Thread by @amit_pawa, This time on the otherside of the webinar situation!!Looking forward to learning [...]

This time on the otherside of the webinar situation!!
Looking forward to learning from @ICUltrasonica @Wilkinsonjonny @PARADicmSHIFT and crew!

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This time on the otherside of the webinar situation!!Looking forward to learning from @ICUltrasonica @Wilkinsonjonny @PARADicmSHIFT and crew! https://abs.twimg.com/emoji/v2/... draggable=

First up... @PARADicmSHIFT

Lots of TEE studies/courses available
FICE
FATE
FEEL
FUSIC
FUSIC HD
BSE level 1 and 2

A focussed study helps to answer a q about “why is my patient hypotensive?”

Focussed studies are:
quick (2 views)
Easy - only needs 50 scans for logbook.

Epiphany often occurs around scan 15!

What are the fundamentals of echo...
You can’t get all the views in all the patients all the time! -

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Ideally- assume the position & get these views

What are the fundamentals of echo...You can’t get all the views in all the patients all the time! - https://abs.twimg.com/emoji/v2/... draggable=

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PLAX - parasternal Long axis

Parasternal Short Axis view!

Apical@4 Chamber view

Now Subcostal View...

Wifi can’t handle all this activity! Gonna focus on learning now!

Now @Wilkinsonjonny talking abound the acutely unwell pt

@Wilkinsonjonny tells a lovely story about lung scanning in a clinical scenario where a pt drops saturations after an interscalene block for shoulder surgery

Next ...

Check out this PLAX - showing normal view followed by kissing ventricles...

Check out the IVC response in this hypotensive patient to filling...

Now - your next patient of the day...

Now - this is a right base view... what is the heart doing here?!

The EPSS shows this patient has a failing ventricle and in another view (not shown) shows a very large proteinaceous Pleural effusion- the Patient needs further management and optimisation before surgery

Spot diagnosis ?... this is the trauma patient from earlier who has plusus alternans on ECG and a swing on arterial line

Jonny has demonstrated Pneumothorax, Hypovolaemia, Pleural effusion and Cardiac tamponade!

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Now @ICUltrasonica !

Why do we need more than focused echo?..

1. Experts aren’t always available
2. Experts aren’t always experts
3. Existing training doesn’t fit

The level we need in Anaesthesia and intensive care is probably the highlighted part here...

Finally @Echotrainer ...

Contents of the talk

The history of accreditation

Why do we need accreditations/certificates?

To enable recognition of special competence against an objective standard , by the broader medical community.

Anaesthesia/Perioperative accreditation is probably met by FICE.

Super cool heartworks simulator!

Guidance for Trainees, but what about old people like me?!

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What if you are a trainer?...

Lots of quality and standards out there and @ICUltrasonica is an author on many of them!

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GPICS guidelines for archiving and reporting...

These are GPICS recommendations

What about medicolegal implications?

So - this IVC is collapsing, so the patient needs fluid right?....

Wrong... watch till end!

Excellent work @PARADicmSHIFT @Wilkinsonjonny @ICUltrasonica @Echotrainer !

Thanks for taking the time and educating us all .

I am inspired to get learning properly now!!

Many thanks @Assoc_Anaes

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