Ultrasound probe grip: the afternoon tea technique.

Background: Globally, ultrasound is being used to assist in central venous and difficult peripheral intravenous access in a variety of emergency and non-emergency clinical settings.

Context: After reading Flood's paper on safe central venous access and noting the difficulties clinicians find in probe stabilisation whilst performing dynamic intravenous access, we decided to share our teaching technique.

Innovation: The purpose of this correspondence is to highlight the 'afternoon tea technique' as a potential teaching method for probe stabilisation.

Traumatic right ventricular rupture following a horse kick.

Cardiac tamponade is a life-threatening and time-critical emergency that requires early recognition and prompt management often alongside other resuscitation considerations. The use of ultrasound in the primary survey greatly assists in the early diagnosis allowing preparations for early definitive management to be made. An unusual case of right ventricular rupture following blunt trauma to the chest from a horse kick is discussed.

Simulating various levels of clinical challenge in the assessment of clinical procedure competence.

Study Objective: Immersive simulation is increasingly used for competency assessment of emergency physicians. This group's concept of hybrid simulation (HS) (combining simulated patients and part-task trainers (a simulator that simulates a limited component of a clinical procedure) to create a multimodal clinical context) requires clinicians to integrate technical and nontechnical skills in a holistic clinical performance for assessment. It also offers the potential to provide authentic simulation of a given clinical procedure across multiple levels of challenge.