Discover and read the best of Twitter Threads about #pocus

Most recents (24)

What do you see in this subxiphoid view? Proceed to poll
#POCUS #ccecho #ccechofirst
What do you see in this subxiphoid view?
Indeed! This view shows the descending Ao with an IABP. I was deceptive in my selection of choices. This view is easily obtained paramedian to your ivc view. #ccecho #ccechofirst
Read 3 tweets
Tired of irradiating your patients with CT scans🙋‍♀️? Learn Renal Ultrasound #POCUS!

1⃣Perform Renal Ultrasound
2⃣Download Hydronephrosis PDF Guide!
3⃣Renal Pathology
4⃣Renal Hemodynamics (RRI/Venous Doppler)

✅New Blog Post! 👉🔗

#medtweetorial (1/25)👇
1 Download the FREE Hydronephrosis Grading PDF Pocket Guide! 👉🔗
2 The kidneys are retroperitoneal organs located on either side of the vertebral column from T12-L3. Notice that the right kidney is slightly more posterior than the left kidney because of the larger size of the liver relative to the spleen. 👉🔗
Read 26 tweets
#POCUS is the FASTEST way to assess your patient's Bladder!

1⃣Learn How to Perform Bladder Ultrasound
2⃣Measure Bladder Volume Correctly
3⃣Recognize Bladder Pathology
4⃣FREE Bladder Volume Calculator!

✅New Blog Post! 👉🔗

#medtweetorial (1/20)
1 Although it is easy to think of the bladder as a sphere it actually takes on other shapes in the body: Triangular Prism, Cylinder (Ellipsoid), or Cuboid

2 In addition to the bladder itself, it is also important to understand the surrounding structures including the pubic bone, abdominal cavity and rectum. The uterus and prostate are also important landmarks for females and males respectively.

Read 22 tweets
Today @NephroP shares his knowledge with our team here at BI during our POCUS Cocktail Club!
When you see cysts - you should see acoustic enhancement!

Complex cysts might have some calcifications and see acoustic shadowing

Take a look!
See how masses look different than cysts - hyperechoic or isoechoic lesions rather than hypoechoic #NephroPocus
Read 6 tweets
Understanding #VExUS from scratch:
A mini #tweetorial on normal hepatic vein waveform genesis 👇 #MedEd #echofirst

1/ Understanding color and direction
2/ What is S wave? #POCUS
3/ V wave #POCUS
Read 8 tweets
Don't let your patients die from AAA or Aortic Dissection! #POCUS

1⃣Learn how to Easily do Aorta Ultrasound
2⃣Learn how to perform the Suprastenral View
3⃣Recognize AAA and Aortic Dissection

✅New Blog Post 👉🔗

2 Start with the Short axis approach and place the probe near the subxiphoid area

3 Identify the Vertebral Body, Aorta, and IVC

Read 25 tweets
#POCUS Intra-renal vein Doppler waveform looking exactly like that of hepatic vein!
#VExUS obtained from a #nephrology clinic patient with pulmonary hypertension. #MedEd
Normal hepatic vein waveform #POCUS Image
Portal vein #POCUS in this patient - increased pulsatility. Image
Read 6 tweets
In 2014 @steveleechmd et al proposed #POCUS fellowship milestones HT @doctoRoblivious @SonoStache @Takeokun

Milestone 1: Clinical Ultrasonography
In 2014 @steveleechmd et al proposed #POCUS fellowship milestones HT @doctoRoblivious @SonoStache @Takeokun

Milestone 2: Education and Training
In 2014 @steveleechmd et al proposed #POCUS fellowship milestones HT @doctoRoblivious @SonoStache @Takeokun

Milestone 3: Administrative Leadership
Read 5 tweets
TEE #POCUS 🧵: For emergency medicine, It's not if, It's when

Survey: Where are you and your ED in stage of a TEE #POCUS program development?

@ACEP_EUS @SCUFellowships @codachange @iceman_ex @SAEMAEUS
TEE #POCUS 🧵 In 2008, I saw #DrMikeBlaivas publish one of the first ED case reports

TEE #POCUS 🧵Years ago I met @JijiElzen of @karolinskainst who was using TEE #POCUS for Trauma. HT @chrismuhr

👉🏽… via @feminemtweets
Read 7 tweets
C’est l’heure du #POCUS du jour !

