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Replying to @Manoj_Wickram @Wilkinsonjonny @NephroP @kyliebaker888 @iceman_ex @icmteaching @TaotePOCUS @RJonesSonoEM @DRsonosRD @coreultrasound
I would go for this one. Young male in ED with collapse. This is PLAX view showing a large mass causing external compression + few other problems.
Gokul Sagar retweeted
🚨 CALLING ALL EM INNOVATORS, RESEARCHERS & CHANGE-MAKERS! 🚨
💡 Got an idea worth sharing?
📊 Research you’re proud of?
🏥 A project that’s making a difference in EM?
OSEM27 wants to hear from YOU!
Abstract submissions are NOW OPEN!
Deadline: 26 February 2027
#MedEd #OSEM27
🤖 Made with AI
Gokul Sagar retweeted
Hey y'all, it's the 10th day of #Blocktober26 -- hope you're enjoying your weekend! Today I want to talk about a common clinical scenario that can be tricky to manage...
🤖 Made with AI
Gokul Sagar retweeted
When I started The Dependent Variable, one of my worries was that I might eventually run out of things I wanted to write about.
I now have the opposite problem.
Already outlined is an article exploring terms such as stressed volume, unstressed volume, compliance, capacitance, venous tone and mean systemic filling pressure.
They are closely related. They are often used almost interchangeably. But they are not the same thing.
Also mapped out is a six-part series on the way we often over-complicate haemodynamics by measuring or calculating ever more numbers:
ScvO₂. The CO₂ gap. P(v−a)CO₂ / C(a−v)O₂. Pulse pressure, diastolic shock index, PPV and SVV. Dynamic arterial elastance: Eadyn = PPV/SVV. Ees/Ea and ventriculo-arterial coupling.
For each of them, I want to start from zero (no prior knowledge assumed) work through what the number actually represents, where it comes from, what physiology sits underneath it, and whether it genuinely helps us make better clinical decisions.
The aim is to take you from novice to expert without making the subject unnecessarily complicated.
Lots more to come from thedependentvariable.com Stay tuned.
Gokul Sagar retweeted
🫀 Suicide LV after TAVR
•Afterload drops → small, hyperdynamic LV obliterates its cavity → dynamic obstruction + shock.
•At risk: women, small LV, septal LVH, high EF/gradient.
•Treat: fluids, phenylephrine, β-blocker. STOP inotropes.
Gokul Sagar retweeted
循環器専攻医にお勧めしたい経食道心シュミレーター
これが無料で使えるのが信じられない
雰囲気的に個人開発と思うんだけど、凄すぎる
自分の操作では一部出せないものもあるけど、TEE触る前に全研修医はこれを操作して欲しい
tee-simulator.anesthbeta.com…
Gokul Sagar retweeted
I built an interactive echocardiography tutorial with Claude Code.
Chapter 07: a 3D heart, the standard imaging views, the probe position, and simulated ultrasound video.
Gokul Sagar retweeted
Clinical relevance of ventriculo-arterial coupling and how to assess it at the bedside
CCR Journal Watch
criticalcarereviews.com/late…
Gokul Sagar retweeted
Dear cardiology fellows 🫀
I built a free TTE cheatsheet with @claudeai I keep open while reading echos: guideline cutoffs, 17-segment walls by view, valve grading and 15 built-in calculators (AVA, SV/CO).
Check it out 👇
echoguide.netlify.app
#EchoFirst #CardioTwitter
Would love some good Anki flash cards for UK EM and ICM exams. If anyone has made these public please share the link.
I have decided to giveaway my USMLE Step 2/3 Anki for free for everyone
This helped me to score a 275 2 years ago
It’s a little bit big, but i’m sure it’s of very high quality
I wish you all success
drive.google.com/file/d/1Q_J…
Gokul Sagar retweeted
Can a nephrologist pass the cardiology #echoboards? Apparently, yes!!
Happy to share that I passed the #NBE Examination of Special Competence in Adult Echocardiography.
With Critical Care echo certification and previously passing the advanced Peri-op TEE exam, I’m now a "Triple Testamur" of the NBE, spanning #cardiology, #criticalcare, and #anesthesia echo.
Passion for #POCUS can take a nephrologist to some interesting places! 😄
Gokul Sagar retweeted
Delighted to be attending European Society for Emergency Medicine EUSEM 2026 and presenting our work on out-of-theatre regional anaesthesia for patients with traumatic rib fractures.
Conferences are also about people. It will be wonderful to reconnect with old friends, meet new colleagues, exchange ideas and learn from the wider emergency medicine community.
Looking forward to more conversations, collaborations and shared learning throughout the conference!
#EUSEM2026 #EmergencyMedicine #RegionalAnaesthesia #RibFractures #TraumaCare #PainManagement #POCUS #Research #Collaboration
Gokul Sagar retweeted
Echo From Scratch | Post #16
Parasternal Long-Axis View: Your First Major Window
The parasternal long-axis view, or PLAX, is one of the foundational views in transthoracic echocardiography.
The patient is generally positioned in the left lateral decubitus position, with the transducer placed near the left sternal border, usually around the 3rd or 4th intercostal space.
The goal is to obtain a plane that displays the LV long axis and the aortic and mitral valves.
A good PLAX view typically shows:
🫱Right ventricular outflow tract
🫱Left ventricle
🫱Left atrium
🫱LV outflow tract
🫱Aortic valve
🫱Aortic root and prox ascending aorta
🫱Mitral valve
The standard PLAX plane provides an important anatomical relationship between the aortic and mitral valves.
Gokul Sagar retweeted
Just how good can you get at saving lives?
Your mastery of clinical skills and expert mental models alone can fail to make things happen if you don’t also strive to master the human factors: control of yourself, your team & your environnment
Developing the right systems and culture in your service is also fundamental to sustained excellent resuscitation
Optimising all of these domains can make some resuscitations appear almost magical to the novice
This is the goal of the Resuscitation Wizardry course
cliffreid.com/wizardry?s=x
Gokul Sagar retweeted
Talk mitral. Think 3D. 🫀🔄
Found this 10-year-old pptx from an international workshop on mitral valve surgery, presented by one of our cardiac surgeons.
Some things in mitral imaging never get old. 👀
1) and 2) are still true today ☺️
#echofirst




























