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Stop KILLING Your Patients with Fluid! Learn how to avoid Fluid Overload with Venous Congestion Evaluation using #POCUS
New BLOG POST on the #VExUS Protocol! Step By Step Guide, Downloadable PDF Pocket Guide, & Calculator
https://pocus101.com/vexus
#medtweetorial
(1/10)
New BLOG POST on the #VExUS Protocol! Step By Step Guide, Downloadable PDF Pocket Guide, & Calculator
https://pocus101.com/vexus #medtweetorial
(1/10)
(2/10) It’s not just about the IVC it’s about what is affected beyond the IVC. Don’t forget the Liver, Gut, and Kidneys.
Venous Congestion in these organs can lead to significant comorbidity. Download the PDF: https://pocus101.com/vexus
Venous Congestion in these organs can lead to significant comorbidity. Download the PDF:
https://pocus101.com/vexus
(3/10) Step 1: Look at the IVC if < 2cm then Grade 0, If > 2cm proceed to the next steps. https://pocus101.com/vexus
https://pocus101.com/vexus
(4/10) Step 2: Evaluate Hepatic Venous Doppler:
https://pocus101.com/vexus
1. Get Image of IVC and hepatic veins.
2. Place color flow Doppler over the hepatic veins. (Should see BLUE-away)
3. Place your Pulse Wave Doppler gate on a hepatic vein
4. Initiate Pulse wave Doppler
https://pocus101.com/vexus 1. Get Image of IVC and hepatic veins.
2. Place color flow Doppler over the hepatic veins. (Should see BLUE-away)
3. Place your Pulse Wave Doppler gate on a hepatic vein
4. Initiate Pulse wave Doppler
(6/10) Step 3: Evaluate Portal Venous Doppler:
https://pocus101.com/vexus
1. Get 2D image of the Right Portal Vein
2. Place color flow Doppler over Portal Vein (Should See RED-toward)
3. Place your pulse wave Doppler gate on the Portal Vein
4. Initiate Pulse wave Doppler
https://pocus101.com/vexus 1. Get 2D image of the Right Portal Vein
2. Place color flow Doppler over Portal Vein (Should See RED-toward)
3. Place your pulse wave Doppler gate on the Portal Vein
4. Initiate Pulse wave Doppler
(8/10) Step 2: Evaluate Intrarenal Venous Doppler:
https://pocus101.com/vexus
1. Get a 2-D image of the Kidney
2. Place color flow Doppler over Kidney.
3. Place your pulse wave Doppler gate on the interlobar vessels
4. Initiate Pulse wave Doppler
Clip
https://pocus101.com/vexus 1. Get a 2-D image of the Kidney
2. Place color flow Doppler over Kidney.
3. Place your pulse wave Doppler gate on the interlobar vessels
4. Initiate Pulse wave Doppler
Clip
(9/10) VExUS Severity Grading:
Download PDF! https://pocus101.com/vexus
Grade 0: IVC <2cm = NO Congestion
Grade 1: IVC >=2cm with any combo of Normal or Mildly Abnl Patterns
Grade 2: IVC >=2cm and ONE severely Abnl Pattern
Grade 3: IVC >=2cm and >2 Severely Abnl Patterns
Download PDF!
https://pocus101.com/vexus Grade 0: IVC <2cm = NO Congestion
Grade 1: IVC >=2cm with any combo of Normal or Mildly Abnl Patterns
Grade 2: IVC >=2cm and ONE severely Abnl Pattern
Grade 3: IVC >=2cm and >2 Severely Abnl Patterns
Special thanks to my colleague @khaycock2 for reviewing this material for me. And of course the #VExUS Pioneers: @ThinkingCC @khaycock2 @WBeaubien @EMNerd_ And the #VExUS superusers! @ArgaizR @NephroP @Wilkinsonjonny @Thind888 @load_dependent. Learning from all of you! 
