Ernest Fischer, MD Profile picture
#Hospitalist | APD | #POCUS | #CCeEXAM testamur | Proceduralist | Allan J. Goody Bedside Medicine Series | Medstar Georgetown University Hospital

Feb 22, 2021, 9 tweets

1/ Basic #CadiacUS models (color coded / labeled) for Educators or Beginners

At least 2 options when learning any #IMPOCUS โ€“ memorize or ๐—ฐ๐—ผ๐—ป๐—ฐ๐—ฒ๐—ฝ๐˜๐˜‚๐—ฎ๐—น๐—ถ๐˜‡๐—ฒ.

Both will get you there but IMO the latter allows for taking next step into advanced imagingโ€ฆ

2/ This is especially true in Cardiac POCUS โ€“ 4 basic views, but actually so many more. #ECHOFirst

Firm understanding of anatomy and spatial relationships is key!

โžฃNote axis of the heart
โžฃ๐—ฅ๐—ฉ the most ๐—ฎ๐—ป๐˜๐—ฒ๐—ฟ๐—ถ๐—ผ๐—ฟ structure
โžฃ๐—Ÿ๐—” the most ๐—ฝ๐—ผ๐˜€๐˜๐—ฒ๐—ฟ๐—ถ๐—ผ๐—ฟ

3/ #PLAx is ๐™๐™ƒ๐™€ view to learn, if any

Major chambers in view
โžฃLA
โžฃLV
โžฃAorta
โžฃRV(OT)

4/ Deconstructing the PLAx view:

โ€ข The ๐—ฝ๐—ฟ๐—ผ๐—ฏ๐—ฒ ๐—บ๐—ฎ๐—ฟ๐—ธ๐—ฒ๐—ฟ ๐—ถ๐˜€ ๐—ผ๐—ป ๐˜๐—ต๐—ฒ ๐—ฅ๐—œ๐—š๐—›๐—ง, or oriented toward the Aorta/LA relative to LV apex
โ€ข The top of the screen (๐—ฅ๐—ฉ) ๐—ถ๐˜€ ๐—ฐ๐—น๐—ผ๐˜€๐—ฒ๐˜€๐˜ to the probe and
โ€ข (Aorta and MV in view)
โ€ข LA and LV free wall furthest

5/ With those constraints one can determine general PLAx probe location

โ€ข Probe marker ~10 oโ€™clock
โ€ข ~3rd intercostal space
โ€ข Perpendicular to chest

6/ ๐—ง๐—˜๐—ฆ๐—ง!

The Apical 3 chamber is a similar view

Deconstructing this is a good exercise to solidify the concept

7/ Anatomical 3D models from
lifesciencedb.jp/bp3d/?lng=en

3D probe by @bysnrk
ultrasoundsimulator.com

8/ This and other models and GIFs
goodybedside.com/3Dpocus

9/ The whole #PLAx run down
#ECHOfirst

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