POCUS Med Ed

The hardcover version of The POCUS Textbook is officially released!!!! Get a copy: amazon.com/dp/B0FV93KW7C/… 🏥100+ Figures without abbreviations 💊Dozens of videos accessible by QR code with NO passwords and NO paywalls 🩹Step-by-step tutorials by Dr. Istrail for all experience levels. @NephroP @Wilkinsonjonny @iceman_ex @POCUSpeek #foamed #meded #MedTwitter

Our paper is out! VExUS + LUS reflect intracardiac pressure changes before and after decongestion in critically ill patients: journals.lww.com/ccejournal/ful… @ArgaizR @ElliottMillerMD @sacalle1 @NarulaSukrit @YaleIMed @TradIMYale

An incredible graphic 👇🏻

amazing

This is also visible in the common carotid artery. Zero diastolic flow and diastolic reversal are specific but not sensitive for severe AR. For example: pubmed.ncbi.nlm.nih.gov/37285079/

Do you routinely use PW Doppler of left subclavian artery in post-TAVR patients with aortic regurgitation? In this study, the spectral Doppler findings, including backward-forward VTI ratio and biphasic flow pattern, were associated with significant aortic regurgitation. jacc.org/doi/10.1016/j.…

Impressed to see #pocus even being discussed in this article. Though #POCUS is discussed as an observer rather than from a skilled practitioner. @NephroP

The man, the myth, the legend in the flesh at our Division of Hospital Medicine Grand Rounds Must watch on why Shorter is Better for antibiotics 1.5x speed since he doesn't drink coffee Imagine a caffeinated @BradSpellberg ...

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What do you think @smithECGBlog @PendellM ? jamanetwork.com/journals/jamai…

Initial ECG with clear ST depressions in the anterior leads. At a minimum, serial ECGs should be done, and a posterior ECG. @PMcardioApp detected it as a STEMI equivalent.

Instructive case from @JAMAInternalMed of a missed posterior OMI leading to free wall rupture. Patient presented with chest pain and this ECG:

Hiatus hernia behind left atrium in PLAX. 👇🏻

This case report describes a woman in her 60s with sequential type I Kounis syndrome and cholecystocardial syndrome, leading to dynamic, reversible electrocardiography changes mimicking acute coronary syndrome. bit.ly/4atrdoe

A top cancer virologist just brewed vaccine beer — and drank it himself. Chris Buck (NCI scientist who discovered 4 human polyomaviruses) engineered brewer’s yeast to produce harmless virus-like particles from BK polyomavirus, fermented it into cloudy Lithuanian-style ale, and consumed it. His reported result: antibody levels rose to protective thresholds with zero ill effects. Family members tried it too.

@RobertHermanMD @PendellM @smithECGBlog @EM_RESUS Thank you. Yes agree, though multiple cardiologists did not feel it necessary for intervention. Hence, all the amazing work you and @smithECGBlog et al are doing!

@pocusmeded @PendellM @smithECGBlog @EM_RESUS The first ECG is diagnostic to me, as well as the Queen of Hearts. POCUS of course can be helpful to convince reluctant colleagues, but diagnosing OMI from this #ECG is not challenging.

Can #pocus be used to augment nonspecific ECG findings? Consider this case. A middle-aged woman with a strong family history of coronary artery disease presents to the hospital with intermittent chest pressure radiating to her arm. Happened 3 separate times, not associated with exertion. On arrival at the hospital, vitals were stable. The initial ECG, read by the emergency physician and admitting physician as showing no ST changes, is shown below. She is admitted to the hospital, and troponins are trended.

@The_Nanashi_O Agreed, although multiple cardiologists on the case dismissed this finding due to not meeting STEMI criteria

@pocusmeded Coming from a POCUS aficionado, expert ECG interpretation skills would've diagnosed this much faster. There is an anterior (V4 most diagnostic) and inferior/apical injury pattern = LAD culprit. But absolutely, POCUS helps!

@PendellM @smithECGBlog @EM_RESUS @RobertHermanMD To learn more about how to use #pocus to evaluate a patient with chest pain, consider getting a copy of The POCUS Textbook: buff.ly/lEWPJO9

This is a clear case in which #pocus can augment the findings of a subtle ecg finding that, if done on admission, would likely have resulted in urgent left heart cath. What do you think about the initial ECG and this case @PendellM @smithECGBlog @EM_RESUS @RobertHermanMD @RJonesSonoEM ?