Husband/dad, General Internist, POCUS zealot, Alum @GIMtoronto and CCUS @westernsono, Core IM @UCalgaryIMRP, Metalhead, guitar, he/him

Joined August 2014
If you love ultrasound and hemodynamics and you are not following @ross_prager you need to start right now!!
(1/X) Challenging case of LVOT obstruction. Post IR procedure for intrabdominal bleeding. Rapidly rising vasopressor requirements (yet no drain blood from drain). Initial POCUS shows:
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I used to teach that IVC measurements could tell you about fluid responsiveness, then it was fluid tolerance, and now I 'm just like "it helps you estimate right atrial pressure... usually... do with that what you will" :P
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Adding to this important PSA from Dr. @katiewiskar - scene from pre-thora in the outpatient clinic... we went somewhere else
PSA: this is why we ALWAS scan with colour doppler (or CPD, in this case) to look for vessels prior to thoracentesis. Indicator is toward patient's head, so the vessel is running on the superior aspect of the rib --> right where you'd normally poke #POCUS #MedEd
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If you are not training folks on the curvilinear in #lungultrasound then you NEED to read this paper by @WalshMH @LeoS_GIM @JaneveDesy @IM_POCUS @GoffiAlberto @joelle_stpierre really stellar work!
Are you team curvilinear or phased array for #lungultrasound? We asked 166 internists/trainees to interpret common lung pathologies from each probe and found:
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Drew B-Lines retweeted
In this case report, we use carotid Doppler to non-invasively quantify the hemodynamics of a pericardial effusion pre-post pericardiocentesis. This may be an alternative option in patients with limited TTE windows @heart_lung @MichaelTPratte @ThinkingCC shorturl.at/lrHJQ
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70sM brought to hosptial for confusion but predominant with fall and difficulty walking. No other collateral or anything on records. His mind is actually quite good. A little slowed but not delirious. Magnetic gait — not the worse — but the feet are not lifting off. 1/4
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I’m thrilled to announce that @VicReedman was awarded the 2023 Social Responsibility Award in Postgrad Med Ed. She is a fierce advocate for patients, especially those often overlooked by our system. I am so proud of her and grateful to @UofT_DoM for recognizing her contributions.
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(Spoiler alert, the answer is yes) :)
Should critical care TEE become a core diagnostic skill for intensivists? Check out our editorial here: authors.elsevier.com/c/1gYh-… @journal_CHEST Thanks to @arntfield & Craig Ainsworth. #foamed #pocus #foamus
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This is a god level POCUS hemodynamics thread from @ArgaizR! A must read for anyone in the business of managing volume in HD patients
Young ♀️ w CKD on HD, seen in Cardiorenal clinic Pt had torrential tricuspid regurgitation due to CVC induced leaflet perforation ➡️ She underwent tricuspid valve replacement surgery 🫀🔪 However, 1 month after discharge she is still using a wheelchair 🤔 1/12🧵
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Young ♀️ w CKD on HD, seen in Cardiorenal clinic Pt had torrential tricuspid regurgitation due to CVC induced leaflet perforation ➡️ She underwent tricuspid valve replacement surgery 🫀🔪 However, 1 month after discharge she is still using a wheelchair 🤔 1/12🧵
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Drew B-Lines retweeted
The Ottawa GIM program is THRILLED that our @LorenzoMadrazo was selected as one of the 2023 @ICREConf chief residents!!!! Wooohoooo!!! #Halifax2023
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When you are passionate about what you do, it doesn’t matter the occasion, the weather or the time, you just do it and you keep doing it. #POCUS @curromir @Tubulocentric @caname08 @JJuega @NephroP @MCeballosNefro – at Cadiz, Spain
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Huge win in Ontario - the unconstitutional bill 124 has been struck down!!!
BREAKING: Ontario Superior Court of Justice strikes down Bill 124 #OnLab #OnPoli
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