Emergency Medicine (FRCPC EM) & POCUS (U of C EM Ultrasound Fellowship) with interests in Physiology, Pharmacology & Medical Toxicology
Calgary, Alberta
Joined September 2013
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Another great thread. RVOT VTI in acute PE. Super helpful in risk stratification and assessing treatment response. Thanks for sharing @khaycock2
1/ Massive PE patient with high clot burden and saddle embolism. RVOT VTI before milrinone/epoprostenol medneb:
These are important stories. Many residents have been similarly affected. We want to be fully invested in the COVID response yet we are left studying indefinitely with no end in sight.
#PGY5Stories #examfail
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Alberta Patients and Physicians: BACK TO THE TABLE - Sign the Petition! chng.it/6X2HPsDf via @CdnChange @shandro #backtothetable #ABdocs4patients
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Another great @westernsono screencast by the talented @katiewiskar on a topic that provides insight into the question “what is this patients fluid-status?” #Doppler-everything #wholebodyultrasound #POCUS
UltraNerds, this one's for you: a screencast covering solid organ doppler assessment of venous congestion. Would love to hear thoughts and feedback from others who are using these techniques! #POCUS #VEXUS #FOAMed
westernsono.ca/screencasts/m…
More ultrasound gold from @westernsono check it out!
54M presented w/ acute hypoxic respiratory failure necessitating intubation and ICU admission. Post-intubation he had a P/F ratio of 54 despite a relatively unremarkable CXR. The PEEP was increased to try to improve oxygenation.
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Incredible series of images. #EDTEE
A great example of how TEE resus can guide our cardiac massage:
40 yo patients, 12 weeks pregnant, in cardiac arrest.
First rhythm check : patient is in PEA and with large amounts of free fluid in her abdomen. Gyno paged stat while resus attempts continue.
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Wonderful explanation of the mechanism of hypoxia in PE. This is why #medtwitter is so great!
1/
Why does acute pulmonary embolism (PE) cause hypoxia?
It took me a while to realize I didn't have a good answer. Think about it: the blood upstream of the clot should be fully oxygenated. Where is the blood that isn't being oxygenated?
The answer is pretty cool...
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Pretty cool to see this #UltraNurse program being used in the ICU setting. Talk about #disruptiveinnovation! Game changing stuff.
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Incredible infographic - thanks for sharing @Wilkinsonjonny
Confused with diastology? Check out my simple infographic to help you get to grips with a confusing concept. You can download it here. criticalcarenorthampton.com/… #FOAMed #POCUS #FOAMcc #echofirst #FOAMus Thx @UltrasoundMD for traces👍 @iceman_ex @avkwong @ICUltrasonica @icmteaching
Great series of tweets on diastology - @khaycock2 please feel free to tweet out more answers to questions you weren’t asked!
1/Sorry if this is common knowledge (I know I wasn't asked) but if anyone is confused by diastology, perhaps this will help (what follows is the most basic explaination and reality is more complicated). Ventricular filling is mostly governed by 3 factors.
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Fantastic thread illustrating some advanced POCUS concepts resulting in a dramatic change in management! #POCUS
@ThinkingCC @iceman_ex @kyliebaker888 @HeyDrNik @NephroP @ria_dancel @avkwong @WBeaubien @EMNerd_ @ottawaheartrob 1/? Last case of the shift. It's 0315 and I'm signing out to on coming attending. Radio calls in for hypotensive hypoxia patiet in respiratory distress.
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Such a great example of how Doppler can help you understand the patient in front of you! @khaycock2 glad they had you take a look under the hood!
Interesting case from tonight (not mine, they asked me to have a look): CHF with worsening symptoms and decreased UO despite his PMD doubling his furosemide. Sorry no videos @ThinkingCC @iceman_ex @heart_lung @avkwong @EMNerd_
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Yes!
EMCrit Podcast 240 - Renal Compartment Syndrome/It's all about the Venous Side and We've Been Fracking it up for Years with @thinkingcc (the newest member of the EMCrit Team): emcrit.org/emcrit/renal-comp…
Cutting edge stuff. teapawt.net/thesgem/status/9873997…
While experience should be valued it is fraught with bias. Blood letting-gurus sung the praises of this treatment modality. Hamilton demonstrated NNH (death) was four back in 1816. However, even William Osler promoted blood letting in his 1923 book. thesgem.com/2017/12/sgem200-… #EBM
Another great post from @PulmCrit teapawt.net/pulmcrit/status/983320…
should the p-value cutoff be reduced from 0.05 to 0.005? ongoing debate exposes statistical dogma.
emcrit.org/pulmcrit/p-value-…