So I keep hearing and seeing people bash the IVC. Casually dismissing it with a shrug. “It’s not really good for volume responsiveness, you know…” All that deserves is an eyeball-rolling emoji. That is, unfortunately, the reaction of docs who are trying to devise a threshold or recipe-based approach to POCUS management (which will be […]
So I ran a couple of twitter polls sets the other day. Here is the first: (if you want the twitter videos see here) and part 2: And to sum it up: So I just wanted to illustrate something I keep bringing up, essentially that the entire IVC literature based on the AP […]
So I had the pleasure of having Jon-Emile drop by my house today and meeting him in real life, and we decided to record a few of our discussions. It was pretty much off the cuff, so do excuse our pauses and mostly my hmmms. But I do think we covered some interesting topics, […]
So yesterday had a case that really brought out this issue. One of my ICU patients didn’t have a great urine output, so instead of playing a guessing game looking at urea, creatinine, ins & outs, etc, etc (hopefully no one is thinking CVP…), I did what any self-respecting bedside sonographer would and went for […]
I recently had a colleague ask me to put on a graph the way I like to assess the IVC, at least conceptually. I posted about this a few weeks ago (http://wp.me/p1avUV-8E), so I tried to come up with something useful for clinicians, correlating IVC variation with respiratory effort. A useful concept to visualize this […]
So I have a huge issue the IVC and its ultrasound assessment. For the most part, neither the yay-sayers or the nay-sayers are applying much sound physical principles, as far as I’m concerned. To assess a patient’s volume status, it may be practical to begin with the sub-xiphoid view of the IVC, since the decision to […]
So take a look at this: I’m sure most experienced bedside sonographers come across this all the time. For those who are starting out, and until now have just been looking at size and variation, take a second to look at the flow. You can actually see the flow stop and start, which tells you […]
So recently a colleague asked me about one of my twitter posts where I had put a clip of doing venous congestion assessment using a handheld – which is without pulsed Doppler (PW). Since VEXUS is predominantly based on Doppler findings, seems like 2D and colour might not cut it, but can it be done […]
So #MedTwitter is truly an incredible forum for case discussion, where you get to exchange with literally some of the best medical minds on the planet who often also happen to be front-line clinicians in the nitty-gritty therapeutic decision-making. Here’s a discussion which I think was great. Recently, Dr. Thind has been generating some great […]
As with all continuing medical education events, this one will make you a better physician. But we know who you are: It’s 2am. Your pager is blowing up. You go to the floor with 3 simultaneously crashing patients. We’ve all been there. As a result, we’ve collectively designed this educational event to bring together an […]
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