i listen to a lot of this stuff and wow are you good. This isn’t that intern basic nonsense that we all know. This is wisdom from experience. It can’t be found in another manner Thank you
38:02 No, ultrasound "might" not help, it "will" definitively tell apart a bulla from a pneumothorax. Lung ultrasound will only tell you whether there is pleura to pleura contact or not, which is why the term "pleura sonography" is much more accurate. As such, it is a trivial way to tell the two apart without any radiation. You can teach a med student to do that within 30 seconds.
is it that easy? why its not more accepted then. i am rom serbia and here i think you can yount on fingers how much hospitals do lung echo for pneumoth
@@nikolamarkovic-e8b It absolutely is. In Germany, where I am from, it is finally getting more traction with a newer generation of doctors entering service. Especially in smaller, more rural hospitals I have made the same experience that almost nobody even knows that lung ultrasound is a thing. I think it is mostly a matter of "That's how it's always been done." I remember in exactly such a small rural hospital, you could also count with your fingers the number of people who used ultrasound to insert central lines.
@@nikolamarkovic-e8b Yes. All you show in lung ultrasound is pleural sliding, i.e. that the visceral and parietal pleura are in contact, which they are in a bulla, but are not in pneumothorax. Everything beyond the pleura is artifact, so it is a bit of a guessing game, but with some experience and knowledge of typical artifacts, one can find valuable signs for pneumonia, atelectasis, pulmonary oedema and more, not to mention that it is the best visualisation of pleural effusions. Lung sliding and seashore signs are among the easiest sonography exams there are and in the hands of an experienced operator even have slightly better sensitivity and specificity than chest x-ray in detecting pneumothorax.
Helpful lecture and clear explanation, thanks. Is there is choosing criteria for epinephrine vs magnesium in patient's not responding or have minimal response with SABA apart from contraindications? thanks
Why are there not more multi-wavelength Pulse CO/Met/Oximeters on the market, particularly compact ones with adult/paed/infant/neonate leads which fit in remote medical responders' backpacks? Does a certain company hold the patents? Also pocket capnographs to plug into BVM circuit?
