SonoAus – synonymous with delivering excellence in point-of-care ultrasound education – went off with a bang in 2018. With our hand picked POCUS world leaders – Chris Fox, Rachel Liu and Arun Nagdev – we had a ball.

With two days of programming topped off with a day of scanning with our all-star cast at our Madhatter’s Tea Party, SonoAus18 brought together a diverse group of medical professionals interested in extending their POCUS knowledge and skills – from students to professors.

Designed to be different to other conferences, SonoAus18 mixed the program up to focus on themes – which just so happened to be based on characters in Lewis Carroll’s Alice through the Looking Glass. Each session provided a mixture of material and delivery styles that engaged and entertained.

The program can be downloaded [here]

 

As proud advocates of the Free Open Access Medical Education (FOAMED) movement, we recorded each of the sessions in days one and two, and will be adding these and associated presentation material we have to the global body of knowledge as we finalise the editing. Keep your eyes peeled – these are not to be missed…

Abdominal ultrasound

Bowel Ultrasound: the new frontier
Day two, Session one | Sunday 25 February 2018 | 30 minutes

Chris Fox discusses the ins and outs of bowel ultrasound. Topics covered:

  • Ultrasound for bowel obstruction: imaging the small and large intestine, cases, tips and tricks
  • Appendicitis
  • Summary

CBD in the ED – impossibly difficult? – Elissa Kennedy-Smith
Day one, Session two | Saturday 24 February 2018 | 13 minutes

Elissa Kennedy-Smith discusses the tips and tricks of imaging the common bile duct in the ED. Topics covered:

  • Anatomy
  • Normal and abnormal sonographic appearances
  • Getting the views – landmarks, tips and tricks
  • CBD vs hepatic artery
  • Cases – the good, the bad, the ugly
  • What impacts your ability to take good images
  • Cases
  • How practical is CBD in the ED
  • Summary

A PDF of Elissa’s presentation can be downloaded [here]

Cardiac/Lung ultrasound

Close calls with the executioner – 3 cases in echo
Day one, Session one | Saturday 24 February 2018 | 37 minutes

Chris Fox discusses cases where transthoracic echocardiography has made a real difference. Topics covered:

  • Case 1: 31 year old female with cough and syncope
  • Case 2: 57 year old female shortness of breath for 1 month
  • Case 3: 31 year old female bus driver BIB paramedics
  • EPSS – E Point Septal Separation for LV function assessment
  • TAPSE – Tricuspid Annular Plane Systolic Excursion ft Ben Smith @ultrasoundjelly
  • The John Travolta sign
  • Using pulse wave Doppler across mitral valve inflow tract during diastole to diagnose pericardial tamponade from pericardial effusion
  • Q&A

Ultrasound in Resuscitation: RUSH
Day one, Session three | Saturday 24 February 2018 | 43 minutes

Rachel Liu discusses her favourite topic – ultrasound in resuscitation and RUSH. Topics covered:

  • How we’ve learned shock – four stages and distinctions
  • Case 1:60 yr female with syncope
  • RUSH – pump, tank, pipe
  • Case 2: 62 yr male dyspnea, diaphoretic
  • Tamponade
  • Case 3: 62 yr female, cardiac risk factors, pulseless in asystole
  • Cardiogenic shock
  • CPR effectiveness and compression guidance, guiding defibrillation decision
  • Shock-Pump Heart and IVC
  • Case 4:90 yr female CHF, COPD, wheeze, rails
  • Tank
  • Spine sign
  • Cholecystitis
  • Pipes Aorta and leg veins/DVT
  • Case 1 review – aortic rupture/dissection

I can’t breathe – triple scan approach
Day one, Session three | Saturday 24 February 2018 | 25 minutes

Arun Nagdev discusses pearls, pitfalls and cases of lung ultrasound. Topics covered:

  • Lung and heart – neither in isolation
  • Case presentation
  • Pulmonary vs Cardiac SOB/Tachycardia/Severe distress – POCUS reduces diagnostic uncertainty
  • Symptom based ultrasound
  • Phased array vs Curvilinear
  • Triple scan approach – echo, lungs, IVC
  • EPSS
  • Cases
  • Q&A

Apologies for some out of focus sections..

