Discover and read the best of Twitter Threads about #haemodynamics

Most recents (7)

Post holiday season, @ICUltrasonica, @wilkinsonjonny & I are back to take you through the most most critical clinical questions on #haemodynamics that ultrasound can answer

We’re now on to question 3 of FUSIC HD

’Is the aorta abnormal?’

#FUSIC #echofirst #POCUS #FOAMus
Aortic dissection is easily missed, carries a high mortality and should be on the differential of any patient with shock, abdo pain or chest pain. Contrary to popular belief the entire aorta can be imaged via transthoracic and abdominal ultrasound. Let’s start with some anatomy
Asc aorta:
Visualised from PLAX view with depth ⬇️ & probe tilted to focus on the root. Tilting superiorly, or moving up a rib space, may help. Examine the AV and look for a dissection flap. Measure the diameter 3-4cm from the AV. The root can also be seen from A5C & A3C views
Read 20 tweets
We’ve seen how to measure VTI and stroke volume with #ultrasound
Our next #FUSIC haemodynamic question brought to you by @icultrasonica, @wilkinsonjonny and I is:

Q2. Does SV respond to fluid, vasopressors or inotropes?

#echofirst #POCUS #haemodynamics #foamed
In Q1 we saw how to measure stroke volume (SV). Q2 helps us manage someone with an inappropriately low SV. Pressors, fluids and inotropes are all treatment options. If If used correctly, they will ↑SV. If not, they won’t, and they may even be harmful.
Measuring VTI before and after each of these interventions will therefore easily show you if they have worked. But can we predict which one is likely to work before we give drugs or a drop of fluid? 1st, let’s go back to some physiology.
Read 25 tweets
What are the key clinical questions about haemodynamics that ultrasound can answer?

@icmteaching, @wilkinsonjonny and I are going to take you through the 10 most important…

starting with...

Q1. Is stroke volume abnormal?

#FUSIC #echofirst #POCUS #ultrasound #haemodynamics
Despite shock being such an important diagnosis, intensive care clinicians are rubbish at detecting a low or high cardiac output (CO) clinically.

Sensitivity of detecting cardiac index (CI) < 2 clinically in this study was 0!

sciencedirect.com/science/articl…
From an apical 5- or 3-chamber view we can use PW Doppler to assess the velocity time integral (VTI) in the LVOT to determine blood flow.

Essentially, LVOT VTI is the average distance travelled by ejected blood during one contraction...

It is also known as stroke distance.
Read 12 tweets
I’m in a graveyard.

Why?

#Risk #CervicalSpine #VertebralArtery #Physiotherapy #PhysicalTherapy

Part III - Risk Assessment of The Cervical Spine

... coming VERY soon! 👀
Part III - Risk Assessment of The Cervical Spine: Directions For The Future

If the vertebral artery test truly is dead (?), where do we go from here?

#CervicalSpine #RiskAssessment #FCP #Physiotherapy #PhysicalTherapy #ClinicalReasoning #Haemodynamics

Thanks to @RikKranenburg @NathanHutting @RogerKerry1 and the Australian Physiotherapy Association for providing me with the impetus to think about, and produce these short films. #Haemodynamics #RiskAssessment #CervicalSpine #FCP #Physiotherapy #PhysicalTherapy #Education Image
Read 3 tweets
Risk Assessment of the cervical spine for NON-MANUAL THERAPISTS

4 case scenarios, to problem solve #RISK in the assessment & management of neck pain presentations.

#ClinicalReasoning #Physiotherapy #PhysicalTherapy #FCP #Haemodynamics #VertebralArtery
Case 1.

Mayumi a 69 year old male archer (retired factory worker).

#ClinicalReasoning #FCP #Physiotherapy #PhysicalTherapy #Haemodynamics
Case 2.

Phil a 41 year male sports shop proprietor and ex-olympic rower.

#ClinicalReasoning #FCP #Physiotherapy #PhysicalTherapy #Haemodynamics
Read 5 tweets
The Vertebral Artery Test Part II:

Risk assessment of the cervical spine

4 clinical cases to try and make sense of risk assessment.

Of interest to ALL #Physiotherapy #PhysicalTherapy #FCP clinicians #Neck #Headache #Haemodynamics #Risk #VBI #CAD

A consideration of major or serious adverse events.

#Risk #LossOfVision #Stroke #Death #VBI #CarotidArtery #CAD Image
Into the 4th decade we go!

#Physio #PhysicalTherapy #VBI #CervicalSpine #Risk

How do we move forward from here? Image
Read 5 tweets
Covid-19 Linked To Life-Threatening Blood Clots in ARTERIES of Lower Extremities

"Awareness of lower limb arterial thrombosis as a possible complication of COVID-19 is important for all providers who take care of these patients” #Physio #PhysicalTherapy cathlabdigest.com/content/covid-…
#Physio #FCP ‘s
Time to brush up on your haemodynamics ✅

"We found that arterial thrombosis associated with COVID-19 infection was characterized by dire outcomes, namely strikingly increased rates of amputation and death, which in our series were 25% and 38%, respectively,"
Be aware that arterial complications will likely present as PAIN in the early stages.

There may be an exercise induced component.

That may be down to deconditioning or fatigue OR it may be due to underlying pathology.

#Haemodynamics #COVID19
Read 4 tweets

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