, and Ken Kaila.
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 published in BMJ Evidence-Based Medicine. 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/