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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
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:
3) TECHNIQUE for lung ultrasound. Use a curvilinear probe if possible, a phased array is second best. Do 12-Point lung exam if possible to increase sensitivity. pocus101.com/complete-guide…
4) Look for #COVID19 Lung PATHOLOGY: Confluent B-lines, Irregular/Thickened Pleura, Subpleural consolidations, and tiny pleural effusions. pocus101.com/complete-guide…
5) Rule out other alternative Diagnoses: PTX, other viral/bacterial PNA, CHF, massive PE, pericardial effusions/tamponade. pocus101.com/complete-guide…
6) Lastly and most importantly please BE SAFE out there! 😷🧑‍⚕️👩‍⚕️💪🙏
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Related threads

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Robert Jones
@RJonesSonoEM
Short image tweetorial on thoracic ultrasound findings in pneumonia. #POCUS #IMPOCUS #FOAMed #FOAMus #Medtwitter #Meded #COVID19 @medpedshosp @cianmcdermott @msiuba @siddharth_dugar @grepmeded @NephroP @emresidents
Normal lung ultrasound. A-profile with thin pleural line with lung sliding. Linear transducer used.
Irregular pleural line with patchy B-lines. Seen in viral (including COVID19) and bacterial pneumonia. This patient had mycoplasma pneumonia. Linear probe used.
Read 11 tweets
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Sonographic_Tendencies
@trigeminy_henry
#COVID19 #tweetorial lung ultrasound for covid or other respiratory inflammatory conditions.
According to several small studies covid-19 lesions include subpleural effsuisons, b lines, air bronchograms, thick irregular pleural lines. These findings are non specific and can be seen with various lung conditions.
Normal lungs show a lines (horizontal reverb lines equidistant from the pleural) thin regular pleural line and lung sliding with respiration
Read 10 tweets
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Tyler Larsen
@TylerLarsenMD
1/
Does atelectasis cause post-operative fever?

I occasionally hear atelectasis listed in the differential diagnosis for early post-op fever (EPF) but this idea has never made much physiologic sense to me.

Let's explore this question in the following #tweetorial.
2/
 Like many US medical students, I first learned this central dogma of post-op fever on my surgical clerkship through the perpetuation of a rather cumbersome and inelegant mnemonic involving the letter W.
3/
Despite its ubiquity, however, there is little published evidence to support this idea. One of the largest systematic reviews on the topic found that in 7 of 8 studies there was no significant association between atelectasis and early post-op fever.

PMID: 21527508
Read 19 tweets
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Pitt Internal Medicine Point of Care Ultrasound
@PittIMPOCUS
A lines, B lines, Consolidation… the ABCs of Lung Ultrasound

But what do they really mean?

Here we attempt a #tweetorial presenting a way of thinking about common patterns seen on lung ultrasound.

See table here for a summary, and thread below for details

#POCUS

1/
We will start with a hypothetical case for illustration
65 y/o f w HFpEF, COPD admitted 4 days ago with acute pancreatitis (now resolved). You are prepping her for discharge but she is now short of breath/hypoxic requiring 4 L O2.

2/
Reportedly coughed a lot after dinner yesterday. Has not gotten any inhalers or antiHTN meds this hosp stay.
Net positive 4L. HR 88 SpO2 90% 4L BP 165/90 RR 22 T 99.8. WBC 22 (from 12 a day ago).
JVP not seen RRR, +S1/S2, 2/6 SEM
Bibasilar crackles, No LE edema. BNP 150.

3/
Read 19 tweets
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Laura London
@jungianLaura
Virtually every school of #psychology that has given rise to a form of treatment has done so from the perspective of #pathology—that there has to be a pathological situation, or state, that the person who is coming for the psychological work wants to be relieved of. ~Ken James
"And a test as to whether or not the given method of treatment works is whether or not the person's symptoms are relieved. Jung completely erased that perspective. I won't even say that he changed it, he just obliterated it." ~Ken James, Ph.D., Jungian analyst
"Because for Jung, doing psychological work had to do with becoming whole. It DIDN'T have to do with ameliorating symptoms." ~Ken James, Ph.D., Jungian analyst
Read 13 tweets
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G. Elliott Morris📈🤷‍♂️
@gelliottmorris
#New PA cong. map increases D chance of winning the House majority by 4%. They only need a 6.8% generic ballot margin now (down from 7.7) to be favored.

Diff. will be closer to 10% in Nov when uncertainty from polls is ⬇️. Redraw is a very big deal.

One major reason the new PA map is such a big gain for Democrats is that it solidifies, not just tips, PA districts in Philly burbs. Also creates one additional vulnerable R district. (Easily seen in this map made by @JMilesColeman)
My forecasting model will have new PA map in the near future. This is not just a simple switch; it’s a coding redesign, restructuring of input, & drawing new geographic files. Takes a while (for me, a student).

In the meantime, just add 3-4% to the model: bit.ly/2018_house
Read 4 tweets

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