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ED U/S Fun


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Played around with the new sonosite today with one of the docs and learned how to do DVT studies. very cooperative pt allowed us to also practice GB views, fast exam, IVC view, cardiac and lung windows. fun stuff.

also learned the best place to store the u/s gel is in the blanket warmer.

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having worked in IR for a couple years I can say with out a doubt US is an amazing tool

 

Need to stay proficient at it, but you can learn a huge amount of info vary rapidly with out radiation or even leaving the department if you are good at it......   

 

IMHO - every ER provider should be using it....

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I was considering becoming a US Tech IF I didn't get into PA school this year, however, the only positions I see available are PRN or OB. I do not see them much in the hospital. I know using US has many advantages, especially in the ER. But I'm wondering what the future holds for the career. Do you work with US Techs in the ER? 

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Our rule of thumb is to try and do at least 1 bedside US per shift to ensure you get experience with scans.  The RUSH exam in hypotension is great to quickly screen for causes of hypotension in a few minutes; I also doing a lot of chest exams (echo + lungs/thorax) in my chest pain/SOB patients.  It's one of those things where if it sits in the corner gathering dust you'll never get comfortable; you just have to start scanning as many patients as possible.

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It is always a guarantee that the u/s gel on the u/s cart will be empty similar to the ketchup bottle in your fridge.

I am making it a point to check the gel at start of shift now.

G Brothers PA-C

 

If your hospital uses the foam hand sanitizer, makes for a great alternative if you just need a quick view, haha, use it all the time for placing tough IV's, no mess to clean up, just rub in!

 

Used it today to start an IV on brachial vein of 90 yo diabetic, on dialysis. Fun stuff indeed.

 

yup, this is about the only time I get to use one, would be an awesome skill to have though

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I have been a registered sonographer since 1979 and a PA since 1997.  Ultrasound technology has come such a long way since I started, and the newer equipment makes it much more accessible.  I still get to do an exam occasionally, and am still amazed by how beautiful exams can be, especially echos.  Would like to resume a little ultrasound work when I go part-time as a PA.

 

If you run out of ultrasound gel, a good sized blob of KY jelly can work just fine.

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also learned the best place to store the u/s gel is in the blanket warmer.

 

O _ O

 

How was I an ER tech at Hennepin for 3 years (with like six US machines rolling around the joint all day every day) and never think of this?

 

I bet there's some reason why you shouldn't, like it lasts longer if you don't, or it breaks down, or the plastic of the bottle isn't rated for the heat... but that's a fine fine idea.

 

(I did keep packets of Surgi-Lube in my pocket so they'd be slightly warmer when it was time for rectal temps)

 

I have fun with the simple, hands-on, no-fancy-machines kind of medicine too, but I'd love to be able to have an ultrasound (and the training and practice time to be good at it). You could say I'm a little bit... jelly.

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Our rule of thumb is to try and do at least 1 bedside US per shift to ensure you get experience with scans.  The RUSH exam in hypotension is great to quickly screen for causes of hypotension in a few minutes; I also doing a lot of chest exams (echo + lungs/thorax) in my chest pain/SOB patients.  It's one of those things where if it sits in the corner gathering dust you'll never get comfortable; you just have to start scanning as many patients as possible.

 

very important - you need to stay sharp on it - this once per shift sounds like a great idea

 

 

 

Used it today to start an IV on brachial vein of 90 yo diabetic, on dialysis. Fun stuff indeed.

 

Ahh the mainstay of IR is US guided PICC's - you are heading that direction!!

 

 

 

O _ O

 

How was I an ER tech at Hennepin for 3 years (with like six US machines rolling around the joint all day every day) and never think of this?

 

I bet there's some reason why you shouldn't, like it lasts longer if you don't, or it breaks down, or the plastic of the bottle isn't rated for the heat... but that's a fine fine idea.

 

(I did keep packets of Surgi-Lube in my pocket so they'd be slightly warmer when it was time for rectal temps)

 

I have fun with the simple, hands-on, no-fancy-machines kind of medicine too, but I'd love to be able to have an ultrasound (and the training and practice time to be good at it). You could say I'm a little bit... jelly.

 

actually it is likely fine - US gel warmers are nothing but little boxes with two open holes in the top that you drop a bottle of gel in each hole - keeps it warm..... if you have ever had an US - try it with cold versus warm gel..... you will never again use cold gel!!!!!!!!

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If anyone is attending SEMPA this year I will be an instructor for the Emergency Ultrasound Workshops. Workshops will be on 5/3 and 5/4 with a focus on basic emergency ultrasound, advanced ultrasound and ultrasound guided procedures. We will be teaching basic physics, FAST, Cardiac, Soft Tissue, Ocular, Renal, Abdominal, LPs, Central Lines, etc. 

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If anyone is attending SEMPA this year I will be an instructor for the Emergency Ultrasound Workshops. Workshops will be on 5/3 and 5/4 with a focus on basic emergency ultrasound, advanced ultrasound and ultrasound guided procedures. We will be teaching basic physics, FAST, Cardiac, Soft Tissue, Ocular, Renal, Abdominal, LPs, Central Lines, etc. 

I did the fast course at sempa  a few years ago. it was pretty good. I still carry the cheat sheet from that course in my lab coat pocket.

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