𝗛𝗲𝗽𝗮𝘁𝗼-𝗷𝘂𝗴𝘂𝗹𝗮𝗿 𝗿𝗲𝗳𝗹𝘂𝘅(HJR)

History, utility and how well does it perform 𝘄𝗶𝘁𝗵 𝘂𝗹𝘁𝗿𝗮𝘀𝗼𝘂𝗻𝗱

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 didn’t just reflect TR

1/ More 3D #POCUS models for educators + beginners! (𝗰𝗼𝗻𝗰𝗲𝗽𝘁𝘂𝗮𝗹𝗶𝘇𝗲 > memorize)

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

https://twitter.com/EAFischer/status/1363930758180651008?s=20

2/ PSAx Orientation

Reminder the
➣𝗥𝗩 is the most 𝗮𝗻𝘁𝗲𝗿𝗶𝗼𝗿 structure
➣𝗟𝗔 the most 𝗽𝗼𝘀𝘁𝗲𝗿𝗶𝗼𝗿

1/ #tweetorial
⮞Optic disc edema vs. Papilledema
⮞Orbital anatomy
⮞Orbital #POCUS 2/ First what is 𝗽𝗮𝗽𝗶𝗹𝗹𝗲𝗱𝗲𝗺𝗮?

𝘐 𝘸𝘪𝘴𝘩 𝘐 𝘤𝘰𝘶𝘭𝘥 𝘨𝘦𝘵 𝘪𝘮𝘢𝘨𝘦𝘴 𝘭𝘪𝘬𝘦 𝘵𝘩𝘦𝘴𝘦...
[source bit.ly/3yceeCT]

1/ Volume Assessment… … is hard

Physical exam for hypovolemia, a thread 2/ Is the above patient?

1/ More 3D #POCUS models for educators + beginners! (𝗰𝗼𝗻𝗰𝗲𝗽𝘁𝘂𝗮𝗹𝗶𝘇𝗲 > memorize)

𝗔𝟰𝗖 and 𝗦𝗖 views
Major chambers in these 4C views:
➣LA
➣LV
➣RA
➣RV

https://twitter.com/EAFischer/status/1363930826224893954

2/ Deconstructing the 𝗔𝟰𝗖 view:

• The 𝗽𝗿𝗼𝗯𝗲 𝗺𝗮𝗿𝗸𝗲𝗿 𝗶𝘀 𝗼𝗻 𝘁𝗵𝗲 𝗥𝗜𝗚𝗛𝗧, or oriented toward the LA/LV relative to RA/RVx
• The top of the screen (𝗔𝗽𝗲𝘅) 𝗶𝘀 𝗰𝗹𝗼𝘀𝗲𝘀𝘁 to the probe and
• Atria are furthest

1/ Basic #CadiacUS models (color coded / labeled) for Educators or Beginners

At least 2 options when learning any #IMPOCUS – memorize or 𝗰𝗼𝗻𝗰𝗲𝗽𝘁𝘂𝗮𝗹𝗶𝘇𝗲.

Both will get you there but IMO the latter allows for taking next step into advanced imaging… 2/ This is especially true in Cardiac POCUS – 4 basic views, but actually so many more. #ECHOFirst

Firm understanding of anatomy and spatial relationships is key!

➣Note axis of the heart
➣𝗥𝗩 the most 𝗮𝗻𝘁𝗲𝗿𝗶𝗼𝗿 structure
➣𝗟𝗔 the most 𝗽𝗼𝘀𝘁𝗲𝗿𝗶𝗼𝗿