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How you got your BP is more important than what your BP is.

For any given operation, there is a window in which one has performed enough of them to feel confidence in doing them, but not enough to have seen the rarer complications. In other words, the confidence comes before the fear; this is why we talk about these things a lot.

Where are DOAC drugs absorbed in GI tract? It depends on the drug!

How do you identify normotensive shock in PE? We show that IVC contrast reflux is a very specific way. sciencedirect.com/science/articl… The PERT Consortium® Thrombosis Research

This is your daily reminder to #POCUS the IVC in two planes! The short-axis view (found by rotating your probe 90 degrees) can be so helpful in those borderline cases. Example 1: is the long-axis IVC plethoric? Hard to tell, but it appears that way 🤔

Whereas in short-axis, the tiny, ellipsoid, collapsed IVC becomes more evident:

CVP shouldn’t be thought of as an indicator of fluid responsiveness but rather it’s indicating the operating point of cardiac performance (contractility & afterload, ie FS curve) & venous return (intravascular stressed volume & vascular compliance, ie VR curve) Jon-Emile Kenny

Webinar on November 12: Join us for The Clinical PE Story: PEERLESS RCT Comparing FlowTriever to CDT, an in-depth discussion on the PEERLESS randomized controlled trial results. This session will explore the RCT outcomes and offer valuable clinical insights into the future of PE

On this day in 1952, Dr. Paul Zoll reported in NEJM the first description of two patients whose hearts were resuscitated using electric charges. Today, automatic external defibrillators (AEDs) are used everywhere to save lives. Learn more: nej.md/GUw39W

Make a wish #thanksgivingClot

1/ Time for another #POCUS pitfalls thread 🧵: the infamous IVC 🤩 I have MANY thoughts on the IVC 💭 When I first started teaching POCUS, I actually disliked the IVC because it was often poorly done or incorrectly interpreted ❌ I have now come to love the IVC, BUT you have

Super interesting and novel. When you see cardiac arrest with burst-suppression, did you know that identical the bursts are (in terms of frequency and morphology) the worse the prognosis? The more irregular and variable the bursts? The better. link.springer.com/article/10.100…

A case of severe aortic regurgitation secondary to endocarditis🫀 Severe AI characteristics on ultrasound: 1. Vena contracta width >6mm 2. Pressure half-time less than 200ms (CW Doppler through regurgitant jet) 3. Diastolic flow reversal in the descending aorta Other features

When looking at RV strain in PE, look at: - VTI is a sensitive indicator of death - RV-PA coupling can be a sensitive predictor of impending shock - TAPSE/PASP can help predict overall outcomes and cardiac output Connor O'Brien Houston Shock Symposium CardioNerds

#POCUS image of the day: What structure does the arrow point to (waving ⛳️) on this subxiphoid #echofirst view? #FOAMed #Nephpearls

Answer: Falciform ligament: sickle-shaped structure that anchors the liver, the anterior abdominal wall and the diaphragm. Seen on #POCUS as a thin mobile structure (waving flag ⛳️ ) when there is ascites. Image courtesy: KenHub

I have formally requested the Trump Administration rescind their unlawful deployment of troops in Los Angeles county and return them to my command. We didn’t have a problem until Trump got involved. This is a serious breach of state sovereignty — inflaming tensions while

“A hospital-wide policy to administer lactated Ringer’s solution rather than normal saline did not result in a significantly lower incidence of death or readmission to the hospital within 90 days after the index admission.” Generations of surgeons in disbelief!😊

Basic cardiac #POCUS views #Nephpearls #FOAMed #FOAMcc

🧵 Starling’s Law: Misunderstood, Misapplied, and Still Misleading 1 🚨 “Starling’s Law explains how the heart increases cardiac output.” You’ve probably heard this a thousand times. But it’s wrong. Or at least - very incomplete. Let’s fix it. Because this matters - for heart