Alistair Murray
174 posts
Alistair Murray
@sononerd
Emergency Physician with an unhealthy interest in critical care ultrasound & echo , motorcycling, #FOAMed and making beer (not all at once)
South Australia Beigetreten Haziran 2012
149 Folgt223 Follower
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@DrNickB_ObAnaes Use the wrapping that the syringe that will be used to draw up the drug to wrap the tip of the vial. That way, when glass breaks it is in wrapper, not fingers
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I don’t normally do videos but here is an old anaesthetist trick for those impossible to open safely glass ampules.
Surprised more don’t know this one it’s handy.
#LifeHacks #MedHacks
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@TheSGEM @First10EM @OrthopodReg @RugbyMD @SAEMonline @AcademicEmerMed Personal experience over professional practice. Entonox sucks. “Just relax” is THE most useless phrase and liable to trigger unfavorable response. No case identical. Modify to suit each case
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What method do you usually use to relocate an anterior dislocated shoulder? #SGEMHOP #EBM
thesgem.com/2022/11/sgem38…
@First10EM @OrthopodReg @RugbyMD @SAEMonline @AcademicEmerMed
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@amit_pawa It will take a change to infection control guidelines/ regulations in Australia. HLD required (based on poor evidence IMHO). Similar guidelines in UK/Ireland
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2nd time in last 2 months that had unanticipated difficulty securing vascular access. It was so easy to take this outta my bag and use it.
What will it take for there to be one handheld device per room? #OtherBrandsAvailable!
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@grahamwalker @ResaELewiss As a doctor working in Aus l, I would be interested in what process efficiencies and support staff you love and find helpful
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🚑🚨❗Okay ER docs of Twitter: The lecture is called "The Reality of American ERs." The audience is Japanese and Australian ER doctors.
What should I say?
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@kyliebaker888 @jrobi09 @Wilkinsonjonny I’ve seen it on a Venue in SA. The key remains on a good B mode image. Fundamentals first. I guess demos remain a challenge to arrange in the current climate
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@jrobi09 @Wilkinsonjonny Hey Jon, Is this not open to Australians? I remember I got rebuffed once before... I would really like to see this one.
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Do you know about the AI enabled Real-Time EF tool from #GEVenueFamily? Watch @Wilkinsonjonny on the #POCUShub show you how to obtain EF with one click of a button! #POCUS #CriticalCare #FOAMed
gehealthcare.smh.re/UC
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A very nice, concise description of some regional analgesia options
Dr Amit Pawa💉🎙️@amit_pawa
Links 1. Interscalene adobe.ly/3nTlHAX 2.Axillary adobe.ly/3qx2c2u 3.ESP adobe.ly/38ThokJ 4.Rectus Sheath adobe.ly/3ixXcZ3 5.Femoral adobe.ly/2LHn1tl 6.Adductor Canal adobe.ly/3oS0Yic 7.Popliteal adobe.ly/3bRBjCr
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Alistair Murray retweetet
We were saddened to hear of the passing of Prof John Harbison, Ireland's first State forensic pathologist with over 30 years of service. Prof Harbison graduated from @tcddublin in medicine in 1960 and lectured in medical jurisprudence for many years with us. #RIP
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Remember - heart failure is about more than the EF.
Sanjiv J. Shah, MD@HFpEF
#HFpEF pearl of the day: Evaluation of motion of the interventricular septum can be helpful to determine etiology/pathophys in HFpEF pts. Case: 58 yo man w/SOB, ascites, 2+ LE edema. EF 50%. Initially referred to hepatology for poss. liver failure. What did liver biopsy show?
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Alistair Murray retweetet
Alistair Murray retweetet
⚡️EFFUSIVE-CONSTRICTIVE PERICARDITIS ⚡️
** MONTHLY ILLUSTRATIVE CASE **
A 55-year-old female marathon runner presents to clinic w/ 6-months of worsening breathlessness (half-marathon time increased by 30 m).
doi.org/10.1002/ehf2.1…
w/ @BadiwalaMD @MakLab_
Consent given.
👌
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Alistair Murray retweetet
We have an awesome library of colorized anatomy! Great for lectures and demos, especially when in-person teaching is not an option! Check out these echo images and more at bit.ly/2OBI5iQ. #FOAMed #FOAMus #POCUS #MedEd #ultrasound #MedTwitter
GIF
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@NephroP Generally would suggest to consider gravity. Fluid induced B lines tend to be more pronounced at bases with effusions. Apical lung assessment ok for sliding screen but inadequate for lung exam
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1/ #Nephrology #POCUS case study:
Dr. X is rounding on an ESRD pt who initially presented with dyspnea after missing a dialysis (HD) session; underwent dialysis in the hospital. Pt asymptomatic at the time of exam and lung #ultrasound revealed 👇 Further story in thread #MedEd
GIF
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@NephroP @cianmcdermott All Sonosite machines automatically focus to the middle of the screen. This is usually ok but means that I do not like them for lung scanning.
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@cianmcdermott You mean like the hand helds where you don't need to manually adjust?
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#POCUS basics - setting the focal zone: its an user controlled feature, giving the best definition at a designated depth of focus resulting in improved lateral resolution. Note the clarity of the structure based on the focal zone placement. 👇#echofirst #MedEd
GIF
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@drevanyates @Pocus101 @NephroP @RJonesSonoEM @RubbleEM You can see features of liver disease both clinically and on u/s that takes closer to ascites. May see clot or the organ injured but beyond EFAST. Harder when drunks fall over and have both
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@DogICUma You might be able to come visit us in South Australia when you get to zero. 🙂. We have had almost no new cases in weeks. Borders closed
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97% recovered. Only 27 active cases of #COVID19 in NZ. Only one new case in the last 7 days.
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Excellent overview of why a limitedDVT exam gives limited answers in a potentially life threatening disease.
Robert Jones, DO@RJonesSonoEM
Pt-Bilat LE pain/swelling 5 days.Prior hx of unprovoked DVT/PE years ago but off meds due to insurance. See thread. POCUS DVT #POCUS #IMPOCUS #FOAMed #FOAMus #MedEd #FOAMcc @ACEP_EUS @medpedshosp @cianmcdermott @jminardi21 @grepmeded @siddharth_dugar @msiuba @NephroP @SonoStache
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@richardbody @NIHR_NCL_MIC Networked images may be preferable but far away in many systems, therefore not generalizable. Use lung u/s as enhanced clinical exam in interim. Still far outstrips CXR for sensitivities, poorer specificities. If include clinical findings you can include u/s
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@sononerd @NIHR_NCL_MIC We did discuss that actually, & it may be in future iterations. The difficulty with using it as a ref standard for large studies is that it's not consistently used/images saved/reported, & operator experience varies. That may change, particularly e.g. in hospital @ home settings
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What’s the reference standard for #COVID19 in a diagnostic study? We know that RT-PCR is only 70-90% sensitive so how do we pick up the rest?
It’s been great to work with the amazing team at @NIHR_NCL_MIC & propose a composite reference standard for new studies... 👍
NIHR HRC Diagnostic & Tech Evaluation@NIHRTechEvalHRC
📃LATEST REPORT: With @richardbody we have proposed the use of a composite reference standard when evaluating new diagnostic tests for #COVID19. We hope this can be used to produce standardised data across research groups. #EvidenceCOVID cebm.net/covid-19/a-com… via @cebmoxford
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