1/7: POCUS Pearl!: Calculating EF Using Simpson's Biplane Method (without math!!) - A Tweetorial: @PennUltrasound @3jeffkramer @Novaleda @cruhlmoore @runawaycar09 @williamhui @Rpourmir @nilan_schnure
2/x: Start with obtaining 2 views above: Apical 4 chamber and Apical 2 chamber. To obtain Apical 2 chamber rotate your probe 90 degrees from A4C view while keeping LV in center (probe marker away from patient or toward ceiling in this case) *Note: My view is too cephalad for A4C
3/x: Try to make sure you are getting a true apical view in each case to most accurately depict chamber size. Apex wall will be thinnest compared to rest of LV and most elongated (base to apex) if you are truly apical.
4/x: Use cine function on your machine to freeze at end-diastole (mitral valve open) and end-systole (mitral valve closed) for both A4C and A2C. You will need these views to obtain stroke volume in both planes.
5/x: When you get these views use your machine's calculation package to 'draw' a series of discs within the chamber of each of the 4 views: A4C diastole, A4c systole, A2C diastole, A2C systole. Take care to only trace endocardium/anechoic chamber and not include trabeculae.
6/x: Each machine will be different but on @MindrayUS_CA you will click measure > simpsons > and use 'auto' to put 3 points in the chamber. Your machine will insert a series of discs to calculate volume in each of the 4 views. Insert the patient's heart rate for additional calcs Image
7/7: Your machine will provide you with ejection fraction and cardiac output without any math! 😎 P.S: you can also skip all of this and keep visually estimating - turns out we are pretty good at it! …ary-wiley-com.proxy.library.upenn.edu/doi/abs/10.119…

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