Using a 1982 portable unit (ADR-4000), we could define, since 1985, a use of ultrasound devoted to the critically ill, different from the traditional one (radiological & cardiological). This technology was sufficient for making, at the bedside, a whole body approach, although a 1992 technology (Hitachi-405) was better for optic nerve assessment. Search for blood in trauma, inserting subclavian venous lines was a basis. The consideration of the lung (the main vital organ) allowed to change the rules of ultrasound. Lung ultrasound (in the critically ill: LUCI) showed its potential for not only allowing immediate diagnoses (pneumonia, pulmonary edema, pneumothorax and others), but mostly, associated to a simple venous approach, to simplify echocardiography. In the CEURF protocols, the heart analysis can be usually reduced to the right ventricle volume (the pericardium is apart). The potential of LUCI to show infra-clinical subtle signs of interstitial edema is the starting point of the FALLS-protocol for assessing a circulatory failure, providing this direct parameter of clinical volemia. The potential of LUCI to show the A-profile (ruling out pneumothorax) or the A’-profile (highly suggesting pneumothorax) is used in the SESAME-protocol, a very fast protocol in cardiac arrest assessment. The BLUE-protocol is a fast protocol assessing a respiratory failure, where only lungs and veins are on focus (the heart is not included). LUCI makes critical ultrasound a holistic discipline for all these reasons. LUCI shows its multifaceted potential from sophisticated ICUs to austere areas, from the elderly to the neonate, where the signs are the same, including ARDS in bariatric patients, and many less critical disciplines up to family medicine. A single, universal microconvex probe is used for our whole body approach. We do not use Doppler nor harmonics. The LUCIFLR project highly decreases medical irradiation. CEURF trains intensivists to this visual medicine since 1989.
Whole Body Ultrasound Centered on the Lung: A Holistic Approach by Daniel Lichtenstein
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Righting the Wrongs of Research
Phoebe Adams, , 2017, The Talks DASsmacc, Bayesian adaptive trials, big data, critical care, critical care research, ICU research, randomised controlled trials, research methods, response adaptive randomization, 0
Mortality measured at a particular time point (landmark mortality) is often regarded as the gold standard outcome for randomised...
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Voices in my Head
Phoebe Adams, , 2017, The Talks DASsmacc, Failure, medicine, mindfulness, performance, Resuscitation, Self-compassion, 0
We are all imperfect, this is the human condition. Pursuing a career in resuscitation means that some of our...
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Peter Brindley interrogates: Rinaldo Bellomo
Phoebe Adams, , 2017, The Talks DASsmacc, Kidneys, trials, 0
A no-holes barred series of 6 provocative medical interrogations. We challenge the state of research, social media, pharmacology, social...
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Burnout, Blissful Ignorance and Addicted to SMACC – Iain Beardsell interrogates: Peter Brindley
Phoebe Adams, , The Talks DASsmacc, 0
After getting his chance to interrogate SMACC Superstars the people finally get their chance to get their own back...
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SonoBYTE: Global Relief Ultrasound
Phoebe Adams, , The Talks DASsmacc, diagnostic imaging, Education, Global health, Point-of-care Ultrasound, Resource-limited environments, training, Ultrasound, 0
The scale of need, wide burden of disease, and complex systems challenges can at times be overwhelming in the...
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Learning from Sim Part III: Critical Moments in the Intensive Care Unit by Jon Gatward
Phoebe Adams, , The Talks DASsmacc, intensive care unit, Simulation, 0
We have difficult conversations in critical care. We deal with sick and complex patients who may be at the...
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SMACCForce: Never too sick to be retrieved
Phoebe Adams, , SMACCForce 2017, The Talks DASsmacc, Retreival critical advenaced prehospital care ECMO iNO, 0
A short talk on retreival medicine. There are still patients out there where someone without insight determine that the...
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NeuroImaging Nibble Subtle Sinus Venous Thrombosis
Phoebe Adams, , 2017, The Talks DASsmacc, NeuroImaging, Subtle Sinus Venous Thrombosis, 0
Neuro Imaging Nibble: Subtle Sinus Venous Thrombosis by Brandon Foreman