Papers of April 2016

Here’s a look at some of the papers that caught our eye this month. We cover the best way to diagnose heart failure, the risks associated with hyperopia and the utility of ETCO2.  Take the time to have a look at the papers yourself and leave any feed back or comments at the bottom of the page.

The Papers

Diagnosing Acute Heart Failure in the Emergency Department: A Systematic Review and Meta-analysis. Martindale JL. Acad Emerg Med. 2015 Dec 21. doi: 10.1111/acem.12878. [Epub ahead of print]

Effect of supplemental oxygen exposure on myocardial injury in ST-elevation myocardial infarction.Nehme Z. Heart. 2016 Mar;102(6):444-51. doi: 10.1136/heartjnl-2015-308636. Epub 2016 Jan 6

Prognostication of out-of-hospital cardiac arrest patients by 3-min end-tidal capnometry level in emergency department. Poon KM. Resuscitation. 2016 Mar 3;102:80-84. doi: 10.1016/j.resuscitation.2016.02.021. [Epub ahead of print]

Within the podcast we talk about the fantastic ultrasound resource that is 5min sono developed by Jacob Avila, make sure you got over to the site and have a look at the superb ultrasound resources on offer. Specific to this podcast is the episode on b lines, Jacob kindly provided the images below from his video.

What’s required to identify significant B-lines on chest ultrasound; summary of Jacobs points

  • Use the phased array probe ideally, curved linear probe is possible but technically more difficult
  • Patient position; choose any that allows access to the chest
  • Probe marker towards patients head
  • Scan 4 zones to each side of the chest, superior medial, superior lateral, inferior medial, inferior lateral

Screen Shot 2016-03-15 at 07.53.23

  • To diagnose b lines you need to see vertical artefact, moving with respiration that extends the full depth of the screen (as shown below)

Screen Shot 2016-03-15 at 07.59.38

  • A positive zone is when you identify 3 b-lines in a zone
  • Pulmonary oedema diagnosed with 2 positive zones on each side of the chest

Related Resources


PHEMCAST Hyperoxia 

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