UBCIMPOCUS

Hub for all things #POCUS within the @UBC Internal Medicine program. CIMUS collaborator and staunch #FOAMed supporter.

[Katie Wiskar @katiewiskar]

One of the most requested teaching topics I get from trainees on our medical wards is cirrhosis and liver disease 🩸

Which is understandable - this is an intimidating topic for many learners, as there are so many layers of complexity to consider 🤔

Here's part 1 (of several to come!) of my cirrhosis tips and tricks: a short 🧵

[Katie Wiskar @katiewiskar]

I confess that my favourite diagnostic POCUS consults are when Nephrology consults us for volume status 😉🤓

[Katie Wiskar @katiewiskar]

Highly, highly recommended. This was a great listen - loved heard the dissection of the trial and the new questions generated by this discussion.

@edu_kattan @AndromedaShock @emcrit

[Katie Wiskar @katiewiskar]

Confession: I LOVE hyponatremia 🤓

(I know, I know. What can I say, I'm a true internist!)

HypoNa is often feared, maligned, and misunderstood - but I promise it doesn't have to be scary!

Here are my top 10 hyponatremia tips and tricks - a 🧵

[Katie Wiskar @katiewiskar]

Cirrhosis tips and tricks part 2: Decompensating events

high yield infographic alert 🚨🔔‼️

These are what bring folks into hospital 🏩; and there are a few nuances here to unpack 🧵

[Katie Wiskar @katiewiskar]

Thoughts?? @ThinkingCC @Thind888 @NephroP @msiuba @icmteaching @khaycock2 @MDBeni very curious to hear your opinions.

This was talked about at our @ubcimpocus Nerd Night over several 🍷🍺 and we are still a bit perturbed

[Viren Kaul, MD @virenkaul]

@katiewiskar @ThinkingCC @G2Disrupt @Thind888 @NephroP @msiuba @icmteaching @khaycock2 @MDBeni @ubcimpocus It’s my favorite quote to trainees. Don’t think we will ever find that single exam/modality/bio marker that will 100% rule in/rule out any condition. Doesn’t mean we will stop trying, but not gonna happen.

Tie it all together + longitudinally otherwise red herrings will get us

[Katie Wiskar @katiewiskar]

New on our @ubcimpocus page: handy procedural
and POCUS consult checklists to serve as on-the-go resources for trainees. Formatted in easy-to-screenshot sizes.

Please use/share if they are helpful! Also found here: https://t.co/qh039oPaet

[Katie Wiskar @katiewiskar]

#POCUS trivia 🤓

Patient presents with sore throat, fever, and this scan.

What's the eponymous diagnosis? #pocuspuzzle

[Tracy Morton @TracyMorton]

A solution on how to remotely mentor for POCUS learners! Congrats to @USaskEM @LindenKolbenson @OlszynskiP @JeremyKatulka and Sydney Murray. @RCC_bc @UBCCPD @TracyDeLeeuw @katiewiskar @ubcimpocus @BCPoCUS @CarolineShooner @SRPCanada @CAEP_EUC

[James Taylor @jamestaylor04]

Attempting to measure respiratory variations of transvalvular flow for a patient with a moderate sized pericardial effusion - so cool to assess tamponade physiology in real-time. Have learned an incredible amount on my @ubcimpocus elective - can't recommend it enough!

[UBCIMPOCUS @ubcimpocus]

@jamestaylor04 Thank you James!! It has been such a pleasure having you. Keep up the scanning!

[Katie Wiskar @katiewiskar]

#POCUS puzzle! 🤓

Can you come up with a unifying diagnosis for these 2 seemingly unrelated POCUS images? (From the same patient)

Answer to come tomorrow! 😉

[PRIME Procedural Research and Innovation @ProcedurePRIME]

Potential downsides/reasons to avoid:

- excessive vasoconstriction can lead to necrosis in areas with poor perfusion*
- often avoided for neuraxial procedures like LP; however epi is used in the anesthesia world for intrathecal and epidural anesthesia

https://t.co/Q6UBarmgXE

[PRIME Procedural Research and Innovation @ProcedurePRIME]

*It used to be maxim that epi should be avoided certain areas: digits, nose, penis, etc. However, this has likely overblown; and epi can likely be added except in areas that may have compromised perfusion for other reasons (ie severe PAD)

https://t.co/EvL4VzvBgo

[PRIME Procedural Research and Innovation @ProcedurePRIME]

Local anesthetic go-to:

[PRIME Procedural Research and Innovation @ProcedurePRIME]

Local anesthesia for procedures! What is your go-to?

(More choices below!)

[Katie Wiskar @katiewiskar]

Huge day for our @ubcimpocus program - finally, a dedicated #POCUS archiving system! 🙌🙌🙌

(Let’s not talk about how nuts it was that we didn’t have one before this 🤦🏼‍♀️)

Thanks to @VCHhealthcare, @CANHealthNtwrk, and @e_qpath for making this happen.

@shanearish - we did it!

[Katie Wiskar @katiewiskar]

#POCUS case! One of the best in a while.

50M, Hx HTN only. Comes in after travelling to a tropical country 2 weeks ago. Started having watery diarrhea at the end of the trip, as did his companions. Now also RUQ pain. No chest pain, SOB, cardiac Sx.

[UBCIMPOCUS @ubcimpocus]

@pdsalinas Thank you for the kind words! 😊🙏🏻

[UBCIMPOCUS @ubcimpocus]

Our latest screencast: learn the game-changing skill of lung ultrasound in this 25-minute screencast from our own Katie Wiskar.

It's a basic application with a lot of nuance, so it's worth spending some time to get it right! #POCUS #FOAMed #ultrasound

https://t.co/BUIEUcDvz5