scholarly journals Impact of a 2-Day Critical Care Ultrasound Course during Fellowship Training: A Pilot Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Vi Am Dinh ◽  
Paresh C. Giri ◽  
Inimai Rathinavel ◽  
Emilie Nguyen ◽  
David Hecht ◽  
...  
Keyword(s):  
Critical Care ◽  
Point Of Care ◽  
Image Interpretation ◽  
Fellowship Training ◽  
Multiple Organ ◽  
Critical Care Echocardiography ◽  
Organ Systems ◽  
Critical Care Ultrasound ◽  
Written Test ◽  
The Impact

Objectives. Despite the increasing utilization of point-of-care critical care ultrasonography (CCUS), standards establishing competency for its use are lacking. The purpose of this study was to evaluate the effectiveness of a 2-day CCUS course implementation on ultrasound-naïve critical care medicine (CCM) fellows.Methods. Prospective evaluation of the impact of a two-day CCUS course on eight CCM fellows’ attitudes, proficiency, and use of CCUS. Ultrasound competency on multiple organ systems was assessed including abdominal, pulmonary, vascular, and cardiac systems. Subjects served as self-controls and were assessed just prior to, within 1 week after, and 3 months after the course.Results. There was a significant improvement in CCM fellows’ written test scores, image acquisition ability, and pathologic image interpretation 1 week after the course and it was retained 3 months after the course. Fellows also had self-reported increased confidence and usage of CCUS applications after the course.Conclusions. Implementation of a 2-day critical care ultrasound course covering general CCUS and basic critical care echocardiography using a combination of didactics, live models, and ultrasound simulators is effective in improving critical care fellows’ proficiency and confidence with ultrasound use in both the short- and long-term settings.

Critical Care Nursing

2017 ◽  
Keyword(s):  
Critical Care ◽  
Kidney Injury ◽  
Multiple Organ ◽  
Major Incident ◽  
Organ Support ◽  
Evidence Based ◽  
Care Environment ◽  
Organ Systems ◽  
General Aspects ◽  
The Impact

This textbook encompasses the knowledge, skills, and expertise needed to deliver excellent nursing care to critically ill patients. Emphasis is placed on a holistic and compassionate approach towards humanizing the impact of the environment, organ support, and monitoring, as well as critical illness itself. Chapters cover the general aspects of critical care such as the critical care environment or critical care continuum and specific organ systems and diseases. The structure of the systems chapters reminds the reader of the underlying anatomy and physiology as well as highlighting areas of particular relevance to critical care. The focus on priorities for management builds on the ABCDE assessment and offers insight into key interventions in urgent situations as well as outlining evidence-based practice. The book is ideal for those new to the critical care environment, but will also act as a reminder for more experienced nurses when faced with a new situation or when teaching/mentoring students. The patient and their family remain the centre of all This new edition brings the definitions, pathophysiology, and management of fast-changing and challenging areas such as ARDS, sepsis and multiple organ dysfunction, resuscitation, and acute kidney injury up to date as well as including any evidence-based changes associated with nursing practice in critical care. A new chapter covers major incident planning and management and the role of critical care in pandemic situations.

scholarly journals Neurological, neuropsychiatric and neurodevelopmental complications of COVID-19

2020 ◽  
pp. 000486742096147
Author(s):  
Christos Pantelis ◽  
Mahesh Jayaram ◽  
Anthony J Hannan ◽  
Robb Wesselingh ◽  
Jess Nithianantharajah ◽  
...  
Keyword(s):  
Organ Damage ◽  
Multiple Organ ◽  
Global Pandemic ◽  
Organ Systems ◽  
Future Challenges ◽  
The Central Nervous System ◽  
The Impact ◽  
Collaborative Efforts ◽  
The Brain

Although COVID-19 is predominantly a respiratory disease, it is known to affect multiple organ systems. In this article, we highlight the impact of SARS-CoV-2 (the coronavirus causing COVID-19) on the central nervous system as there is an urgent need to understand the longitudinal impacts of COVID-19 on brain function, behaviour and cognition. Furthermore, we address the possibility of intergenerational impacts of COVID-19 on the brain, potentially via both maternal and paternal routes. Evidence from preclinical models of earlier coronaviruses has shown direct viral infiltration across the blood–brain barrier and indirect secondary effects due to other organ pathology and inflammation. In the most severely ill patients with pneumonia requiring intensive care, there appears to be additional severe inflammatory response and associated thrombophilia with widespread organ damage, including the brain. Maternal viral (and other) infections during pregnancy can affect the offspring, with greater incidence of neurodevelopmental disorders, such as autism, schizophrenia and epilepsy. Available reports suggest possible vertical transmission of SARS-CoV-2, although longitudinal cohort studies of such offspring are needed. The impact of paternal infection on the offspring and intergenerational effects should also be considered. Research targeted at mechanistic insights into all aspects of pathogenesis, including neurological, neuropsychiatric and haematological systems alongside pulmonary pathology, will be critical in informing future therapeutic approaches. With these future challenges in mind, we highlight the importance of national and international collaborative efforts to gather the required clinical and preclinical data to effectively address the possible long-term sequelae of this global pandemic, particularly with respect to the brain and mental health.

scholarly journals The use of critical care echocardiography in peri-arrest and cardiac arrest scenarios: Pros, cons and what the future holds

2020 ◽  
pp. 175114372093699 ◽  
Author(s):  
Luke Flower ◽  
Olusegun Olusanya ◽  
Pradeep R Madhivathanan
Keyword(s):  
Cardiac Arrest ◽  
Critical Care ◽  
Intensive Care ◽  
Patient Care ◽  
Core Competence ◽  
Point Of Care ◽  
Response To Treatment ◽  
Monitoring Tool ◽  
Critical Care Echocardiography ◽  
Focused Echocardiography

