@ThinkingCC Great case. Take it opening pressures were quite high.
2 questions - 1. Any concerns re LP with ICP high? 2. ONSD wide but no Optic disc elevation?
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Rob Devins
22 posts
Assessed a 50M w meningitis this am. Here was my neuropocus.
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@ross_prager Great case.
Question- with no TT windows/hyperinflated lungs did you go SubX blindly?
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The patient deteriorates acutely so pericardiocentesis is performed with TEE confirming guidewire.
GIF
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Post arrest patient with hemodynamic instability and no transthoracic views. TEE shows: What do you do? (See next for poll)
GIF
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@RJonesSonoEM @USIGcleveland @NephroP Great clip. Any chance we can use this clip and twinkling image in educational videos we're producing for CPoCUS. I can email you more details re request. My email is doc_gob@hotmail.com. Thx!
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@POCUS_Doug @ThinkingCC With the growing use of TEE, we can look for saddle emboli/Prox R PA quite easily, and forego looking for the the secondary RV strain with its inherent false positives peri arrest.
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@ThinkingCC PE a bit trickier. As you know, the RV dilates during CPR. So I wouldn’t hang my hat on PE 40 mins into a code. But definitely for patients that code in the hospital or during ambulance transport, can be helpful
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Let’s not forget that without point of care ultrasound, forget about making the diagnosis of tamponade, dissection or massive PE. And on top of that optimizing chest compressions position. So I don’t think this is a very good point imo. We have to move forward in cardiac arrest.
ILCOR@Ilcor_org
#ILCOR #AdvancedLifeSupport Point-of-care Ultrasound is intuitively appealing to find reversible causes, but we don't actually know it helps 1/
Montréal, Québec 🇨🇦 English
Rob Devins retweetledi
I suspect this video represents the majority of truckers, but not the majority of money made from click bait.
. 🇨🇦 🌈@gtlem
#CanadaTruckers BLASTS #TruckersForFreedom2022 Says "It's RIDICULOUS - we need to be vaxxed" Want to bring it back & forth over the border Want a job? GET VACCINATED #TruckerConvoy2022 #FreedomConvoyCanada #TrudeauDictatorshipMustGo #TrudeauResign #TrudeauIsACoward #cdnpoli
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@AndrewMFried @cnwilsono @PeterEamonn @mackendc @rehberg_joshua Great clip. Thx for sharing. Beyond the clot in R PA, the L PA is well seen, somewhat of a rarity. Was there significant clot burden on the L side?
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Recent arrest with #ResusTEE revealing large clot in right main PA @cnwilsono @PeterEamonn @mackendc @rehberg_joshua
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@gidsgvilla_r @kyliebaker888 Great vids. Challenging to parse out the acute RV strain from the Chronic as clear RVH in the A4C. In favour of acute is the under filled hyper dynamic LV, paradoxical septal bowing s’en better in the PSS, and what appears to be so called clot in transit in the RV.
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@kyliebaker888 The experience of many is that B’fly TTE views are poor. A big drawback in this study, is that for the cart based machines, the curvilinear probe was used for the TTE views.
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In my experience, it is the obese patient who most needs the increased resolution of the traditional devices - and they are a growing group. Would like to see a study in a 'healthy overweight' group.
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@ThinkingCC @GVWINFOCUS @SeeWithSound Great work. Congrats Philippe.
Question:
Can you share reference or a quick "how to" for LUS score?Thx
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Great work by @GVWINFOCUS and @SeeWithSound ! Honoured to have been involved! ccforum.biomedcentral.com/articles/10.11…
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@kyliebaker888 3.
This gives you a short axis view of the IVC from a lateral perspective. Screen left is anterior, screen right posterior so you can actually see the AP dimension change. You were probably aware of this already, but just in case...
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Really interesting - Does the IVC ever collapse in latero-lateral dimension? Would be a good simple project.
Eduardo R Argaiz@ArgaizR
AKI in young pt with morbid obesity on mechanical ventilation and prone position (COVID-19). Cr 2.7 mg/dl. Persistent oliguria despite 2L crystalloid and Lasix gtt. BP 130/80. No vasopressor. CRT 1 sec. CPK 7000, K 6.7, UA: Blood +++, no RBC, SG 1.020, FENa 0.2% 1/
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@kyliebaker888 2.
In the long axis view, locate the appropriate segment of the IVC in the superior-inferior dimension, centre it on the screen and rotate the probe 90°, so the indicator is anterior.
3.
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@kyliebaker888 Interesting question.
1.
In the case that the original tweet describes, one can actually get an AP diameter using the lateral approach.
2.
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working on @iBookCC chapter on submassive & massive PE. what questions do you have on this? tweet 'em at me & will try to address in the chapter.
GIF
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Great tool for POCUS proficient, IT challenged oldtimers.
Thank you.
Ben C. Smith@UltrasoundJelly
Introducing a new tool for research and education: PLUCK lets you extract a high quality still image from your ultrasound clip, annotate, and save it. Top journal download presets also included. Free to use. ultrasoundoftheweek.com/pluck/ #FOAMed #FOAMus
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@edwardbrowden @CarolBlymire Funny, I was thinking it’s very much like talking to the leftward leaning politically correct
Why don’t we just agree that just like this young ladies rigidity left her coworkers in dismay, rigidity on either side of the political spectrum it’s something to be admonished.
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@Al_Errazuriz @ultrasoundpod 58 yo last nite with very similar RA appearance, clearly going thru TV on occasion. Hemodynamically little unstable. CTPA bilateral Saddle emboli. Echogenic structure - presumed clot - in RA not migrating over 1.5 hrs while in ER. In your case do you think it was all clot?
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Great protocol. Even though it would be unlikely to change management - all pts get at least a D dimer - the heart rate score in the rGeneva score should be modified for pregnant patients. A heart rate of 95, which would accord them 5 points, is commonplace in later pregnacy
Amal Mattu@amalmattu
A rational approach to PE workup in pregnancy medscape.com/viewarticle/90… based on recent AnnIM article (Medscape registration free) #FOAMed @UMEmergencyMed
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@arntfield Rob Devins, ER doc, Belleville, On. ER U/S director. TTE for 7 yrs. Getting TEE probe this fall? Do you do hands on training?
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@katyperry Jordyn Devins again.
You are my favourite singer. I am coming to your concert in Ottawa on July 16 and would love to meet you.
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