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

Apr 16, 2021, 9 tweets

1/ More 3D #POCUS models for educators + beginners! (𝗰𝗼𝗻𝗰𝗲𝗽𝘁𝘂𝗮𝗹𝗶𝘇𝗲 > memorize)

𝗔𝟰𝗖 and 𝗦𝗖 views
Major chambers in these 4C views:
➣LA
➣LV
➣RA
➣RV

2/ Deconstructing the 𝗔𝟰𝗖 view:

• The 𝗽𝗿𝗼𝗯𝗲 𝗺𝗮𝗿𝗸𝗲𝗿 𝗶𝘀 𝗼𝗻 𝘁𝗵𝗲 𝗥𝗜𝗚𝗛𝗧, or oriented toward the LA/LV relative to RA/RVx
• The top of the screen (𝗔𝗽𝗲𝘅) 𝗶𝘀 𝗰𝗹𝗼𝘀𝗲𝘀𝘁 to the probe and
• Atria are furthest

3/ With those constraints one can determine general 𝗔𝟰𝗖 probe location

• Probe marker ~3 o’clock (𝘶𝘴𝘶𝘢𝘭𝘭𝘺 2:30)
• ~5rd IC space
• ~Midclavicular line (𝘢𝘭𝘵𝘩𝘰𝘶𝘨𝘩 𝘗𝘔𝘐 𝘢𝘯𝘥 𝘢𝘱𝘦𝘹 𝘢𝘳𝘦𝘯'𝘵 𝘢𝘭𝘸𝘢𝘺𝘴 1:1)
• Probe tilted to head

4/ Another 𝗔𝟰𝗖 look

And for those interested the 𝗶𝗻𝗳𝗲𝗿𝗼𝘀𝗲𝗽𝘁𝗮𝗹 + 𝗮𝗻𝘁𝗲𝗿𝗼𝗹𝗮𝘁𝗲𝗿𝗮𝗹 LV walls are seen

5/ 𝗧𝗘𝗦𝗧!

The 𝗦𝗖 long axis is also a 4 chamber view

• The 𝗽𝗿𝗼𝗯𝗲 𝗺𝗮𝗿𝗸𝗲𝗿 𝗶𝘀 𝗼𝗻 𝘁𝗵𝗲 𝗥𝗜𝗚𝗛𝗧, or oriented toward the ventricles and apex
• The top of the screen (𝗥𝗩>𝗥𝗔) 𝗶𝘀 𝗰𝗹𝗼𝘀𝗲𝘀𝘁 to the probe and
• Left sided chambers are furthest

6/ With those constraints one can determine general 𝗦𝗖 probe location

• Probe marker ~3 o’clock (𝘶𝘴𝘶𝘢𝘭𝘭𝘺 2:45)
• ~Subxyphoid (𝘴𝘩𝘰𝘰𝘵 𝙩𝙝𝙧𝙤𝙪𝙜𝙝 𝘭𝘪𝘷𝘦𝘳)
• Probe tilted to head

7/ Another 𝗦𝗖 look

(𝘵𝘩𝘦 𝘚𝘊 𝘥𝘰𝘦𝘴 𝙣𝙤𝙩 𝘩𝘢𝘷𝘦 𝘱𝘳𝘦𝘥𝘪𝘤𝘵𝘢𝘣𝘭𝘦 𝘤𝘰𝘳𝘰𝘯𝘢𝘳𝘺 𝘴𝘦𝘨𝘮𝘦𝘯𝘵𝘢𝘵𝘪𝘰𝘯)

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

ping @DRsonosRD - #FOAMed 3D models your team at @VaveHealth could do interesting things with, I'm sure.

9/ The whole #A4C and #SC run down
#echofirst

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