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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‘Everything’ at the End of Life
Phoebe Adams, , 2017, The Talks DASsmacc, critical care, Dying, End of life, 0
The meaning of ‘everything’ from the perspective of the patient, their family, their doctor and their health economist. We...
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Helping Without Harming
Phoebe Adams, , 2017, The Talks DASsmacc, communication in critical care, Debriefing, feedback, interprofessional education, negotiation, performance gaps, 0
You’ve been resuscitating the patient for hours and finally caught up with volume. You come back on your next...
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Prehospital Care: The Future is Now
Phoebe Adams, , 2017, The Talks DASsmacc, future, medtech, prehospital, Resuscitation, Trauma, 0
Trauma is an epidemic. It is globally the biggest killer in young people.This talk will outline the current deficits...
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Neuroimaging Nibble Subtle SAH
Phoebe Adams, , 2017, The Talks DASsmacc, Uncategorized, CT, Subtle Subarachnoid haemorrhage, 0
Neuro Imaging Nibble: Subtle Subarachnoid haemorrhage on CT by Jordan Bonomo
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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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The Problem with Physiology
Phoebe Adams, , 2017, The Talks DASsmacc, hemodynamics, outcomes, Physiology, 0
Critical care clinicians can change physiology with a number of tools. They can repeatedly, often and mercilessly change physiological...
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Four Tragic Dog Deaths: Lessons in Program Design and Development
Phoebe Adams, , The Talks DASsmacc, Administration, emergency medicine, innovation, medical education, Point-of-care Ultrasound, Program Design, Research, 0
Academic programs are built on four main pillars: clinical excellence, research, education, and administration. These apply whether you build...
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Diagnosing Meningitis – CSF lactate, procalcitonin and fungitell, when to pull the trigger on steroids/abx?
Phoebe Adams, , 2017, The Talks DASsmacc, antibiotics, bacteria, brain, CSF, CT, emergency department, fungitell, lactate, LP, Meningitis, Neuro EM, procalcitonin, steroids, 0
The golden hour of meningitis involves rapid identification, workup, and treatment. In most cases, the diagnosis of meningitis is...