Grand Rounds Recap 2.20.19

Grand Rounds Recap 2.20.19

This week’s grand rounds started with Dr. Colmer reviewing some fascinating cases in this months Morbidity and Mortality. We then split up into groups and did the quarterly sim focusing on informed consent led by Drs. LaFollette and Lang. This was followed by some challenging oral boards cases chosen by Drs. McDonough and Hill. Look forward to next week!

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US - Saphenous vein cannulation: Ultrasound of the Month

US - Saphenous vein cannulation: Ultrasound of the Month

Vascular access difficulties…everyone’s favorite. There’s certainly no way to disrupt your flow and efficiency than a patient who you cant get access on. In this month’s ultrasound case of the month, Dr. Jared Ham discusses a technique using ultrasound to get quick and easy access.

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The Anatomy of Femoral Vascular Access

The Anatomy of Femoral Vascular Access

Prior to the widespread availability of point-of-care ultrasonography, invasive medical procedures were performed by the “landmark method”.  Landmark methods are based on surface anatomy, palpation, and sometimes trigonometry, and are fraught with the potential for error.  Complications, while unquantified in the misty past, were likely much more common than in the current era of readily available bedside imaging.  Vascular access procedures are inarguably safer and more successful when guided by sonography, but interpretation of ultrasound images still requires an understanding of both surface and deeper anatomy to relate the two-dimensional screen image to three-dimensional reality.  Further, there are circumstances where either the urgency of the resuscitation, or compromised access to the patient, requires that vascular access be obtained using landmarks rather than real-time imaging.  In such cases a detailed understanding of regional anatomy is critical to maximize procedural success and minimize complications.

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