Emergency Physician and POCUS enthusiast. Founder of Peachtree POCUS Consulting @PeachtreePOCUS
Mar 2 • 13 tweets • 3 min read
1/ Wild cardiac arrest with #POCUS playing a major role
An elderly male was sent from the nursing home in cardiac arrest. Per the prehospital report that we got, the patient was in vfib and refractory to 5 defib attempts. The patient got amio as well as several doses of epi.
2/ We had a 10 minute ETA.
I had a brief discussion with the resident on dual sequential defibrillation for refractory shockable rhythms. A few recent clinical trials have shown significant benefit when performed early in refractory shockable rhythm.
Sep 26, 2024 • 11 tweets • 3 min read
1/ The #POCUS was not what it seemed
A strong 3rd year resident presented me this case.
A 47f p/w with a complaint of 1 month of abdominal distention and bloating. She has a history of alcohol use disorder and fibroids but no other medical history. Her exam showed distention
2/
"I looked with an ultrasound" he said, " Her liver took up the entire abdomen. It was huge."
Seemed to check out from the history. Her labs were unremarkable so he placed a bed request for medicine.
Oct 22, 2021 • 13 tweets • 4 min read
Tamponade tweetorial 1/ 68m with a h/o COPD and lymphoma, presented with SOB unrelieved with home albuterol. Had an O2 sat 88% with EMS which improved with CPAP. BP 87/50 and HR 160 which improved to BP 127/70 and HR 115 after 1 L of LR. Exam had increased WOB and clear lungs
2/ CXR showed cardiomegally which prompted cardiac #POCUS. Any significant SOB patient should have a cardiac and lung #POCUS to quickly assess for emergent pathology
Feb 16, 2021 • 8 tweets • 3 min read
1/ Resident presents a case of a 56 year old f w/ h/o COPD with 2 weeks of new bilateral leg swelling, high BNP and normal CXR. "I'm going to admit her for new onset CHF" he says. Sounds reasonable, but "new onset CHF" requires a #POCUS, so I go to the bedside.
PSLA view next:
2/ PSLA view shows normal LV systolic function which is the first clue to search for alternate causes. While this could be HFpEF, note that the interventricular septum looks flat...