H, 30a, consulte pour douleurs au bras gauche suite à une rixe avec plaie par tournevis il y a 1 mois.

Cliniquement : masse indurée en regard du biceps.
Conclu comme hématome du biceps par son médecin traitant.

Il consulte devant la persistance de douleurs aux Urgences.

Vous me connaissez, it’s #POCUS time 😉
Je découvre à la pose de la sonde d’échographie un muscle remanié, avec des plages hypoéchogènes non spécifiques à l’intérieur faisant penser à du sang remanié.

Je me suis dis que c’était un hématome vieilli en voie de résorption, jusqu’à ce que je monte la sonde un peu...
Read 7 tweets
Fundoscopy 👁‍🗨 got you down? See clearly into the 👀 with #POCUS!

1⃣Learn How to Perform Ocular Ultrasound
2⃣Recognize Retinal Detachment, PVD, ⬆️ ICP, + MORE!
3⃣Free Ocular Ultrasound PDF Pocket Card!

✅New Blog Post! 👉🔗

(2) Download the Free Ocular Ultrasound PDF Pocket Card! 👉🔗
(3) Obtain the Transverse View:

Place the probe lightly on the gel covering the patient’s eye with the probe indicator pointed towards the patient’s right to obtain a transverse view.

Read 23 tweets
A #MedEd Thread for #pulm #criticalcare #applicants. How do you pick a program? What questions do you ask in a fellowship #interview? Here are some ways programs differ and tagged @IUPCCM experts to answer any questions you may have! #MedTwitter
#PAH: Does Pulm house pulmonary hypertension and manage vasodilator therapy? Or is this managed by a different department? Are there opportunities to learn this if so? @TimLahm @RFPMachado
#IP: Do you have experts performing advanced #bronchoscopy such as #navigational? Does Pulm place stents, valves? Is there #EBUS volume for general fellows to become proficient? How much of this is done by other departments such as Thoracics or ENT? @ChrisKniese
Read 13 tweets
Journal Club in the time of COVID 🤓🩺😷

@ubcimpocus had our inaugural #POCUS journal club with our fellow @teres_sono (welcome to #MedTwitter Terry!!).

The topic was all things #VEXUS and some really great questions came up (1/)
Note COVID modifications:

- small group, all seated 6ft apart
- masks, wipes, hand sanitizer easily accessible
- no shares food; individual drinks (yes, gasp, alcohol - #professionalism)
- Zoom mtg on individual devices to enable distanced screen sharing
Many questions came up, both technical and philosophical:

- When scanning the hepatic vein, does it matter which branch (L/mid/R) you scan? (My answer: I scan whichever gives me the best waveform (3/)
Read 9 tweets
@ACEP_EUS Practical Guide to Critical #POCUS Vols 1 + 2 author @lataylor1218 brought together many #POCUS protocols for undifferentiated presentations (a thread)
Read 14 tweets


Kidney Replacement Therapy #KRT & #AKI

One ring to rule them all
To this day: NO difference in outcomes between

- Difussion vs Convection
- Std vs ⬆️ dose
- Early vs Late ⏰

The problem is #AKI & what it represents. #KRT can’t change that, no matter how you do it

💥SOLUTE & VOLUME control💥
becomes the only GOAL

1. Nutrition 🥩
2. Potassium 🍌
3. Acid base 🧪
4. Phosphorus 🦴
5. Fluid balance 💧
Read 15 tweets
#POCUS inferior with RVMI (late presentation at 24h+ after symptoms).
Read 3 tweets
#POCUS case - F/80. Known mesenteric stenosis (celiac origin, and SMA). Has upper abdominal pain off and on - ? mesenteric angina. Now presents with severe upper abdominal pain. Tender+++ epigastrium, no peritonism. Normal GB ultrasound and lipase. Lactate 0.4. Previous CT:
Epigastric tenderness and normal lactate argue against acute mesenteric occlusion. #POCUS - SMA origin
#POCUS Color doppler SMA
Read 6 tweets
Having trouble figuring out Ultrasound Knobology, Probes, Modes?

Master #POCUS settings including probe movements, orientation markers, ultrasound planes, B-mode, M-mode, all Doppler settings, and MORE!

New Blog Post! 👉🔗

(2) Before choosing your ultrasound probe, always ask yourself:

• What application am I using this for?
• How deep are the structures?
• How big or small of a footprint do I need?
• Does it involve a procedure?
• Does it involve a cavity?

