It’s been a while, #MedSky Been busy with a top-priority project 🥰

Fabulous little thread on #LungUltrasoung Agree with all of these! 🙌 #emimcc

Segun Olusanya (He/Him)@drfreeze.bsky.social · 2y ago

I had the pleasure of teaching lung #pocus at a “train the trainers” course, with the ever excellent @avkwong.bsky.social and Cian McDermott as faculty Some reflections from the day: (1/n)

A quick #VEXUS thread 🧵- 3 reasons why the portal vein is the most useful single venous doppler waveform 🥇 (if you're only going to do ONE site to look for venous congestion, this is probably the most useful one!) #emimcc

Non-invasive positive pressure ventilation - BiPAP and CPAP, for example - can be a bit of a black box to most of us ⬛️ Once it's started, the nuances of how to adjust it to optimize each patient's physiology takes skill, experience, and often, a bit of trial and error 🔎 #emimcc

We've all been there: a Saturday on call in the hospital, with a list of 30 patients to round on 😵‍💫 Ward rounding can seem like an endless task - but it doesn't have to be! ⏰ Here are my top 10 tips for ward rounding efficiency 🧵- #emimcc

Love;y thread with take-home top tips Honestly, learn lung US. It is *such* a useful skill in the assessment of the critically ill!

Katie Wiskar@katiewiskar.bsky.social · 2y ago

1/ One of the BIGGEST #POCUS misconceptions is that B lines 🟰 pulmonary edema 🤦‍♀️ Did you know that there is actually a wide DDx for B lines? Check out my latest video about #LungUltrasound for interstitial syndromes 👀; or read on for the highlights 👇 🧵 #emimcc www.youtube.com/watch?v=eSuA...

1/ One of the BIGGEST #POCUS misconceptions is that B lines 🟰 pulmonary edema 🤦‍♀️ Did you know that there is actually a wide DDx for B lines? Check out my latest video about #LungUltrasound for interstitial syndromes 👀; or read on for the highlights 👇 🧵 #emimcc www.youtube.com/watch?v=eSuA...

Lung Ultrasound for Interstitial Syndromes

YouTube video by UBC IM POCUS

youtube.com

Doppler ultrasound for venous congestion - #VEXUS - has truly been game-changing in my clinical #POCUS practice. Here's the TL;DR on the concept of #VEXUS - 🧵 #emimcc

Sometimes, being a good doc isn't about knowing EVERYTHING about a disease; it's about knowing when to involve experts 🤓 Prime example? Staph aureus bacteremia 🦠 ☠️ Did you know that involving your ID colleagues early actually ⬇️ mortality?? 🤯 #emimcc www.sciencedirect.com/science/arti...

Infectious disease consultation for Staphylococcus aureus bacteremia – A systematic review and meta-analysis

Mortality and morbidity of Staphylococcus aureus bacteremia (SAB) still remains considerably high. We aimed to evaluate the impact of infectious disea…

sciencedirect.com

Truly one of the best conference ! Amazing program! Check it out 👇 #emimcc

Katie Wiskar@katiewiskar.bsky.social · 2y ago

One last plug: there is no better conference to teach you all about volume status than The Hospitalist and The Resuscitationist! The speaker panel is full of hemodynamic allstars 💫Check it out! ccusinstitute.wixsite.com/ccus/events/...

The elusive volume status has got to be one of the most ubiquitous questions in medicine - and the most widely misunderstood 😕 It's my favourite soapbox 🎙️ - so much so, that I've made a 20-min video highlighting the 5 key rules of volume status Video link ⬇️, but here's the TLDR: 🧵 #emimcc

The explosion of immunotherapy in the oncology world means that we’re increasingly seeing patients with associated toxicities: pretty much every “-itis” you can think of 🤕 #emimcc

Wow so much #dogmalysis in one🧵 Brilliant education from @katiewiskar.bsky.social

Katie Wiskar@katiewiskar.bsky.social · 2y ago

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 🧵 #emimcc

Thanks so much for this Katie! ☺️ Wanted to add another concept to your list of great tips!! Something I learned & keep in mind. bsky.app/profile/alau...

Anthony Lau, PharmD BCPS@alaurx.bsky.social · 2y ago

1/ Day 16 of Pharmacy Advent: Let’s talk hyponatremia—seeing it more frequently in ED. Why is hypokalemia risk factor for Na overcorrection & risk of ODS? We’ll briefly review recent SRMA on slow vs fast Na correction too. Here we go, let’s dive in!👇 #medsky #pharmsky #EMsky #HMsky #nursesky #emimcc

confession: i LOVE my upstairs colleagues who manage hypona my ED mgt: 3%? (ie sz, coma; ie: no) resist the urge to give fluid (can make Na go up too fast or go down; obscures labs) order ALL of the labs so the very smart and hardworking upstairs experts ie @katiewiskar.bsky.social can fix it

