Ernest Fischer, MD Profile picture
#Hospitalist | APD | #POCUS | #CCeEXAM testamur | Proceduralist | Allan J. Goody Bedside Medicine Series | Medstar Georgetown University Hospital
Jul 10 โ€ข 17 tweets โ€ข 6 min read
๐—›๐—ฒ๐—ฝ๐—ฎ๐˜๐—ผ-๐—ท๐˜‚๐—ด๐˜‚๐—น๐—ฎ๐—ฟ ๐—ฟ๐—ฒ๐—ณ๐—น๐˜‚๐˜…(HJR)

History, utility and how well does it perform ๐˜„๐—ถ๐˜๐—ต ๐˜‚๐—น๐˜๐—ฟ๐—ฎ๐˜€๐—ผ๐˜‚๐—ป๐—ฑ

a thread Pasteur (not Louis) first described HJR as a sign of TR in 1885

Rondot in 1898 actually coined the phrase HJR and noted that it didnโ€™t just reflect TR Image
Jan 17, 2022 โ€ข 9 tweets โ€ข 4 min read
1/ More 3D #POCUS models for educators + beginners! (๐—ฐ๐—ผ๐—ป๐—ฐ๐—ฒ๐—ฝ๐˜๐˜‚๐—ฎ๐—น๐—ถ๐˜‡๐—ฒ > memorize)

Parasternal Short axis (PSAx) starts with a good PLAx, then rotation 90ยบ clockwise

2/ PSAx Orientation

Reminder the
โžฃ๐—ฅ๐—ฉ is 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
Nov 12, 2021 โ€ข 13 tweets โ€ข 6 min read
1/ #tweetorial
โฎžOptic disc edema vs. Papilledema
โฎžOrbital anatomy
โฎžOrbital #POCUS 2/ First what is ๐—ฝ๐—ฎ๐—ฝ๐—ถ๐—น๐—น๐—ฒ๐—ฑ๐—ฒ๐—บ๐—ฎ?

๐˜ ๐˜ธ๐˜ช๐˜ด๐˜ฉ ๐˜ ๐˜ค๐˜ฐ๐˜ถ๐˜ญ๐˜ฅ ๐˜จ๐˜ฆ๐˜ต ๐˜ช๐˜ฎ๐˜ข๐˜จ๐˜ฆ๐˜ด ๐˜ญ๐˜ช๐˜ฌ๐˜ฆ ๐˜ต๐˜ฉ๐˜ฆ๐˜ด๐˜ฆ...
[source bit.ly/3yceeCT]
Jun 23, 2021 โ€ข 14 tweets โ€ข 6 min read
1/ Volume Assessmentโ€ฆ โ€ฆ is hard

Physical exam for hypovolemia, a thread 2/ Is the above patient?
Apr 16, 2021 โ€ข 9 tweets โ€ข 5 min read
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
Feb 22, 2021 โ€ข 9 tweets โ€ข 5 min read
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