(3) Handling the ultrasound probe and proper movement is essential to obtaining optimal ultrasound images. Learn the Essential Movements:


Read 27 tweets
🚨 Multi-part case #Tweetorial
24y man no PMH. 3-4 days myalgias, freq diarrhea. 2L saline given on med floor -> hypox/tachypnea. COVID pend.
A 👍
B RR30-34, SpO2 92% 5L NC
❤️ MAP 90, HR 110s ->150s over 12 hrs
D Avpu
E Anxious
L CRP 58 (ULN 0.9), Cr 1.4 (no baseline), Lact 4.8 Image
WOB is moderately elevated.

What diagnostic manuever do you think is most important at this point?
Unlike most MC questions, you also get to choose a therapeutic maneuver while dx is happening. What's your first choice?

More case details to follow tomorrow!
Read 25 tweets
Cinco dicas para o interno de Medicina que vai começar seu ciclo em Cardiologia:

1. Não vá com desinteresse ao estágio só porque seu futuro será na Ortopedia, por exemplo. As pessoas não se importam que você seja um patologista na hora de uma parada. Acima de tudo, você é médico
2. Isso pode ser controverso, mas saiba que o estetoscópio está morrendo. O USG point-of-care #POCUS traz muita sensibilidade ao exame, mas precisa de tempo para aprendizado. Mesmo que você não tenha oportunidade de fazer, conheça o método e observe bastante. Será o futuro.
3. A Cardio não tem muitos diagnósticos mirabolantes. Nosso forte são as terapias altamente influenciadas por evidências. Conheça e se familiarize com os sinais, sintomas e exames complementares das grandes síndromes: SCA, IC, HAS, dislipidemia, doenças valvares e pericárdicas.
Read 7 tweets
1/ #Nephrology #POCUS case study:
Dr. X is rounding on an ESRD pt who initially presented with dyspnea after missing a dialysis (HD) session; underwent dialysis in the hospital. Pt asymptomatic at the time of exam and lung #ultrasound revealed 👇 Further story in thread #MedEd
2/ Based on the 2-zone lung #POCUS, Dr. X orders for another session of HD. Notably, pt says he is at his 'dry weight' and HD nurse says they could only get 1.5L off during first session. Dr. X doesn't change his/her mind.
Info on various lung scan zones👇
3/ Patient becomes hypotensive during HD and only ~500cc fluid could be removed.
Why can't we get more fluid out of a hypervolemic patient? Dr. X is perplexed and decides to more #POCUS Here is the IVC
Read 16 tweets
#POCUS #echofirst The correct answer is dilated coronary sinus [48% got it right (of 229 votes)]. From #IMPOCUS standpoint, 2 main causes: persistent left superior vena cava and pulmonary HTN. This pt had the former. Normal anatomy of the coronary sinus (Read #thread)👇 #MedEd
More anatomy: 3D CT angio
We need to understand the anatomy first to understand #pocus orientation
Original image shows the typical location of CS in PLAX view. Don't confuse with descending aorta. You can also see CS from the apical window. From apical 4C, tilt the transducer posterior (in the opposite direction as you would for the 5-chamber view) #POCUS
Read 7 tweets
#POCUS teaching case: #Dialysis patient c/o sob, reports weight gain. BP low to begin with (~100-110 mmHg systolic) & drops further during ultrafiltration. Dr. X performs IVC #ultrasound at the bedside and sees this 👇 - probably volume depleted? See #thread
#MedEd #nephrology
2/ Dr. X orders to stop ultrafiltration. BP stabilized a little bit.
All done?
Wait, something doesn't make sense. Why did the patient gain weight? (usually #dialysis patients know their dry weight well). Why sob?
In the meanwhile, radiology tech performs chest #X-ray 👇
3/ That's not good. Diagnosis is apparent but lets get Dr. Y who does more than just IVC #POCUS
Subcostal view 👇
Significant pericardial effusion
Read 12 tweets
Differentiating portal venous gas from pneumobilia on ultrasound. See thread. #POCUS #FOAMus #FOAMed #IMPOCUS #MedEd #MedTwitter #ultrasound @ACEP_EUS @USIGcleveland @MetroHealth_EM @aedrake65
Case 1. Liver TRV sweep. Which is present? Answer poll.
Case 1. Which is present?
Read 9 tweets

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