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#POCUS #IMPOCUS
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
4/ D wave #POCUS
5/ A wave #POCUS
6/ Hepatic vein waveform - CVP - EKG correlation
Having a simultaneous EKG is necessary to avoid incorrect interpretation of the waveforms #POCUS
7/ Exercise caution! #POCUS
8/ All 7 slides in video form (10 secs each) #POCUS

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#POCUS #IMPOCUS #VExUS #tweetorial #MedEd #echofirst

More from @NephroP see all

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NephroPOCUS
@NephroP
#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
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NephroPOCUS
@NephroP
@Thind888 @FH_Verbrugge @khaycock2 Dear hemodynamic masters, saw a cirrhotic pt with oliguria (relatively preserved Scr) & pulmonary congestion. Based on these findings, suggested norepinephrine (pressors). Agree? any educational input appreciated.
Basically I interpreted as high output cardiac failure with elevated filling pressures leading to pulmonary congestion.
This tracing I believe is right intra-renal 'arterial' with diminished diastolic flow. Correct me if I'm wrong.
Sorry, didn't realize that the scale dropped
Read 4 tweets
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NephroPOCUS
@NephroP
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

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