SUMMER SCHOOL BRUCOLI 2015

Per il terzo anno consecutivo la SIMEU ha organizzato a Brucoli, in terra di sicilia, la full immersion per infermieri.
Tra i vari argomenti che si sono trattati non poteva non esserci l' Ecografia?
Due giorni tra un pizzico di teoria e tanta pratica ed i discenti che alla fine, hanno avuto un assaggio di quello che l'ecografia può offrire per la professione!
Nella prima giornata è intervenuta la presidente IPASVI la dott.ssa B.Mangiacavalli, che ha illustrato le nuove prospettive della responsabilità professionale dell'infermiere.
Sono le occasioni di confronto di questo tipo, che fanno pensare che i sacrifici ed i giorni di ferie presi per questo scopo siano ben utilizzati e ben spesi.
Grazie ragazzi per l'impegno ed ora la sonda passa a voi!!!
Ovviamente grazie anche a Luca il maestro

LEZIONE MASTER NOVARA

E' terminata la unit di ecografia nel Master Universitario di Accessi venosi centrali per le professioni mediche ed infermieristiche  dell' Università del piemonte orientale (UPO).
Grazie ai discenti ed ai miei preziosi collaboratori / amici, Angela, Flavio, Fabiana, Riccardo che in due giorni mi hanno aiutato ad utilizzare il tempo concessomi per una full immersion di prove pratiche con Phantom per accessi vascolari e Phantom preparati ad hoc per scovare oggetti nascosti.
Grazie a tutti ed in particolare ad Alessandra, Carla e Luisa ed ovviamente ai discenti per la loro partecipazione!!!

...siamo quasi alla frutta....

prima della prova pratica...

Phantom di Agar Agar

con magica sonda da 18MHz!!!

POLMONI ED ULTRASUONI

Articolo che mette in correlazione l'aspetto ecografico polmonare, valori biochimici e variazione della clinica del paziente.

Interesse infermieristico scarso

J Cardiovasc Med (Hagerstown). 2015 Jan 7. [Epub ahead of print]

Lung ultrasound and transthoracic impedance for noninvasive evaluation of pulmonary congestion in heart failure.

Facchini C¹, Malfatto G, Giglio A, Facchini M, Parati G, Branzi G.

aDivisione di Cardiologia, Ospedale San Luca, Istituto Auxologico Italiano IRCCS bDipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università di Milano-Bicocca, Milan, Italy.

Abstract

BACKGROUND:

In patients with heart failure, many indexes are available for noninvasive identification of pulmonary congestion: E/E' at echocardiography; plasma levels of brain natriuretic peptide (BNP) (pg/ml); number of B-lines at lung ultrasound; and transthoracic conductance [thoracic fluid content (TFC)TT = 1/Ω] at impedance cardiography (ICG).

METHODS:

We obtained 75 measures from 50 patients (72 ± 10 years, NYHA 2.4 ± 0.7, ejection fraction 31 ± 7%), 25 of them studied before and after intravenous diuretics, in whom we assessed the following: E/e' from Doppler echocardiogram; BNP plasma levels; presence and number of B-lines at lung ultrasound; and TFCTT from ICG. We determined the relationship among these indexes and their change with treatment, and compared B-lines and TFC for the diagnosis of pulmonary congestion. Finally, we considered the timing and the personnel required for performing and interpreting each test.

RESULTS:

A mutual relationship was observed between all the variables. After clinical improvement, changes in each variable were of similar direction and magnitude. Congestion (estimated by chest radiograph) was present in 59% of the patients: TFC value and B-line number had the best sensitivity and specificity for its detection. BNP determination and ICG assessment were performed by a nurse (15 min), and echocardiography and lung ultrasound were performed by a cardiologist (15 min).

CONCLUSION:

The correlation between all indexes and their consensual change after improvement of the clinical status suggests that they all detect pulmonary congestion, and that using at least two indexes improves sensitivity and specificity. The choice among the methods may be determined by the patient characteristics or by the clinical setting.

