Toronto POCUS

With week 3 coming to an end there has been much Ultrasounding going on. Over the last 2 weeks during our Wednesday morning teaching we have been looking at papers covering ultrasound and its use in detecting DVTs, bedside ECHOs, and eFAST in trauma. During this teaching we have been reviewing case studies and images collected throughout the week by the team including my patient I had seen with intussusception.  This week we had an excellent lecture at grand rounds by one of the leading Doctors in Ultrasound showing various ways in which ultrasound can be used and helpful as an extension of the clinical exam.  Throughout the week the team and I have been scanning various patients in the department.  Learning how to improve on getting the 4 chamber view of the heart, reviewing for testicular torsion, and looking for abscesses and much more. 

I had my first 2 ED shifts this week – very similar cases to what we would see in the UK. However it is good to see the similarities and variation in our assessment and management.  Also the way the health care system works and how this compares with the U.K.  It was good to be involved in the resuscitation of an unwell medical patient and again to reflect on practice.  I was able this week to observe a trauma resuscitation, there are similarities to what we do and also noticeable differences – tends to be a lot of people present depending on the classification of trauma. Trauma 1 being multi-trauma and trauma 2 being less serious.  On Thursdays there is Emergency Medicine seniors/fellows teaching which I go to if there is not a scanning session on and the teaching has been excellent.  This teaching has ranged from discussing current literature on prehospital interventions in paediatric trauma, and paediatric drownings and management. This week we discussed an interesting case of myocarditis that had presented to the ED, and then we had a plastics Consultant give a talk on burns.  Next week is the last week of the POCUS elective where we do a bit more scanning with the staff who oversee the program rather than just with the fellows.

Below are some pictures of the department.  Resuscitation room, Wednesday morning teaching with the team doing image review.  In the Resus room they are able to connect up the ultrasound to the big screen so everyone can watch the eFAST.