Katie Wiskar@katiewiskar.bsky.social · 2y ago

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 🧵 #emimcc

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 🧵 #emimcc

Want to learn about VA coupling? (I promise only mild-mod use of calculus.) Do you like Montreal, specifically on May 22-23, 2025? Check out the H&R Conference! ccusinstitute.wixsite.com/ccus/events/... @thinkingcc.bsky.social, @katiewiskar.bsky.social

HR2025 - Fluid Tolerance, all Things VExUS & Shock Hemodynamics | CCUS.meducate

For more info and for the preliminary schedule, please click here or copy/paste: https://thinkingcriticalcare.com/2024/06/05/hr2025-the-hospitalist-the-resuscitationist-montreal-may-21-24-2025-hr25/

ccusinstitute.wixsite.com

Next to fluids, IV diuretics are some of the most commonly mis-prescribed medications in acute medicine 💉🩸 Let's unpack 5 common diuretic prescribing mistakes, and how to correct these 🧵 #emimcc

I am SO thrilled to share this paper, which has truly been a labour of love on a topic I care about deeply. "Demystifying Volume Status: An Ultrasound-Guided Physiologic Framework," now published online in @accpchest Let us know what you think! #emimcc journal.chestnet.org/article/S001...

#FluidTolerance is one of the hottest topics in acute medicine going into 2025 🔥 In the words of @marcogarrone.bsky.social - an EM doc with a self-professed case of #POCUSmania - "You want to know when to assess for fluid tolerance? The sooner the better! Come check it out at #HR25!"

And we are so thrilled to have you there!! 🙌 Come join us #HR25 - May 22-23 in beautiful Montreal 🇨🇦

Marco Garrone@marcogarrone.bsky.social · 2y ago

#hr2025 coming up May 22-23 in Montreal! Much as I've taught there, I've always got home feeling that I had learnt more. Not just a stellar faculty, a bunch of truly welcoming people who will talk us into loads of cutting edge concepts @thinkingcc.bsky.social @katiewiskar.bsky.social link below

Suggested New Year's Resolution: more mindful prescribing of IV fluids 🫧 Far too often I see IV fluids thrown around with minimal consideration; meanwhile, we'll deliberate for hours about a dose of lasix 🤦‍♀️ Here are the 10 most common fluid prescription mistakes I see 🧵 #emimcc

#hr2025 will be an absolutely excellent event. I’m looking forward to joining in and talking about ventilation, ECMO, and POCUS. It would be great to see as many of you there as possible. Register here: ccusinstitute.wixsite.com/ccus/events/hr… @katiewiskar.bsky.social @thinkingcc.bsky.social

HR2025 - Fluid Tolerance, all Things VExUS & Shock Hemodynamics | CCUS.meducate

<p>HR2025 is about putting it all together. We’ve been talking about the venous side for a long time and it has been fantastic seeing how much it has taken off. There’s enough data out there to show a...

ccusinstitute.wixsite.com

All heart failure is NOT the same; and diuretics are NOT always the answer ‼️ In the very wise words of Dr. Frederik Verbrugge - "Elevated cardiac filling pressures and fluid overload are both important, yet grossly different features of acute decompensated heart failure." #emimcc

Excited to be giving a talk @ #HR25: Top 10 Infectious Diseases Mistakes for Non-ID Clinicians to Avoid 🦠🧫 Hope to see you there for some cool ID pearls!

Katie Wiskar@katiewiskar.bsky.social · 2y ago

Migrated over from the other place 🐣 to check out these blue skies 🦋 In the meantime - registration for the Hospitalist and the Resuscitationist #HR25 is open!! May 22-23 in Montreal 🇨🇦 There’s no better gathering of hemodynamic and physiology enthusiasts 🩺 thinkingcriticalcare.com/2024/06/05/h...

1/ Day 16 of Pharmacy Advent: Let’s talk hyponatremia—seeing it more frequently in ED. Why is hypokalemia risk factor for Na overcorrection & risk of ODS? We’ll briefly review recent SRMA on slow vs fast Na correction too. Here we go, let’s dive in!👇 #medsky #pharmsky #EMsky #HMsky #nursesky #emimcc

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 to do it right! #emimcc

Agree 100%% I am a huge #VEXUS nerd but I do NOT find reporting a numeric score to be useful. Describe what you’re seeing in each waveform 👌🏻 #emimcc

Lars Mølgaard Saxhaug@load-dependent.eurosky.social · 2y ago

I’ll put my neck out here: I’m an avid venous doppler user, I find it immensely useful, especially when vena cava is unrelible. I never ever score VExUS though, I report individual components and my interpretation of them in the particular setting. #emimcc #pocus #echosky

I’ll put my neck out here: I’m an avid venous doppler user, I find it immensely useful, especially when vena cava is unrelible. I never ever score VExUS though, I report individual components and my interpretation of them in the particular setting. #emimcc #pocus #echosky

@IM_Crit_@imcrit.bsky.social · 2y ago

For #POCUS #VExUS aspiring users: 1. VExUS can assess only the dark side of the moon: the venous side. A detailed hemodynamic assessment should look also at the 💙 itself (RV/LV function, pericardial effusion etc) & the lungs (B-lines? effusions?) 2. VexUS does not assess for volume responsiveness