PMID:

25575275

[PubMed - as supplied by publisher]

La formazione in telemedicina è equiparabile alla formazione di persona?

Leggendo questo articolo sembrerebbe proprio così anche se sarei curioso di capire la metodica del corso per via telematica e che tipo di tutoraggio è stato messo in opera......

J Telemed Telecare. 2015 Jun;21(4):235-9. doi: 10.1177/1357633X15575446. Epub 2015 Mar 11.

A comparison of telemedicine teaching to in-person teaching for the acquisition of an ultrasound skill - a pilot project.

Brisson AM¹, Steinmetz P², Oleskevich S³, Lewis J³, Reid A³.

Author information

Abstract

Telemedicine is widely used for medical education but few studies directly investigate how telemedicine teaching compares to conventional in-person teaching. Here we determine whether telemedicine teaching is as effective as in-person teaching for the acquisition of an ultrasound skill important in trauma care. Nurses with no prior ultrasound experience (n = 10) received study material and a teaching session on how to locate and image the hepatorenal space (Morison's pouch). One group of nurses was taught in-person (In-person Group) and the other group was taught via telemedicine (Telemedicine Group). Telemedicine allowed two-way audio and visual communication between the instructor and the nurses. A comparison of the teaching techniques showed that telemedicine teaching was equivalent to in-person teaching for the acquisition of practical and theoretical skills required to locate Morison's pouch. The average time required to locate Morison's pouch after teaching was similar between both groups. The results demonstrate that telemedicine teaching is as effective as in-person teaching for the acquisition of bedside ultrasound skills necessary to identify Morison's pouch. Remote teaching of these bedside ultrasound skills may help in the diagnosis of intra-abdominal bleeding in rural healthcare centers.
© The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

KEYWORDS:

Telemedicine; tele-education; telecare; telehealth; teleradiology

Ultrasuoni in cardiochirurgia

 Articolo nel quale i colleghi Norvegesi sono stati "allenati" a verificare precocemente i versamenti pericardici e pleurici attraverso l'uso di un ecografo tascabile
Scand Cardiovasc J. 2015 Feb;49(1):56-63. doi: 10.3109/14017431.2015.1009383. Epub 2015 Feb 6.

Focused ultrasound of the pleural cavities and the pericardium by nurses after cardiac surgery.

Graven T¹, Wahba A, Hammer AM, Sagen O, Olsen Ø, Skjetne K, Kleinau JO, Dalen H.

¹Department of Medicine, Levanger Hospital, Nord-Trøndelag Health Trust , Levanger , Norway.


Abstract

OBJECTIVES:

We aimed to study the feasibility and reliability of focused ultrasound (US) examinations to quantify pericardial (PE)- and pleural effusion (PLE) by a pocket-size imaging device (PSID) performed by nurses in patients early after cardiac surgery.


DESIGN:

After a 3-month training period, with cardiologists as supervisors, two nurses examined 59 patients (20 women) with US using a PSID at a median of 5 days after cardiac surgery. The amount of PE and PLE was classified in four categories by US (both) and chest x-ray (PLE only). Echocardiography, including US of the pleural cavities, by experienced cardiologists was used as reference.


RESULTS:

Focused US by the nurses was more sensitive than x-ray to detect PLE. The correlations of the quantification of PE and PLE by the nurses and reference was r (95% confidence interval) 0.76 (0.46-0.89) and 0.81 (0.73-0.89), both p < 0.001. PE and PLE were drained in one and six (eight cavities) patients, all classified as large amount by the nurses.


CONCLUSIONS:

Cardiac nurses were able to obtain reliable measurements and quantification of both PE and PLE bedside by focused US and outperform the commonly used chest x-ray regarding PLE after cardiac surgery.

