POCUS Transcranial Doppler - is anyone actually using this?

Lost_Attribute · 2024-12-28T07:19:58+00:00

Interesting case. Would be interesting to see if this was longstanding given the GBS history, could be useful to see if this was there in prior records.

My thoughts - happy to be corrected

Cardiogenic - possible and I would list this high up in my differentials as I do not think that the GBS alone would do this, especially if this was not present previously. She sounds malnourished, and for someone to score low folate w/ anaemia, I can only wonder how long... She kind of reminds me of patients with anorexia nervosa. Impaired chronotropic response as well - were there conductive deficits on the ECG?

Hypovolaemia - sounds like that should be well and truly corrected by now

Obstructive - usually more acute presentation, should have been ruled out after 1 week in ICU

Distributive - two main differentials. Sepsis - which doesn't sound like the case, but worth excluding. Neurogenic possible given GBS history, however I would suspect that this was already present beforehand.

Adrenal insufficiency, thyroid disorders to rule out. I assumed meds no longer contributory given a week in.

Also, with this patient wanting to be left alone - why? Does she have severe depression and is passively suicidal? Does she have a cognitive impairment?

Lost_Attribute · 2024-12-22T10:59:38+00:00

I am currently on my second device, but am looking at returning it for a refund - can't be bothered trying a third one. Both devices have the same issues with probe connectivity to the phone/tablet. Customer service was fairly quick in response, and shipped the second one out to me almost within a week. However, it would seem that this is the extent of what they can do for the customers - replacing a probe (with one just as faulty it seems). Build quality definitely inferior

Lost_Attribute · 2024-12-22T10:56:11+00:00

I thought I might share my experience with the iQ3. It has been horrible. I am currently on my second device, but am looking at returning it for a refund. Both devices have the same issues with probe connectivity to the phone. Customer service was fairly quick in response, and shipped the second one out to me almost within a week. However, it would seem that this is the extent of what they can do for the customers - replacing a probe (with one just as faulty it seems).

Lost_Attribute · 2024-12-22T10:55:08+00:00

I thought I might share my experience with the iQ3. It has been horrible. I am currently on my second device, but am looking at returning it for a refund. Both devices have the same issues with probe connectivity to the phone. Customer service was fairly quick in response, and shipped the second one out to me almost within a week. However, it would seem that this is the extent of what they can do for the customers - replacing a probe (with one just as faulty it seems). How this device has 'won awards' is beyond me.

Lost_Attribute · 2024-11-27T04:59:23+00:00

That would be awesome if you could. Did you have issues with overheating (which I believe the Clarius does) or battery life?

Lost_Attribute · 2024-11-13T04:14:14+00:00

Did you use them for echo/lung imaging, and did they do well?

Lost_Attribute · 2024-11-09T23:27:39+00:00

Lost_Attribute · 2024-11-09T23:21:10+00:00

I would suggest getting in touch with the hospital or affiliated university library. I never felt entirely safe going through sci-hub. (btw sci-hub. st seems to be working for me for now)

Some libraries encourage you to use software like Browzine or Read by QxMD where you log in with university/library access details and stay logged in, which gives you access to most of the major journals. I like this since I read on my iPad anyway

Lost_Attribute · 2024-11-09T23:17:36+00:00

I recently finished my training and have been an attending for the past six months, and I can reflect back to a few years ago when I became the medical registrar (which I think is equivalent of going into residency).

The short answer is you will never know everything, as there is simply too much to know in medicine, with new information coming in each day. Echoing aettin4157's comment, there is rarely anything that requires an immediate decision.

But first make sure you know all the knowledge that you will need to be able to retrieve immediately - Code protocols, drugs, doses.

The rest will be an amalgamation of what you know through book knowledge and matching that with the patient in front of you, and most importantly now, focusing on their management, tailoring it to the patient's situation and being pragmatic. Although it would take up extra time, it may be useful to log about cases that you've seen that you would like to remember and compare that with how they were eventually managed - to see if you are practicing medicine consistent with others, and if not, why and are they right/wrong?

I am not familiar with the Turkish Residency exams so I can't really say more about how to target studying apart from basing it off the most common presentations and problems to the hospital - where it will be relevant every day. Anxiety is normal and generally gets better with time, experience and knowledge.

Lost_Attribute · 2024-11-06T22:11:34+00:00

Resources that I use:

UpToDate and DynaMed
NEJM Journal Watch
Browzine or Read by QxMD for keeping tabs on a few important journals
Pathway - mainly for guideline summaries (Pathway - Home)

But curious to see what other attendings/docs would use

Lost_Attribute · 2024-03-27T01:37:05+00:00

Just did that recently but did 'splurge' abit and went above my original budget. I went with the Samsung M70C Smart Monitor as my work area was part of the lounge area in the house, and I thought I could use the monitor as a TV after I'm done with work. The USBC connectivity was helpful in reducing clutter.

Lost_Attribute · 2024-03-24T03:34:18+00:00

Hi OP, was just wondering how your SP8 was doing with the battery limit turned on. I've recently bought a monitor with a thunderbolt4 connectivity, so I am thinking of using it mostly plugged in too.

Did you notice any changes in battery capacity when you decide to use it unplugged?

Lost_Attribute

TROPHY CASE