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Rishi Kumar, MD | RK.MD @rishikumarmd

Cardiac Anesthesiologist · CVICU Intensivist · iOS App Developer (RKref.app) · #POCUS/TEE · #FOAMed · Techie · instagram.com/rishimd

Joined August 2008
  • Tweets 10,016
  • Following 124
  • Followers 6,088
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Rishi Kumar, MD | RK.MD@rishikumarmd
11 Feb 2021
Made this free perioperative/ICU reference sheet a while ago. Click the link to download/share! Hopefully many of you all find it helpful! rk.md/2020/rk-perioperative-… #foamed #criticalcare #anesthesia #icu
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Pulm. velocity accel time (PVAT) estimates the severity of PA pressure elevation when TR jets are difficult to analyze. PVAT = time from flow onset to peak velocity. PWD at the PV in this PSAX #TTE shows a PVAT ~ 150 ms (normal is > 130 ms). #echofirst #medtwitter
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Happy New Year to all! #MedTwitter, what things do you all do at the beginning of every year? Here are a few things I do: - Subscription renewals - Backdoor Roth IRA contribution - Look for competitive rates on utilities
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One last update for my free EchoTools iOS app before 2024! As always, I appreciate your continued support for this project! echotools.app #pocus #ultrasound #medtwitter
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The transhepatic (TH) IVC view (phased array in RUQUS, tilt beam cranio-posteriorly, pan around). Poor agreement in measurements b/w TH and SC IVC views, and outside of extremes, IVC measurements don't guide my clinical practice in the CVICU. #echofirst #medtwitter #pocus
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Cause we're spreading holiday cheer with... mortality benefits! #MedTwitter
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Academic attendings who constantly complain about their trainees' weaknesses should spend less time ridiculing and more time actually teaching/mentoring. We were ALL in their shoes at one point. Take pride in nurturing your trainees' success! #medtwitter
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Love GE Healthcare's Auto-VTI tool! Applying it here to an apical 3-chamber ("long-axis") TTE view to assess volume responsiveness. Hoping to see more tools like this expand across manufacturers. #echofirst #pocus #ICU #medtwitter
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Identify tasks that you regularly perform and learn how to automate them.
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ME-LAX TEE view showing pre-and-post surgical IVS myectomy for HOCM. Note DIASTOLIC flow across the IVS - an expected finding caused by unroofed septal perforators (systolic flow would be concerning for VSD). #medtwitter #echofirst #cvsurgery #anesthesiology
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Lung #POCUS with air bronchograms (yellow arrows) - patent airways amid consolidated lung tissue signaling atelectasis, PNA, etc. Dynamic bronchograms move with respiration while static suggest trapped air (RLL atelectasis seen here caused by a pleural effusion) #medtwitter #ICU
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Where are my fellow cardiac anesthesiologists taking the first #ABA cardiac anesthesia board exam tomorrow? #anesthesia #medtwitter
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Thanks for sharing my post!
Simplify Rx 📱
@simplify_drugs
22 Nov 2023
What’s the procedure ? And where it is used 🤔
Epidural blood patch procedure

ALT Epidural blood patch procedure
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Or the famed MAC with 100% immobility… AKA general anesthesia without an airway. I really think every proceduralist should have to provide a (supervised) anesthetic for every procedure they’re going to do as part of their training.
Leslie Matthews, MD, PharmD@LeslieMDPharmD
16 Nov 2023
Replying to @jholloway_MD @APSForg
EXACTLY. yet things like this, “don’t intubate, we want MAC,” “we don’t want a CSE, do a spinal” and “why are you placing another IV, she only needs 1” are real things i’m told as an ATTENDING all the time. safety shouldn’t be sacrificed for someone else’s convenience. ever.
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I’ve had several direct discussions with attending cardiologists about issues writing “recommend CV anesthesia” or “recommend MAC” in the chart without actually talking to an anesthesiologist beforehand. 😬
Jordan Holloway, MD (she/her)@jholloway_MD
16 Nov 2023
Replying to @LeslieMDPharmD @APSForg
“Consider rapid sequence intubation” I cannot fathom trying to tell an interventional cardiologist how they should dictate their heart cath plans. Or an endoscopist how they should perform endoscopy. Let alone *publishing guidelines* to that effect. Wild.
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What single app helps you the MOST with organizing tasks? Things? Tick Tick? Notion? Notes/Reminders? Bear? Fantastical? Something else? #apple #appstore #macos #ios
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An overview of axis deviation on the blog: rk.md/2017/ekg-axis-deviatio… #medtwitter #foamed
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RV-PA coupling utilizes the effective PA elastance (Ea) and the RV end-systolic elastance (Ees). Learn more on the blog! #meded #medtwitter rk.md/2023/right-ventricular…
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What's the a.) imaging modality, b.) view, c.) pathology, d.) likely causes? #POCUS #EchoFirst #MedEd #MedTwitter
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3D TEE imaging of the tricuspid valve (TV) is beautiful! 🤩 Important spatial relationships to understand are the SLTV-PLTV commissure for the coronary sinus, ALTV-SLTV commissure for the RCC-NCC of the AoV, and RCA coursing along the lateral aspect. #pocus #tee #echofirst
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That means so much! I really do appreciate the kind words! 🙏
Elle R. Kaplan, M.D.@elle_kaplan
14 Oct 2023
Replying to @rishikumarmd
Incredibly helpful app that I recommend to all training levels and specialties 🤓My POCUS use has skyrocketed thanks to @rishikumarmd and EchoTools. Whether periop or in the ICU, I use it more than any other medical app 💯🔥
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