ICU Cons + ICS Council. FUSIC committee ❤️POCUS / FOAMed. Editor: Ox. Handbook of Thoracic Anaesthesia & founder Critical Care Northampton. All views my own
May 9, 2023 • 21 tweets • 8 min read
In part 1, I talked renal physiology to warm you all up!😉😂
In part 2, we are talking pharmacology and how we combine💊
See 🧵 below
I’m presenting the whole talk at the fabulous #SOA23 ..book now!
You don’t have to just use furosemide! Everyone’s favourite loop…
Let’s use our physiology and pharmacology knowledge to combine some of them, to achieve good natriuresis as well as diuresis👍👏🤷♂️
May 6, 2023 • 20 tweets • 16 min read
Deresuscitation has become more and more ubiquitous within ICU practice. But what tools can we use to do it? Over the next 2 Tweetorials, i’ll explain some pharmacological methods. Focussing on the JICS mix!
#FOAMed#POCUS#FOAMcc#medtwitter
The brilliant paper in question is well worth a good read through. For both its novel description of combination diuretic therapy, and its golden descriptions of simple and complex fluid/renal physiology.
It’s a pretty vital muscle, and a muscle often forgotten. It’s no wonder why, when it’s weak, your patients won’t liberate from the ventilator!
So, does #POCUS have a role in assessing it. Of course it does!🤷♂️😂
Where do we scan then?? Linear/curvilinear or phased probe positions shown👍👇
We don’t tend to use linear for the basal sections, as you need depth for the PLAPS points. To see the pleura clearly, minimise depth and drop gain down, you get a real concept of sliding on the screen.
Probe position shown with marker to right shoulder, left Parasternal edge; roughly at intercostal spaces 2-3/3-4🤷♂️
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What should you see on ultrasound, and the associated sono anatomy🤔
BTW, this is the only basic position you need for this. Dipping the tail or lifting the tail then get you inflow and outflow views. This is more advanced. #FUSIC
Mar 29, 2021 • 7 tweets • 5 min read
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Here is a quick Tweetorial on Abdominal Aorta #POCUS for you all!
Apply careful firm pressure to displace pesky bowel gas. I start at the umbilicus; you can find the vertebral body easily here. You can then move up or down, tracing the vessel. The aim is to see as much of the vessel as you can. Marker - right (SAX) or to the head (LAX).
Mar 25, 2021 • 9 tweets • 10 min read
So; there are often debates regarding ultrasound probe manoeuvres 🤷♂️
Here we slide the probe along a slug trail of gel, quite crudely, across a wide area of the body. This is often used to ‘window shop’, for structures we can’t see at first. When they snap into view, we can fine-tune movements 👍 Also allows view of larger organs.
