Saturday, April 30, 2016

Toxicologic Ultrasound in SHock

April 28, 2016, 9:34 pm
Incidence and patterns of cardiomyopathy in carbon monoxide-poisoned patients with myocardial injury. Cha YS et al. Clin Toxicol 2016 Apr 11 [Epub ahead of print]

At last year’s Social Media and Critical Care (SMACC) conference in Chicago, I gave a talk remarking on how bedside ultrasound imaging in critically ill toxicology patients is underused and little studied. I suggested that it could provide crucial information in a number of settings. For example, visualizing the inferior vena cava (IVC) in salicylate toxicity to help guide rehydration, or evaluating left ventricular (LV) function to distinguish myocardial dysfunction from vasodilation in the unstable hypotensive patient with calcium channel blocker overdose.
I suggested that a simple, two part protocol looking at the IVC and left ventricle in these patients was an idea whose time had come. Building on the rapid adoption of the FAST and RUSH exams, I suggested that this protocol should be called Toxicologic Ultrasound in SHock — the TUSH exam..."