Musculoskeletal ultrasound

Why use ultrasound for shoulder dislocation? – Arun Nagdev
Day two, Session three | Sunday 25 February 2018 | 17 minutes

Arun Nagdev discusses the three ways ultrasound can be of assistance in shoulder dislocations. Topics covered:

  • Confirmation of presence/absence of a dislocation – posterior vs anterior presentation on ultrasound
  • Guiding analgesia for reduction – ultrasound guided joint injections including low volume interscalene approach
  • Confirmation of reduction
  • Tips and tricks
  • Summary and Q&A

Pre-hospital ultrasound

Paramedic-performed POCUS in an Australian HEMS – Ben Meadley
Day one, Session three | Saturday 24 February 2018 | 26 minutes

Ben Meadley discusses the why and how of paramedic-performed POCUS in an Australian HEMS. Topics covered:

  • Ambulance Victoria background
  • PANTS – Paramedic Acute New Toy Syndrome
  • History of integration of POCUS
  • Establishing an educational curricula for training paramedics
  • MICA flight paramedic training
  • Technology
  • Retrospective analysis and observations in the 1st year
  • Cases where POCUS made a difference
  • Future directions
  • Summary

A PDF of Ben’s presentation can be downloaded [here]

Early pregnancy

3 hare raisers in the 1st trimester – Chris Fox
Day one, Session three | Saturday 24 February 2018 | 20 minutes

Chris Fox discusses three cases where point of care ultrasound made THE difference in a life-and-death situation.

  • Case 1 – 22yo FM, ‘Asthma attack’, bradycardic, hypotensive, cyanotic, PEA on arrival
  • Case 2 – 32yo FM, altered mental status, hypotensive, sinus tach 140s, BP 70/palp, RR16, GCS3, temp 36.9, pulse ox. 94%
  • Case 3 – 32yo FM, RLQ abdominal pain, weakness, diabetes, BP 90/55, HR130, RR16, Temp 37.3, Pulse Ox. 98%

Mistakes in diagnosing ectopic pregnancy – Chris Fox
Day two, Session four | Sunday 25 February 2018 | 25 minutes

Chris Fox discusses ectopic pregnancy. Topics covered:

  • The importance of an empty bladder in endovaginal examinations
  • Intracavity imaging anatomy orientation
  • Imaging protocol – saggital plane, coronal plane, ovaries,
  • First trimester ultrasound – intrauterine, extrauterina, can’t find it
  • Early IUP – signs, normal vs abnormal
  • Extrauterine gestation
  • Ectopic – ring of fire, TV and TA appearances, location, cornuate vs interstitial, mantle
  • No definitive IUP – indeterminate, Beta HCG
  • Misdiagnosis
  • Summary

Regional Anaesthesia

Opioids and Nerve Blocks – 3 common nerve blocks – Arun Nagdev
Day one, Session four | Saturday 24 February 2018 | 27 minutes

Arun Nagdev discusses three common ultrasound guided nerve blocks and how these can be used to reduce the use of opioids. Topics covered:

  • Multi-modal pain management
  • Femoral nerve block
  • Posterior Tibial Nerve Block
  • Brachial Plexus Block
  • Anatomy and innervation, indications, pattern recognition, in- and out-of-plane approaches
  • Impact on pain control
  • Summary

A PDF of Arun’s presentation can be downloaded [here]

Three obscure and useful nerve blocks – Arun Nagdev
Day one, Session two | Saturday 24 February 2018 | 46 minutes

Arun Nagdev highlights ten years of work at Highland General Hospital exploring the utilisation of ultrasound guided nerve blocks in the emergency department. Topics covered:

  • Preparation for procedures
  • In plane vs out of plane approach
  • Nerves on ultrasound
  • Needle location
  • Local anaesthesia – systemic toxicity, anaesthetic choice
  • Superficial cervical plexus block
  • RAPTIR – retroclavicular approach for the infraclavicular brachial plexus block
  • SAPB – serratus anterior plane block
  • Q&A

A PDF of Arun’s presentation can be downloaded [here]