Question for #POCUS #echofirst twitter How do we define hyperdynamic LV in eyeball qualitative assessment? (for quantitative is LVEF>70%). Is there a more specific way to distinguish hyperdynamic vs normal LV systolic function on POCUS, aside from pattern recognition/gestalt?

Have always said: atelectasis v PNA is a clinical distinction... dynamic air bronchograms point to PNA, other features help (relative volume loss, shape of lung, etc). But this article does a nice quantification of lung u/s-based dx process to distinguish. pubmed.ncbi.nlm.nih.gov/34582414/

Do you Swan?? Then check out this #POCUS guided insertion technique.. doi.org/10.1016/j.rmcr… ------------- #MedEd #CHESTTrainees POCUS 101 Society of Point-of-Care Ultrasound (SPOCUS) IM POCUS Focus Philips POCUS #PulmonaryHypertension #shock #HeartFailure

41 YO ♀️, diffuse systemic sclerosis + PAH. Very interesting EKG... And I was lucky enough to capture this W sign on pulmonary valve M mode!

How does your institution “release” trainees to perform central lines without supervision? Please feel free to comment, esp if none of the below or combination of methods

Speaking of central lines: How do you confirm you are in a vein before dilating?

Also for funsies: Which way do you hold the needle/syringe when performing procedures?

👨🏻 SOB > 3 weeks 🏥: Hemoptysis + 🫀murmur + 🦵edema #POCUS @kosmosplatform - B profile + Bilateral 🫁 effusion - Mild ascitis - IVC > 2 cm. HV: S < D. PV: High PI w/ reverse flow -🫀: Severe Ao insuff + vegetation Dx: Aortic Valve Endocarditis 🔜: ATB + 🔪

50👨🏻 SOB + ortopnea ~ 3 weeks 🏥⤵️. 72h ago echo: LVEF ~30% 🆕〽️: HR 120-130(ST), BP 90/67 (74), CRT >6/ cold & altered 🧠. Sp02 94% NC 3l #POCUS ➖ LVEF < 30%. 🫁 Mild B profile. IVC > 2 cm. HV & PV ⚠️ 💮 Cardiogenic Shock Tx: Inotropic support ➡️ CC unit. Etiology (?)

Let’s talk about LPs! Do you use ultrasound? 1/

How many times do you reposition the needle if unsuccessful? 2/

Any tips and tricks from our #proceduralists for LP success? Katie Wiskar Ria Dancel, MD Sanjay A. Patel, MD (he/him/his) Jamie Galen Josephine Cool Carolina Ortiz MD 3/

Crowd souring: Do any #IMPOCUS people know studies on ability of novice POCUS users to adequately assess for RV strain and dilation? Have found a lot on LV function, pericardial effusion, IVC, but not RV. Renee Dversdal NephroPOCUS Nilam Soni Benji Mathews, MD MBA Jamie Galen Ria Dancel, MD Irene Ma

Join us every tuesday in august for POCUS based cases on The Clinical Problem Solvers VMR. There will be POCUS based case presentations & teaching with Sanjay A. Patel, MD (he/him/his), Ria Dancel, MD , Gigi Liu , Jamie Galen, Ravi Singh & Daniel Restrepo, MD Join here for links to VMR's: clinicalproblemsolving.com/meeting-join-l…

Clinical reasoning levels up with #POCUS every Tuesday this month. See link below to get the unique zoom links to join us!

Let’s talk about bleeding complications in paracentesis.

Lots of good answers here! Let’s talk about that the findings were before I post the clip that gives it away 😉

#POCUS is vastly superior to CXR when it comes to effusions -> detection, quantification and characterisation! What do we think is going on here? Poll below