(1/x) How did I get into #pocus and research?
It starts (like most good stories) in an overheated medical tent at Pemberton Music Festival listening to Snoop Dog.
A 🧵
Cardiac #POCUS parameters in the assessment of pulmonary hypertension
#FOAMed#Nephpearls
Click 'ALT' for abbreviations
Courtesy: 2022 ESC/ERS pulm HTN Guidelines
ALT Ao, aorta; IVC, inferior vena cava; LA, left atrium; LV, left ventricle; PH, pulmonary hypertension; RA, right atrium; RAP, right atrial pressure; RV, right ventricle; RVOT AT, right ventricular outflow tract acceleration time; sPAP, systolic pulmonary artery pressure; TAPSE, tricuspid annular plane systolic excursion; TR, tricuspid regurgitation; TRV, tricuspid regurgitation velocity. a Refers to collapse on inspiration.
Pressure control spontaneous ventilation vs volume assist-control ventilation in #ARDS, 🇫🇷 RCT
🔎PC-SV vs ACV, similar Vt/PEEP
PC mode set to encourage spontaneous ventilation ⬇️ need for sedation/adjunctive therapies for hypoxemia but not ⬇️ mortality
🔓bit.ly/3TAfFI6
Fabulous video and case report showing an intubation technique using hyperangulated video laryngoscopy and a DuCanto suction catheter preloaded with a bougie onlinelibrary.wiley.com/doi/…@JACEPOpen@jducanto
Another deadly triage ECG missed, and the waiting patient leaves before being seen. What is this nearly pathognomonic ECG?
hqmeded-ecg.blogspot.com/202…
79 year old gentleman presents with a few days' history of shortness of breath on exertion. T1RF on ABG. Team felt x-ray showed some haziness at the left base - treated with IV antibiotics and fluids. Debate about whether to get a CTPA in view of significant O2 requirement. (2/5)
Similar to a prior 🧵regarding traumatic deaths in 'The Iliad':
Here I will examine the deaths in the movie 'Braveheart' to estimate how many of these might have been prevented if modern level 1 trauma centers and surgical care were available in Scotland at the time.
(1/)
Brain Injury Associated Shock (aka BIAS) - Haemodynamic compromise from isolated severe TBI is rare & in our services experience, indistinguishable from haemorrhagic shock in sick multi-trauma patients.
tinyurl.com/r3umpbka
Check out this CDC study: when a pathogen was found, #1 cause?
Rhinovirus.
Flu was #2.
Strep pneumo is #3, then 4 more viruses before you hit another bacteria.
(This study is well pre-COVID, but rest assured it would be well represented now).
#SHEASpring2024
3/
Communication as code leader during a cardiac arrest is hard.
Here are 5 things you can do to improve your code communication right now. 👇
A 🧵
#medtwitter#foamed#meded
Quick Free Airway Education!
Taking time to correctly position a patient is, in my view, the NUMBER ONE way to improve your chances of successful airway management
I've made a short (5 min) free lesson
Please have a look and give your feedback after
tinyurl.com/airway-positioni…
22yr old primigravida, 28 wk, no other comorbidy presents with SOB and chest pain. 88%on RA
TAPSE 13 , Bp 89/60 map 63 , High Trop, RR 30 and pulse 100. Right heart strain on echo. CTPA confirms near occlusive bilateral PE’s . To Thrombolyse or not?
Interfacility transport has inherent risks. We should not be transferring in the middle of the night unless a critical intervention is happening shortly after arrival at the tertiary center #NAEMSP2024