Discover and read the best of Twitter Threads about #pocusforcovid
Most recents (7)
1/10 Obviously I'm not in Brussels today for the @BelgianBara meeting so I thought I would do a quick intro to periop #POCUS for lung & ultrasound to accompany the lecture #BARA2020 
2/10 So why should we all embrace lung #pocus - first off it's relatively easy to learn - after 25-30 scans learner accuracy has been shown to reach up to 93% (Arbelot et al) #BARA2020
pubs.asahq.org/anesthesiology…
pubs.asahq.org/anesthesiology…
3/10 It may actually be better at "ruling in or out" pathology at the bedside than more traditional diagnostic methods including Chest Xray, auscultation & BNP #BARA2020
journal.chestnet.org/article/S0012-…
onlinelibrary.wiley.com/doi/full/10.11…
jamanetwork.com/journals/jaman…
journal.chestnet.org/article/S0012-…
onlinelibrary.wiley.com/doi/full/10.11…
jamanetwork.com/journals/jaman…
#COVID19 Damages So Many Organs at 3 Different Stages/Time Points!
New Post on Multiorgan #POCUS Approach with ED/Outpatient and Inpatient Algorithms. #tweetorial #medtweetorial👇 (1/6)
pocus101.com/multiorgan-poc…
#POCUSforCOVID #cardiotwitter
New Post on Multiorgan #POCUS Approach with ED/Outpatient and Inpatient Algorithms. #tweetorial #medtweetorial👇 (1/6)
pocus101.com/multiorgan-poc…
#POCUSforCOVID #cardiotwitter
1) Knowing the 3 Stages #COVID19 can help figure out when to look for specific diseases during the admission process
Stage 1: Constitutional symptoms
Stage 2: Pulmonary Complications
Stage 3: Cardiac/Thromboembolic Complications
Figure by Akhmerov 2020
pocus101.com/multiorgan-poc…
Stage 1: Constitutional symptoms
Stage 2: Pulmonary Complications
Stage 3: Cardiac/Thromboembolic Complications
Figure by Akhmerov 2020
pocus101.com/multiorgan-poc…
2) ED/Outpatient Setting should initially focus on Stage 2 (Pulmonary Complications) on #POCUS but still screen for Stage 3 Cardiovascular Complications Using Cardiac/DVT ultrasound.
pocus101.com/multiorgan-poc…
pocus101.com/multiorgan-poc…
1/ Findings = B-lines, fragmented pleural line (best description yet @RogueClaire @ChuckWurster), reduced lung sliding & consolidation patterns
2/ Light beam artifact = ground glass opacity. Broad, band-shaped bright vertical artifact. Appears and disappears, arises from pleural line
The largest study of ultrasound for #COVID19 to date (that I'm aware of) - retrospective, 30 pts with COVID confirmed via PCR, who underwent both lung US and CT
Lung US was compared to CT which was used as the reference standard
#POCUSforCOVID
thieme-connect.de/products/ejour…
1/
Lung US was compared to CT which was used as the reference standard
#POCUSforCOVID
thieme-connect.de/products/ejour…
1/
All US scans were performed at the bedside by a single physician
-6 region scan per hemithorax (anterior, lateral, posterior divided into upper and lower regions)
-scanning in BOTH longitudinal and transverse
-used BOTH convex and linear probes
-5-8 min per scan
2/
-6 region scan per hemithorax (anterior, lateral, posterior divided into upper and lower regions)
-scanning in BOTH longitudinal and transverse
-used BOTH convex and linear probes
-5-8 min per scan
2/
Yet *another* scoring system:
0 pt: normal pleural line, A lines, <3 B lines
1 pt: >3 B lines
2 pt: coalescent B lines
3 pt: consolidation
Total score summed up (0-36 pt):
-none: 0 pt
-mild: 1-7 pt
-moderate: 8-18 pt
-severe: 19+ pt
3/
0 pt: normal pleural line, A lines, <3 B lines
1 pt: >3 B lines
2 pt: coalescent B lines
3 pt: consolidation
Total score summed up (0-36 pt):
-none: 0 pt
-mild: 1-7 pt
-moderate: 8-18 pt
-severe: 19+ pt
3/
So many great minds currently involved in UK-wide #POCUSforCOVID
Brief tweetorial to summarise learnign points from @giovolpicelli
1/ CXR is inferior - GV stopped doing CXR except in certain circumstances #POCUSforCOVID
1/ CXR is inferior - GV stopped doing CXR except in certain circumstances #POCUSforCOVID
2/ CT reserved for complex patients in which complications suspected eg. chronic lung disease #POCUSforCOVID
@afneil The focus on ventilators is about as useful as focusing on whether we have enough coffins. There are more valuable interventions that are being totally ignored in uk at present. Let's run through them:
@afneil 1. Early intervention at home for ALL who develop mild #COVIDー19 symptoms - give them ALL a 5 day course of #chloroquine or #Hydroxychloroquine - this will prevent vast majority of severe cases needing to anywhere near a hospital
@afneil 2. Give PEP - post exposure prophylaxis of #chloroquine or #Hydroxychloroquine to the household members in a home where a person develops symptoms. Evidence is that most transmission is within the household. So stop the virus there!
Complete Guide to Lung Ultrasound in #COVID19 with Algorithm PDF, Technique, Pathology, and Differential Diagnoses. NEW Blog Post and #tweetorial #medtweetorial @viamdinh
pocus101.com/complete-guide…
#COVID19 #POCUS
#POCUSforCOVID
pocus101.com/complete-guide…
#COVID19 #POCUS
#POCUSforCOVID
1) Make sure Lung Ultrasound is INDICATED. See algorithm below. Only perform #POCUS if vital signs are abnl and will change management/disposition. Click here to download PDF of algorithm: pocus101.com/complete-guide…
2) PREPARE for the exam with proper PPE and disinfection technique. For PDF of disinfection protocols check out: cpocus.ca/about-ultrasou… also check out @atchiem protocol at UCLA below:
