@ProcedurePRIME

PRIME: Procedural Research and Innovation for Medical Educators. We aim to advance procedural research + education within Internal Medicine. R/T not endorsement

Joined March 2022
  • Tweets402
  • Following695
  • Followers744
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PRIME Procedural Research and Innovation retweeted
Nick Mark MD
@nickmmark25 May 2023
Interesting RCT in @NEJM about platelet transfusions prior to CVC placement in people w/ thrombocytopenia (Plt 10-50k): - higher rate of grade 2-4 bleeding w/o Plt transfusion: 11.9% vs 4.9% - difference driven by much more bleeding w/ subclavian lines nejm.org/doi/full/10.1056/NE… 1/
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PRIME Procedural Research and Innovation retweeted
NephroPOCUS
@NephroP13 Apr 2023
#POCUS image of the day 📸 Classic example of rapid atrial swirl sign (RASS) - rapid opacification of right atrium after saline (preferably agitated but not necessary) injection. Positive test suggests correct placement of central venous catheter #MedTwitter #Nephpearls #FOAMcc Image courtesy: pubmed.ncbi.nlm.nih.gov/2555…
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PRIME Procedural Research and Innovation retweeted
Katie Wiskar
@katiewiskar14 Nov 2022
Ok team. Let's talk about this mysterious, pulsatile-appearing thing in the abdomen. Many of you were concerned that this was a massive AAA 😱😱😱 And, to be fair, that was my first split-second reaction when I scanned the patient as well. BUT!
Katie Wiskar
@katiewiskar13 Nov 2022
#POCUS puzzle time again: What's the large circular anechoic structure seen here? Probe is placed on the patient's abdomen in the epigastric region. Patient was in the ICU in profound shock NYD.
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PRIME Procedural Research and Innovation retweeted
Carlos A. Metidieri Menegozzo MD, PhD, FACS, TCBC@carlosmenegozzo12 Nov 2022
Replying to @ProcedurePRIME @DrGalenMD @MFleshner301 @ria_dancel @katiewiskar @JosephineCool1 @IM_POCUS @G2Disrupt @cameron_baston @DrKukaracha @medmanny @EAFischer
Agree 100%. I've been teaching a simple approach for tube thoracostomy using ultrasound. Published it in 2018. This seems like a great opportunity to share! sciencedirect.com/science/ar…
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PRIME Procedural Research and Innovation retweeted
SrivatsaNagachandan@Srivatsa3412 Nov 2022
#Usg #thoracentesis #avoidinghemothorax #upperborderoflowerrib #safeentry
PRIME Procedural Research and Innovation@ProcedurePRIME12 Nov 2022
One of the feared complications in thoracentesis is hemothorax due to laceration of an intercostal artery. Let's talk about how to avoid it 🧵
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PRIME Procedural Research and Innovation retweeted
Segun Olusanya (He/Him) [email protected]@iceman_ex12 Nov 2022
This is a nice thread on a common #pocus procedure. #foamed
PRIME Procedural Research and Innovation@ProcedurePRIME12 Nov 2022
One of the feared complications in thoracentesis is hemothorax due to laceration of an intercostal artery. Let's talk about how to avoid it 🧵
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PRIME Procedural Research and Innovation retweeted
Olugbenga Okusanya MD@okusanyamd12 Nov 2022
This is pretty neat. Directly applies to pigtail placement. The rib is your first target. Not the space.
PRIME Procedural Research and Innovation@ProcedurePRIME12 Nov 2022
One of the feared complications in thoracentesis is hemothorax due to laceration of an intercostal artery. Let's talk about how to avoid it 🧵
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PRIME Procedural Research and Innovation retweeted
Critical Concepts@critconcepts10 Nov 2022
Whaaat
PRIME Procedural Research and Innovation@ProcedurePRIME10 Nov 2022
Poll time! Who has tried manual aspiration of CSF during lumbar punctures to decrease collection time?
7%Do it all the time
52%You're insane
42%Here for the comments
212 votes • Final results
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PRIME Procedural Research and Innovation retweeted
Jamie Galen@DrGalenMD10 Nov 2022
Replying to @ProcedurePRIME
Would love to see this method studied more thoroughly. My concern would be too rapid lowering of ICP ⬆️ risk of post-LP headache. What do you think @cynarmandmd @mrobbinsmd
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PRIME Procedural Research and Innovation retweeted
Katie Wiskar
@katiewiskar8 Nov 2022
#POCUS trivia 🤓 Patient presents with sore throat, fever, and this scan. What's the eponymous diagnosis? #pocuspuzzle
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PRIME Procedural Research and Innovation retweeted
Gigi Liu
@G2Disrupt19 Oct 2022
Replying to @G2Disrupt @critconcepts @katiewiskar @ria_dancel @ProcedurePRIME @EAFischer @medmanny @JosephineCool1 @DrGalenMD @DrKukaracha
Also, recommend reverse trendelenburg to increase the size of the ascites pocket when doing the procedure. Scan like MAD for vessels and use power doppler with the appropriate gain and velocity scale.
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PRIME Procedural Research and Innovation retweeted
Critical Concepts@critconcepts19 Oct 2022
Replying to @katiewiskar @ria_dancel @ProcedurePRIME @EAFischer @medmanny @G2Disrupt @JosephineCool1 @DrGalenMD @DrKukaracha
Suprapubic is not so bad with a good ultrasound view
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PRIME Procedural Research and Innovation retweeted
Katie Wiskar
@katiewiskar19 Oct 2022
Replying to @ria_dancel @ProcedurePRIME @EAFischer @medmanny @G2Disrupt @JosephineCool1 @DrGalenMD @DrKukaracha
Interesting - I actually think it’s easier with some fluid in the bladder (easier to see and therefore avoid )
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PRIME Procedural Research and Innovation retweeted
Ria Dancel, MD@ria_dancel19 Oct 2022
Replying to @ProcedurePRIME @EAFischer @medmanny @G2Disrupt @JosephineCool1 @katiewiskar @DrGalenMD @DrKukaracha
Suprapubic if I must. Though I’d find bladder first, make them empty it, and look again before poking.
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PRIME Procedural Research and Innovation retweeted
Katie Wiskar
@katiewiskar19 Oct 2022
Replying to @ProcedurePRIME
I’ve gone suprapubic in a pinch. Thorough check for vessels, identify bladder. Usual safety rules.
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PRIME Procedural Research and Innovation retweeted
Jordan Merz, MD@jpmerzMD19 Oct 2022
If you aren't using ultrasound for your lumbar punctures, you should be (even @SocietyHospMed says so). I was able to guide a resident through his first ever LP to champagne! @ProcedurePRIME
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PRIME Procedural Research and Innovation retweeted
Max Diddams@MaxDiddams16 Oct 2022
Replying to @ria_dancel @ProcedurePRIME @medmanny @G2Disrupt @IM_POCUS @MFleshner301 @DrGalenMD @katiewiskar @JosephineCool1 @TanpingWong @shanearish
What a timely question! pubmed.ncbi.nlm.nih.gov/3571…
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PRIME Procedural Research and Innovation retweeted
Katie Wiskar
@katiewiskar20 Sep 2022
Replying to @ProcedurePRIME
Definitely think there is a distinction between posting a single image/clip for teaching vs posting a whole case. And even many “cases” for me with US are simply a series of images with discussion around the findings.
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PRIME Procedural Research and Innovation retweeted
NephroPOCUS
@NephroP20 Sep 2022
Replying to @katiewiskar @ProcedurePRIME
💯Don't share any information that is not critically important for interpretation of the image. Obviously, no patient identifiers.
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PRIME Procedural Research and Innovation retweeted
Jamie Galen@DrGalenMD3 Aug 2022
Fascinating mechanism⬇️ What do you think @ebtapper?
PRIME Procedural Research and Innovation@ProcedurePRIME3 Aug 2022
Replying to @ProcedurePRIME
In cases of severe portal HTN, the pressure gradient that exists between intra-abdominal vessels and the abdominal cavity itself can cause vessels to rupture with rapid fluid removal and a sudden drop in intra-abdominal pressure.
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