Velocity Time Integral (VTI) and the Passive Leg Raise: Taking Volume Assessment to the Next Level

Velocity Time Integral (VTI) and the Passive Leg Raise: Taking Volume Assessment to the Next Level

Hypotensive patients requiring volume resuscitation are a regular occurrence for emergency physicians. Clinicians are often faced with determining whether patients will respond favorably to IV fluids both before and during vasopressor administration. The ability for point of care ultrasound (including assessment for B lines and IVC collapsibility) to predict volume status and fluid responsiveness has mixed evidence. Here we explore the velocity time integral (VTI), a measurement that can be coupled with a passive leg raise to more accurately assess for true fluid responsiveness.

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Locating the Dislocation: Shoulder Ultrasonography

Locating the Dislocation:  Shoulder Ultrasonography

Still using propofol and brutacaine for shoulder dislocations?  There is a better way.  Bedside ultrasound for shoulder dislocations has been shown to reduce narcotic use, number of sedations, length of stay, cost, and radiation. Let's review the technique for shoulder ultrasonography and intra-articular injection of the glenohumeral joint. 

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