KEYWORDS:

PSID; echocardiography; pocket-size; postoperative; training

PMID:

25611808

[PubMed - in process]




PMCID:

PMC4389761




Free PMC Article

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M.E.P.I.O. 3^ EDIZIONE

Anche quest'anno partirà il master di I livello M.E.P.I.O., è stato modificata la durata che ora è biennale.
Per informazioni si può andare su contatti del link a fondo pagina.
Vi aspettiamo


Il Consiglio di Amministrazione ha approvato, nella seduta del 29 aprile 2015, l'attivazione per l'a.a. 2015-2016 del Master in Metodiche Ecoguidate per le Professioni Infermieristiche ed Ostetriche.
Pur conservando 60 CFU e gli stessi costi di partecipazione, il master MEPIO sarà BIENNALE (2016-17) per consentire che le attività di tirocinio e di tesi siano spalmate su tempi più lunghi e favorire la partecipazione di chi è già occupato.
L'inizio attività è previsto per i primi mesi del 2016.
L'immatricolazione dovrà avvenire entro fine 2015  con le modalità che verranno indicate subito dopo l'approvazione da parte del Consiglio Scientifico e pubblicizzate sui siti istituzionali.

RATE E SCADENZE
- Tre rate: I rata € 200 all’immatricolazione; II rata € 800 entro aprile 2016; III rata € 500 entro ottobre 2016

- sanzioni amministrative: come previsto dal Regolamento Tasse e Contributi a.a. 2015-2016

-la data oltre la quale la non regolarizzazione della contribuzione implica la mancata iscrizione è: 10 gennaio 2016

-le norme di rimborso in caso di rinunce o mancata regolarizzazione della contribuzione: non sono previste norme di rimborso 

 http://www.mepio.altervista.org

MEGLIO IL LACCIO O IL BRACCIALE?

Am J Emerg Med. 2014 Jul;32(7):761-4. doi: 10.1016/j.ajem.2014.04.020. Epub 2014 Apr 18.

Randomized trial of tourniquet vs blood pressure cuff for target vein dilation in ultrasound-guided peripheral intravenous access.

Nelson D¹, Jeanmonod R², Jeanmonod D³.

Author information

• ¹2. St. Luke's University Hospital, 801 Ostrum St, Bethlehem, PA 18015, USA.
• ²2. St. Luke's University Hospital, 801 Ostrum St, Bethlehem, PA 18015, USA. Electronic address: rebeccajeanmonod@yahoo.com.
• ³2. St. Luke's University Hospital, 801 Ostrum St, Bethlehem, PA 18015, USA. Electronic address: jeanmono@yahoo.com.

Abstract

BACKGROUND:

Ten percent of the time, peripheral intravenous access (PIV) is not obtained in 2 attempts in the emergency department. Typically, a tourniquet is used to dilate the target vein; but recent research showed that a blood pressure (BP) cuff improves dilation, which may translate to increased PIV success.

OBJECTIVES:

We sought to determine if there is improved success in obtaining ultrasound-guided PIV using a BP cuff vs a tourniquet in "difficult stick" patients.

METHODS:

This is a prospective, randomized, single-blinded trial. Adult patients requiring PIV with at least 2 prior failed attempts were enrolled. Patients were assigned to tourniquet or BP cuff for target vein dilation randomly. Nurses prepared the patient for PIV attempt by either placing a BP cuff inflated to 150 mm Hg or placing a tourniquet on the chosen extremity. The extremity was draped to blind the physician to assignment. Physicians then attempted ultrasound-guided PIV. Failures were defined as IVs requiring greater than 3 ultrasound-guided attempts or 30 minutes, or patient intolerance. If failure occurred, the physician was unblinded; and the patient could be crossed over and reattempted.

RESULTS:

Thirty-eight patients were enrolled. The success rate for the tourniquet group (n = 17) and BP cuff group (n = 21) was 82.4% and 47.6%, respectively (P = .04). There were no differences between groups for vessel depth, diameter, or procedure time. Six in the BP cuff group were crossed over and had successful PIV obtained with tourniquet.

CONCLUSIONS:

Tourniquet is superior to BP cuff for target vein dilation in ultrasound-guided PIV.
Copyright © 2014 Elsevier Inc. All rights reserved.

PMID:

24856748

[PubMed - indexed for MEDLINE]