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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Sepsis, Brazil, Women in ICU… Who Cares? Peter Brindley interrogates: Flavia Machado
Phoebe Adams, , 2017, The Talks DASsmacc, brazil, Sepsis, women, 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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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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SonoBYTE: Mitral Valve Magic by James Rippey
Phoebe Adams, , The Talks DASsmacc, Mitral Valve, SonoBYTE, Ultrasound, 0
The appearance of high quality hand held ultrasound machines mean we will all have imaging available at our finger...
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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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In Honour of the Clot (Consider the Lobster)
Phoebe Adams, , 2017, The Talks DASsmacc, Coagulation, Dinosaurs, Evolution, Fibrinogen, haemorrhage, Lobsters, thrombolysis, tPA, 0
A talk about David Foster Wallace, evolution, and what do when the thrombolysis bisque hits the fan.
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CRITICAL ILLNESS… HEROES, VICTIMS, VICTORS, SURVIVORS?
Phoebe Adams, , The Talks DASsmacc, 0
Chair: Liz Crowe Panel: Carol Hodgson, Margaret Herridge, James Piercy, Martin Bromiley, Rob Rogers, David Menon Critcal care is...
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SonoBYTE: Echo in Cardiac Arrest by Haney Mallemat
Phoebe Adams, , The Talks DASsmacc, cardiac arrest, ECHO, SonoBYTE, 0
Ultrasound is an important adjunct for caring for cardiac arrest patients, but trans-thoracic can deter from important hands-on compressions....
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Resuscitation for the Resuscitationist
Phoebe Adams, , The Talks DASsmacc, Resuscitation, 0
Panelist participation in the “Resuscitation for the Resuscitationist” panel session.