UBCIMPOCUS

One of the most requested teaching topics I get from trainees on our medical wards is cirrhosis and liver disease 🩸 Which is understandable - this is an intimidating topic for many learners, as there are so many layers of complexity to consider 🤔 Here's part 1 (of several to come!) of my cirrhosis tips and tricks: a short 🧵

I confess that my favourite diagnostic POCUS consults are when Nephrology consults us for volume status 😉🤓

Highly, highly recommended. This was a great listen - loved heard the dissection of the trial and the new questions generated by this discussion. @edu_kattan @AndromedaShock @emcrit

Confession: I LOVE hyponatremia 🤓 (I know, I know. What can I say, I'm a true internist!) HypoNa is often feared, maligned, and misunderstood - but I promise it doesn't have to be scary! Here are my top 10 hyponatremia tips and tricks - a 🧵

Cirrhosis tips and tricks part 2: Decompensating events high yield infographic alert 🚨🔔‼️ These are what bring folks into hospital 🏩; and there are a few nuances here to unpack 🧵

Thoughts?? @ThinkingCC @Thind888 @NephroP @msiuba @icmteaching @khaycock2 @MDBeni very curious to hear your opinions. This was talked about at our @ubcimpocus Nerd Night over several 🍷🍺 and we are still a bit perturbed

@katiewiskar @ThinkingCC @G2Disrupt @Thind888 @NephroP @msiuba @icmteaching @khaycock2 @MDBeni @ubcimpocus It’s my favorite quote to trainees. Don’t think we will ever find that single exam/modality/bio marker that will 100% rule in/rule out any condition. Doesn’t mean we will stop trying, but not gonna happen. Tie it all together + longitudinally otherwise red herrings will get us

New on our @ubcimpocus page: handy procedural and POCUS consult checklists to serve as on-the-go resources for trainees. Formatted in easy-to-screenshot sizes. Please use/share if they are helpful! Also found here: ubcimpocus.com/procedureconsu…

#POCUS trivia 🤓 Patient presents with sore throat, fever, and this scan. What's the eponymous diagnosis? #pocuspuzzle

A solution on how to remotely mentor for POCUS learners! Congrats to @USaskEM @LindenKolbenson @OlszynskiP @JeremyKatulka and Sydney Murray. @RCC_bc @UBCCPD @TracyDeLeeuw @katiewiskar @ubcimpocus @BCPoCUS @CarolineShooner @SRPCanada @CAEP_EUC

Attempting to measure respiratory variations of transvalvular flow for a patient with a moderate sized pericardial effusion - so cool to assess tamponade physiology in real-time. Have learned an incredible amount on my @ubcimpocus elective - can't recommend it enough!

@jamestaylor04 Thank you James!! It has been such a pleasure having you. Keep up the scanning!

#POCUS puzzle! 🤓 Can you come up with a unifying diagnosis for these 2 seemingly unrelated POCUS images? (From the same patient) Answer to come tomorrow! 😉

Potential downsides/reasons to avoid: - excessive vasoconstriction can lead to necrosis in areas with poor perfusion* - often avoided for neuraxial procedures like LP; however epi is used in the anesthesia world for intrathecal and epidural anesthesia pubmed.ncbi.nlm.nih.gov/29782398/

*It used to be maxim that epi should be avoided certain areas: digits, nose, penis, etc. However, this has likely overblown; and epi can likely be added except in areas that may have compromised perfusion for other reasons (ie severe PAD) emdocs.net/wp-content/upl…

Local anesthetic go-to:

Local anesthesia for procedures! What is your go-to? (More choices below!)

Huge day for our @ubcimpocus program - finally, a dedicated #POCUS archiving system! 🙌🙌🙌 (Let’s not talk about how nuts it was that we didn’t have one before this 🤦🏼‍♀️) Thanks to @VCHhealthcare, @CANHealthNtwrk, and @e_qpath for making this happen. @shanearish - we did it!

#POCUS case! One of the best in a while. 50M, Hx HTN only. Comes in after travelling to a tropical country 2 weeks ago. Started having watery diarrhea at the end of the trip, as did his companions. Now also RUQ pain. No chest pain, SOB, cardiac Sx.

@pdsalinas Thank you for the kind words! 😊🙏🏻

Our latest screencast: learn the game-changing skill of lung ultrasound in this 25-minute screencast from our own Katie Wiskar. It's a basic application with a lot of nuance, so it's worth spending some time to get it right! #POCUS #FOAMed #ultrasound ubcimpocus.com/ubcimpocus-tut…