The clinical value of whole blood point-of-care biomarkers in large animal emergency and critical care medicine

2015 ◽  
Vol 25 (1) ◽  
pp. 138-151 ◽  
Author(s):  
Rolfe M. Radcliffe ◽  
Ben R. Buchanan ◽  
Vanessa L. Cook ◽  
Thomas J. Divers
2014 ◽  
Vol 2014 ◽  
pp. 1-17 ◽  
Author(s):  
Saul Chemonges ◽  
Kiran Shekar ◽  
John-Paul Tung ◽  
Kimble R. Dunster ◽  
Sara Diab ◽  
...  

Animal models of critical illness are vital in biomedical research. They provide possibilities for the investigation of pathophysiological processes that may not otherwise be possible in humans. In order to be clinically applicable, the model should simulate the critical care situation realistically, including anaesthesia, monitoring, sampling, utilising appropriate personnel skill mix, and therapeutic interventions. There are limited data documenting the constitution of ideal technologically advanced large animal critical care practices and all the processes of the animal model. In this paper, we describe the procedure of animal preparation, anaesthesia induction and maintenance, physiologic monitoring, data capture, point-of-care technology, and animal aftercare that has been successfully used to study several novel ovine models of critical illness. The relevant investigations are on respiratory failure due to smoke inhalation, transfusion related acute lung injury, endotoxin-induced proteogenomic alterations, haemorrhagic shock, septic shock, brain death, cerebral microcirculation, and artificial heart studies. We have demonstrated the functionality of monitoring practices during anaesthesia required to provide a platform for undertaking systematic investigations in complex ovine models of critical illness.


2015 ◽  
Vol 7 (4) ◽  
pp. 567-573 ◽  
Author(s):  
Paru Patrawalla ◽  
Lewis Ari Eisen ◽  
Ariel Shiloh ◽  
Brijen J. Shah ◽  
Oleksandr Savenkov ◽  
...  

ABSTRACT Background Point-of-care ultrasound is an emerging technology in critical care medicine. Despite requirements for critical care medicine fellowship programs to demonstrate knowledge and competency in point-of-care ultrasound, tools to guide competency-based training are lacking. Objective We describe the development and validity arguments of a competency assessment tool for critical care ultrasound. Methods A modified Delphi method was used to develop behaviorally anchored checklists for 2 ultrasound applications: “Perform deep venous thrombosis study (DVT)” and “Qualify left ventricular function using parasternal long axis and parasternal short axis views (Echo).” One live rater and 1 video rater evaluated performance of 28 fellows. A second video rater evaluated a subset of 10 fellows. Validity evidence for content, response process, and internal consistency was assessed. Results An expert panel finalized checklists after 2 rounds of a modified Delphi method. The DVT checklist consisted of 13 items, including 1.00 global rating step (GRS). The Echo checklist consisted of 14 items, and included 1.00 GRS for each of 2 views. Interrater reliability evaluated with a Cohen kappa between the live and video rater was 1.00 for the DVT GRS, 0.44 for the PSLA GRS, and 0.58 for the PSSA GRS. Cronbach α was 0.85 for DVT and 0.92 for Echo. Conclusions The findings offer preliminary evidence for the validity of competency assessment tools for 2 applications of critical care ultrasound and data on live versus video raters.


Author(s):  
Paul Atkinson ◽  
Bob Jarman ◽  
Tim Harris ◽  
Rip Gangahar ◽  
David Lewis ◽  
...  

Point-of-Care Ultrasound in Emergency Medicine and Resuscitation provides a curriculum-based guide to the integration of ultrasound into everyday practice for clinicians in emergency medicine and critical care medicine and for resuscitation. In addition to describing commonly used protocols, we focus on how ultrasound can be used to help to answer specific clinical questions and provide guidance for procedures at the point of care, augmenting traditional clinical skills. This chapter introduces the general concepts of using ultrasound at the bedside, describes how to use point-of-care ultrasound (PoCUS), and provides clinical scenarios as examples of where PoCUS can improve clinical care.


2016 ◽  
Vol 19 (2) ◽  
pp. 157-158 ◽  
Author(s):  
Pablo Blanco ◽  
Francisco Miralles Aguiar ◽  
Alfredo Vallejo

Author(s):  
Brintha Sivajohan ◽  
Himani Dhar

Dr. Robert Arntfield is a critical care intensivist and traumatologist at London Health Sciences Center where he also acts as the medical director of the Critical Care Trauma Unit. Originally interested in emergency medicine, he then carved his pathway to enter the realm of critical care. Dr. Arntfield is a world-renowned expert in critical care ultrasonography and lectures globally on the topic. He is currently working in collaboration with multiple artificial intelligence and technology companies to advance the applications of Point-of-Care Ultrasound (POCUS). We had the opportunity to talk to Dr. Arntfield about the field of critical care medicine at LHSC, in Canadian healthcare, and the significance of the POCUS within the field.


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