(1/x) One of the biggest challenges when learning #pocus is that a lot of the case volume is relatively normal.
Here's some pathology you can use to hone your interpretation.
A 🧵
Note: This image has both a pericardial effusion (with some fibrin) and a pleural effusion
#foamed #medtwitter #pocus
Here's some pathology you can use to hone your interpretation.
A 🧵
Note: This image has both a pericardial effusion (with some fibrin) and a pleural effusion
#foamed #medtwitter #pocus
(2/x) Notice anything on the aortic valve?
This patient had fevers, weight loss, and this #pocus is supportive of aortic valve endocarditis.
Importantly, many of these patients will still require TEE to fully characterize the lesion (e.g. size) and to assess for other complications like root abscess.
This patient had fevers, weight loss, and this #pocus is supportive of aortic valve endocarditis.
Importantly, many of these patients will still require TEE to fully characterize the lesion (e.g. size) and to assess for other complications like root abscess.
(3/x) This is a clip you don't want to stare at too long... 👀
When you use #pocus during cardiac arrest, you might see pathology like this where the patient has suddenly deteriorated into ventricular fibrillation and you caught it with the probe on the chest.
Put down the probe and shock! ⚡️
When you use #pocus during cardiac arrest, you might see pathology like this where the patient has suddenly deteriorated into ventricular fibrillation and you caught it with the probe on the chest.
Put down the probe and shock! ⚡️
(4/x) This clip is a bit more subtle, but what is that behind the heart in the far field?
This is a mass posterior to the atria compressing the atria. x.com
This is a mass posterior to the atria compressing the atria. x.com
(5/x) This clip shows a somewhat depressed LV and significant aortic regurgitation.
Its hard to grade aortic regurgitation on one view (and without other measurements) so I like to ask myself, could this cause hemodynamic compromise?
Definitely.
This ended up being severe aortic regurgitation on further measurements.
Its hard to grade aortic regurgitation on one view (and without other measurements) so I like to ask myself, could this cause hemodynamic compromise?
Definitely.
This ended up being severe aortic regurgitation on further measurements.
(6/x) This is a bit of a chaotic #resusTEE . This is a mid-esophageal view that is visualizing the RV in the far field, the pulmonic valve, and the main pulmonary artery.
Notice the significant amount of echogenic material throughout the RV.
This represents a massive clot in transit through the RV.
Notice the significant amount of echogenic material throughout the RV.
This represents a massive clot in transit through the RV.
(7/x) This is a super ominous transcranial Doppler tracing.
Normal tracings should have all the blood flow of the MCA above the baseline. (forward flow in the brain is good).
As intracranial pressure rises, you can have blunting of diastolic flow and then eventually flow reversal.
This is a sign of impending herniation or brain death.
Normal tracings should have all the blood flow of the MCA above the baseline. (forward flow in the brain is good).
As intracranial pressure rises, you can have blunting of diastolic flow and then eventually flow reversal.
This is a sign of impending herniation or brain death.
(8/x) This is a scan of a patients thigh with swelling and pain. Notice anything?
In addition to a bit of edema in the subcutaneous tissue, there are A-line patterns (horizontal bright white lines with reverberations deeper).
A-lines indicate air - air in the subcutaneous tissue can be indicative of necrotizing fasciitis. In the right clinical context, this is the same as seeing air/gas on a CT or x-ray.
In addition to a bit of edema in the subcutaneous tissue, there are A-line patterns (horizontal bright white lines with reverberations deeper).
A-lines indicate air - air in the subcutaneous tissue can be indicative of necrotizing fasciitis. In the right clinical context, this is the same as seeing air/gas on a CT or x-ray.
(9/x) Finally, in a patient with shock, don't miss RV failure.
The clues to RV failure in this clip are:
1) RV is greater than LV diameter
2) RV lateral annulus is not moving much longitudinally
3) RV free wall is not contracting
4) RV apex has relatively preserved function (note: McConnell's sign is NOT indicative of PE, but rather, acute RV failure of any etiology).
The clues to RV failure in this clip are:
1) RV is greater than LV diameter
2) RV lateral annulus is not moving much longitudinally
3) RV free wall is not contracting
4) RV apex has relatively preserved function (note: McConnell's sign is NOT indicative of PE, but rather, acute RV failure of any etiology).
جاري تحميل الاقتراحات...