📎Point-of-Care Ultrasound (POCUS) for IM Residents

💧All about volume status

Part 2️⃣: Inferior Vena Cava Point-Of-Care Ultrasound

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1/ How? Rock the probe (phased array w/ indicator pointing cranially) just below xiphoid (midline). You will be between aorta and IVC. Try to identify Ao first (more medial) and than fan the probe laterally and you will see IVC.

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📎Point-of-Care Ultrasound (POCUS) for IM Residents

💧 How to assess volume status (IVC + 🫁 US), when to do it, and some evidence-based medicine behind it

Part 1️⃣: Let’s talk about some numbers first and why you should do it on a daily basis

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1/ ⚠️We struggle with JVD evaluation

If you look up the data, JV exam is inferior to IVC ultrasound in assessing CVP (part of the volume status exam). IVC US has a higher sensitivity (82%) and lower failure rate (10%).

📄 20 studies that Internal Medicine Residents should read in the first year 👇

1/ 🏃‍♀️ RACE II trial: Lenient resting HR < 110 was non-inferior to a strict HR < 80 in patients with atrial fibrillation.

🧵 2/🧂SALT-ED trial: one of the reasons I prefer LR > NS

⚠️Balanced crystalloids (LR, Plasma-Lyte) does not reduce duration of hospitalization when compared to NS. However, balanced crystalloid use is associated with a reduction in major kidney-related events.