Echocardiography is being increasingly deployed as a diagnostic and monitoring tool in the critically ill. This rise in popularity has led to its recommendation as a core competence in intensive care, with several training routes available. In the peri-arrest and cardiac arrest population, point of care focused echocardiography has the potential to transform patient care and improve outcomes. Be it via diagnosis of shock aetiology and reversibility or assessing response to treatment and prognostication. This narrative review discusses current and future applications of echocardiography in this patient group and provides a structure with which one can approach such patients.

scholarly journals Laboratory testing for COVID-19 in suspected human cases and the impact of corona virus pandemic on the global health system

2020 ◽  
Vol 5 (4) ◽  
pp. 498-504
Author(s):  
Debashis Mania ◽  
T.K. Mandal ◽  
A.K. Bera ◽  
Brig. Rajiv Sethi
Keyword(s):  
Laboratory Testing ◽  
Multiple Organ ◽  
Human Beings ◽  
Indian Health ◽  
Corona Virus ◽  
Organ Systems ◽  
The World ◽  
The Impact ◽  
Organ Invasion ◽  
Different Parts

COVID-19, coronavirus (SARS-CoV-2) infection has become pandemic after first appearing in Wuhan, China in December 2019. It destroyed the life of millions of people throughout the different parts of Europe, America, Asia and others in the world. Various groups of scientists throughout the globe have claimed on trialing for the corona vaccine and for finding out suitable medication for the treatment of COVID-19. No vaccine or medicines are successfully reported to short out the issue for saving the valuable life of human beings, till date. The mechanism of SARS-CoV-2 infection and organ invasion are not understood and it creates difficulty in clinical diagnosis and treatment of corona patients. The pathogenic mechanism of SARS-CoV-2 infection is not very much clear and it may invade multiple organ systems of respiratory, digestive and hematological in a confirmed case. The impact of corona virus outbreak on the global and Indian health systems is also reviewed herewith.

Critical Care Ultrasound (DRAFT)

2018 ◽  
Author(s):  
Christopher K. Schott
Keyword(s):  
Emergency Medicine ◽  
Critical Care ◽  
Critically Ill Patients ◽  
Patient Management ◽  
Point Of Care ◽  
Rapid Response Team ◽  
Response To Treatment ◽  
Response Team ◽  
Critical Care Ultrasound ◽  
Point Of Care Ultrasonography

Point of care ultrasonography (POCUS) is a tool that can be used at the bedside to aid in the diagnosis and treatment of critically ill patients. The ability to directly visualize physiology, pathology, and response to treatment can add valuable information in patient management particularly in time sensitive situations with acutely decompensated patients as may occur in the context of rapid response team (RRT) events. Although most of the data on POCUS to guide resuscitations has been published through emergency medicine (EM) and pre-hospital studies, the same approach can be easily adapted for in-hospital RRT events. This chapter reviews validated POCUS protocols for the assessment of hypotensive, hypoxic, or arresting patients and the ways it can be incorporated into in-hospital RRTs.

Effectiveness of an Advanced Critical Care Echocardiography Course

2019 ◽  
Vol 35 (11) ◽  
pp. 1332-1337 ◽  
Author(s):  
Pralay Kumar Sarkar ◽  
Michel Boivin ◽  
Paul H. Mayo
Keyword(s):  
Critical Care ◽  
Image Acquisition ◽  
Image Interpretation ◽  
Left Ventricular ◽  
Structure And Function ◽  
Important Place ◽  
Critical Care Echocardiography ◽  
Ventricular Structure ◽  
Hands On ◽  
And Function

Background: Advanced critical care echocardiography (CCE) involves comprehensive assessment of cardiac structure and function for frontline critical care applications. This study reports the effectiveness of a 3-day course in advanced CCE. Methods: We studied the outcome of 5 consecutive advanced CCE courses delivered between 2013 and 2017. A total number of 239 learners were studied. The course included didactic lectures, image interpretation sessions, and hands-on training with normal individuals as models. Training domains included left ventricular structure and function, right ventricular structure and function, valve function using comprehensive 2-dimensional imaging, and Doppler-based measurements for cardiac pressures and flows. Measurements of course outcome included pre- and postcourse assessment of knowledge, image acquisition, and image interpretation skills. Learners rotated between hands-on training and interpretation sessions. The teacher-to-learner ratio was 1:3 during hands-on training. Interpretation sessions consisted of review of normal and abnormal echocardiographic videos with interactive small groups. Learners completed a video-based knowledge assessment examination before and after completion of the course. Hands-on image acquisition skills were tested at the completion of the course during all the years. For years 2016 and 2017, a precourse hands-on skill test was also performed. Results: There was a statistically significant improvement in knowledge and image interpretation skills in the cohort of 239 learners over 5 years of study period. There was improvement in image acquisition skills over the 2-year period when it was measured pre- and postcourse. Conclusions: A 3-day course on advanced CCE resulted in improvement knowledge/image interpretation and hands-on image acquisition skills. Clinical Implications: Advanced CCE has assumed an important place in hemodynamic monitoring of critically ill patients. A course of similar design may facilitate training of frontline clinicians in advanced CCE.

scholarly journals Fellowship training in critical care ultrasound

2018 ◽  
Vol 65 (7) ◽  
pp. 847-849 ◽  
Author(s):  
Brian Buchanan ◽  
Hailey Hobbs ◽  
Robert Arntfield
Keyword(s):  
Critical Care ◽  
Fellowship Training ◽  
Critical Care Ultrasound
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