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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More from @EAFischer

23 Jun
1/ Volume Assessmentโ€ฆ โ€ฆ is hard

Physical exam for hypovolemia, a thread
2/ Is the above patient?
3/ What do we mean by โ€œ๐—ฑ๐—ฟ๐˜†โ€? By ๐˜ƒ๐—ผ๐—น๐˜‚๐—บ๐—ฒ ๐˜€๐˜๐—ฎ๐˜๐˜‚๐˜€?

๐——๐—ฒ๐—ต๐˜†๐—ฑ๐—ฟ๐—ฎ๐˜๐—ฒ๐—ฑ is often ~ hypertonicity / intracellular volume contraction

๐—ฉ๐—ผ๐—น๐˜‚๐—บ๐—ฒ ๐—ฑ๐—ฒ๐—ฝ๐—น๐—ฒ๐˜๐—ถ๐—ผ๐—ป is โ†“extracellular volume w/ blood volume contraction
bit.ly/3d1GWhh
Read 14 tweets
16 Apr
1/ More 3D #POCUS models for educators + beginners! (๐—ฐ๐—ผ๐—ป๐—ฐ๐—ฒ๐—ฝ๐˜๐˜‚๐—ฎ๐—น๐—ถ๐˜‡๐—ฒ > memorize)

๐—”๐Ÿฐ๐—– and ๐—ฆ๐—– views
Major chambers in these 4C views:
โžฃLA
โžฃLV
โžฃRA
โžฃRV
2/ Deconstructing the ๐—”๐Ÿฐ๐—– 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 LA/LV relative to RA/RVx
โ€ข The top of the screen (๐—”๐—ฝ๐—ฒ๐˜…) ๐—ถ๐˜€ ๐—ฐ๐—น๐—ผ๐˜€๐—ฒ๐˜€๐˜ to the probe and
โ€ข Atria are furthest
3/ With those constraints one can determine general ๐—”๐Ÿฐ๐—– probe location

โ€ข Probe marker ~3 oโ€™clock (๐˜ถ๐˜ด๐˜ถ๐˜ข๐˜ญ๐˜ญ๐˜บ 2:30)
โ€ข ~5rd IC space
โ€ข ~Midclavicular line (๐˜ข๐˜ญ๐˜ต๐˜ฉ๐˜ฐ๐˜ถ๐˜จ๐˜ฉ ๐˜—๐˜”๐˜ ๐˜ข๐˜ฏ๐˜ฅ ๐˜ข๐˜ฑ๐˜ฆ๐˜น ๐˜ข๐˜ณ๐˜ฆ๐˜ฏ'๐˜ต ๐˜ข๐˜ญ๐˜ธ๐˜ข๐˜บ๐˜ด 1:1)
โ€ข Probe tilted to head
Read 9 tweets

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