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On this episode of The Sonography Lounge hosts Lori and Trisha sit down with Dr. Charlotte Derr & Dr. Allyson Hansen to discuss the GUARD Protocol (Gastric Ultrasound for Aspiration Risk Determination).

With the increased use of GLP-1 Agonists (Semaglutide, with brand names such as Ozempic, Wegovy, Rybelsus, Etc) for both diabetes and weight loss, there has been an increased number of aspirations in patients undergoing procedures. One of the effects of GLP-1 agonists is delayed gastric emptying which keeps patients feeling "full" thus reducing the desire to eat and overall caloric intake and blood sugar variations. Typically 6-8 hours not eating is enough time for a patient about to undergo an elective procedure to digest and empty their stomachs thus reducing the risk of aspiration while under anesthesia. With patients on GLP-1 agonists, we are seeing gastric contents remaining for several days after the last meal which can increase the risk of aspiration. 

Dr. Derr and Dr. Hansen, discuss how they are using ultrasound and the GUARD protocol to determine the volume of food in a patient's stomach before elective and emergency procedures. This quick and simple bedside technique can drastically alter a provider's pre-procedure course of action.

 CHARLOTTE DERR, MD, RDMS, FPD-AEMUS, FACEP

Dr. Derr is the Professor of Emergency Medicine and the Fellowship Director of the Advanced Emergency Medicine Ultrasound Fellowship Program at the University of South Florida Morsani College of Medicine in Tampa, FL and serves as the Co-Medical Director at Gulfcoast Ultrasound Institute.

She is a fellow of the American College of Emergency Physicians and is a registered diagnostic medical sonographer. She has also obtained the Focused Practice Designation in Advanced Emergency Medicine US from the ABEM.

She has authored and co-authored numerous articles, book chapters, and other publications on ultrasound and lectures throughout the US and internationally on diagnostic ultrasound.

 ALLYSON HANSEN, DO

Dr. Allyson Hansen is the Ultrasound Director at the University of South Florida Emergency Medicine program. She received her education at the University of South Florida and Campbell University. Dr. Hansen completed her Hackensack University Medical Center residency and Emergency Ultrasound Fellowship at Tampa General Hospital. She is passionate about teaching and is an instructor at Gulfcoast Ultrasound Institute.

Gulfcoast Ultrasound Institute: GUARD Protocol Blog

GUARD Protocol YouTube Hot Tip

USF HEALTH: GUARD protocol blog

Upcoming POCUS Courses @ Gulfcoast Ultrasound Institute

CME and Cross training resources:

Gulfcoast Ultrasound Institute (Training materials and programs): www.gcus.com

Certification Agencies:

American Board of Emergency Medicine (ABEM): https://www.abem.org/public

Sonographer / Physician: American Registry of Diagnostic Medical Sonography (ARDMS): www.ardms.org

Physicians: Alliance for Physician Certification & Advancement (APCA): www.APCA.org

Point of Care Healthcare Providers: Point of Care Certification Academy (POCUS): www.pocus.org

Sonographer / Physician: Cardiovascular Credentialing International (CCI): www.cci-online.org

 Find an accredited long-term Ultrasound Program: https://www.caahep.org/Students/Find-a-Program.aspx