Greg Hall

@alandrummond2 Congrats to the team. Wade and Curtis came to us and worked incredibly hard getting certified as providers and instructors. Then to go and set up their own program is just plain outstanding. A real inspiration and fantastic leadership on all levels.

Renfrew County Paramedics first in Canada to use Point of Care Ultrasound. Chief Nolan is a national treasure - he really is insideottawavalley.com/news-story/108…

@dan___kim When ED function depends max flow and stat everything, other depts/admin fail to understand and plan for how crippling any downtime is. Our dept had CT down for 25% of month...and we're a regional stroke centre.

Had to fill out a survey about downtime I think the scale of “difficult to disastrous” is appropriate 🤣

@dan___kim But what the patient/their neighbour/homeopath assumed: July 2021 -Red eye: vaccine reaction -Dysarthria: vaccine reaction -Fever: vaccine reaction -SOB: vaccine reaction -V&D: vaccine reaction -Trauma: vaccine reaction triggered events

VACCINES work!!! March 2020 -Red eye: COVID -Dysarthria: COVID -Fever: COVID -SOB: COVID -V&D: COVID -Trauma: COVID July 2021 -Red eye: conjunctivitis -Dysarthria: stroke -Fever: urosepsis -SOB: CHF -V&D: gastro -Trauma: trauma

@KimiChernoby "The tech was just doing their job" misses point. Telling someone to find the doctor assumes person not the doctor, that is the implicit bias. If the tech instead asked them to I.D. self if they hadn't already=diligence and lesson for the MD.

Tried to be helpful by bringing my patient a sandwich and the tech stopped me and told me I needed to go find the doctor for permission to feed the patient. 😑

Looking forward to a weekend of POCUS guru goodness! What a lineup!

#paperinapic by @KirstyChallen @BrianAlperMD reanalysis of ECASS-3 failing to show efficacy of tPA in 3-4.5hrs but confirming increase in harm (bleeding). Will @CAEP_Docs @ACEPNow @American_Heart @HeartandStroke reconsider the management of these patients?

Useful tips found after 1st 50 #POCUS: use PPE even in triage/mates/suspected #COVID, some pts cannot move (PLAPS), use Hand-Held, flight mode, remove password, avoid rip off end where probe is attached,use 3 basin (dirty-cleaning-clean), practice ur aim. No stethoscope. & YOURS?

@EMO_Daddy @CAEP_Docs @eddeestyle @emergmedottawa @TheSGEM @docschull @HowardOvens @hrosenberg33 @SAEMEBM @alandrummond2 Distributing work type that minimizes risk based on age and other criteria makes sense when staffing good. What does everyone think when there's not enough young ER docs available? Ask youngins to do dangerous # hrs or have a rad on front line vs experienced 60 yo ER doc?

Not convinced that senior ED docs need to put themselves at higher risk to "show leadership" - does your family know that at 65yo has a 25x higher case fatality rate than those in 30s (5.0 vs 0.2%)? - have you explored other options to have patients screened by younger MDs & RNs?

@TomJelic Obtained Health Canada approval for Butterfly by completing a form. Now it's just a question of the company being able to meet the new Canadian demand.

Help me take better care of my patients!

Hey @GovCanHealth now that we are facing a pandemic, it would be nice to have a handy ultrasound device that is easy to clean between critically ill patients. @ButterflyNetInc is stuck waiting your approval! Can we make that happen now as we need devices like this!!

@lacticacidq3 @TomJelic @GovCanHealth @ButterflyNetInc What no one has been able to answer for me is almost all cart systems have cooling fans with non-HEPA filters. So if there is aerosolization of virus, is having active fans going a good idea? Disinfecting cooler impossible. Cover cart with a gown or bag first?

@JoelTurnerEM @motorcycleERdoc @ultrasoundREL @dan___kim Might be feasible in lower volume clinics and rural areas.

@JoelTurnerEM @motorcycleERdoc @ultrasoundREL @dan___kim Joel are you using the Butterfly in a bag approach? Probe cover or similar bag, discarded after scan and quick disinfectant wipe then next patient? The fact a negative lung scan is going to probably take on the order of 3min would be the biggest issue for screening.

Asymptomatic #COVID19 is out there. Saw a patient the other day with an unrelated acute medical issue requiring hospitalization but no respiratory/flu-like symptoms ➡️ tested positive for COVID. Should we be wearing PPE at all times in the ED? academic.oup.com/jid/advance-ar…

Learn about the clinical utility and technique for lung ultrasound in COVID-19 cases with Dr. Dan Kim, an emergency physician in Vancouver: ow.ly/MuCC50yNooM

@dan___kim @SSRN Anyone know about safety of laptop and cart based machines with their cooling fans and potential for viral spread? Doubt the filters were built for virus sized particles and even if they were, what would the disinfection protocol be? Should we be using fanless handhelds only?

From @SSRN, probably one of the first papers describing #ultrasound #POCUS findings of #COVID19 Common findings -B lines -Subpleural consolidation -Air bronchograms -Irregular pleural line -Localized pleural effusion ssrn.com/abstract=35447…

Wondering how my fellow ER colleagues, who by necessity are at high risk for COVID-19 exposure, are dealing with their own social distancing and isolation. Stopped visiting your parents, immunocompromised friends? Still going out for dinners? Stopped visiting the gym?

Multidisciplinary Response to the @CARadiologists #POCUS Position Statement - by @CAEP_docs @ACEP_EUS @CASUpdate @critcaresociety @pocusnetwork & others #articleShareContainer" target="_blank" rel="nofollow noopener">journals.sagepub.com/doi/full/10.11…

Know what grinds my gears? Referring to the ED doc as "Jack of all trades, master of none." We are master Resuscitationists Masters of action on little to no info We speak 20+ specialty languages We know the relevant lit across medicine We're Masters. Stop saying we're not

Teaching bedside physical exam with #IMPOCUS @IMUS_Spokane #SGIMForum sgim.org/File%20Library…

A study by @fhberger @Sunnybrook shows overnight final reads can decrease imaging recalls to the ED #RSNA2019 #IamERad #WeCanMakeADifference @RSNA @ASER_ERad

POCUS also helps by getting us back to more hands-on time examining our patients and sharing our findings. More human contact=less burnout.

The Place of POCUS in Prevention of Physician Burnout aiumthescan.wordpress.com/2019/09/10/the… via @AIUM_Ultrasound