PRIME Procedural Research and Innovation

402 posts

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PRIME Procedural Research and Innovation

PRIME Procedural Research and Innovation

@ProcedurePRIME

PRIME: Procedural Research and Innovation for Medical Educators. We aim to advance procedural research + education within Internal Medicine. R/T not endorsement

가입일 Mart 2022
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PRIME Procedural Research and Innovation
PRIME Procedural Research and Innovation@ProcedurePRIME·
Hi #medtwitter! We’re #PRIME - a group of (mostly) Internal Medicine physicians dedicated to advancing procedural innovation, safety, and research. Follow us for discussions around procedural technique; evidence updates, live Q&A, and more!
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Jamie Galen
Jamie Galen@DrGalenMD·
@ProcedurePRIME Spontaneous Bacterial Peritonitis (SBP) is a diagnosis reserved for patients with cirrhosis. Cardiac ascites / malignant ascites are different entities in terms of their peritonitis risk and treatment threshold. @ebtapper ?
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Nick Mark MD
Nick Mark MD@nickmmark·
Interesting RCT in @NEJM about platelet transfusions prior to CVC placement in people w/ thrombocytopenia (Plt 10-50k): - higher rate of grade 2-4 bleeding w/o Plt transfusion: 11.9% vs 4.9% - difference driven by much more bleeding w/ subclavian lines nejm.org/doi/full/10.10… 1/
Nick Mark MD tweet media
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NephroPOCUS
NephroPOCUS@NephroP·
#POCUS image of the day 📸 Classic example of rapid atrial swirl sign (RASS) - rapid opacification of right atrium after saline (preferably agitated but not necessary) injection. Positive test suggests correct placement of central venous catheter #MedTwitter #Nephpearls #FOAMcc Image courtesy: pubmed.ncbi.nlm.nih.gov/25550065/
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Ria Dancel, MD
Ria Dancel, MD@ria_dancel·
I've decided that using a #POCUS subcostal 4 chamber or bicaval view to make sure the guide wire is in RA before dilating & placing a central line prevents catheter misplacement and saves me time overall. Esp when doing a left IJ approach. My new standard of care @ProcedurePRIME
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Katie Wiskar
Katie Wiskar@katiewiskar·
Ok team. Let's talk about this mysterious, pulsatile-appearing thing in the abdomen. Many of you were concerned that this was a massive AAA 😱😱😱 And, to be fair, that was my first split-second reaction when I scanned the patient as well. BUT!
Katie Wiskar@katiewiskar

#POCUS puzzle time again: What's the large circular anechoic structure seen here? Probe is placed on the patient's abdomen in the epigastric region. Patient was in the ICU in profound shock NYD.

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PRIME Procedural Research and Innovation
PRIME Procedural Research and Innovation@ProcedurePRIME·
One of the feared complications in thoracentesis is hemothorax due to laceration of an intercostal artery. Let's talk about how to avoid it 🧵
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PRIME Procedural Research and Innovation
PRIME Procedural Research and Innovation@ProcedurePRIME·
@critconcepts They’re small arteries! I don’t have a good citation for the average velocity of flow; but lowering your Nyquist will only increase your sensitivity, and I’ve never run into trouble with excess signal. Will play around with different Nyquists and report back
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탐색

@DrGalenMD @ebtapper @NEJM @phlegmfighter @RabbleRouseED @ria_dancel @TanpingWong @MFleshner301