We are please to introduce this section of the site. Manoj Wickramasinghe has become prolific on Twitter with his beautiful US clips! He is a POCUS enthusiast (and a good one!!), and much of what he does is placed into beautiful Tweetorials; everyone from beginner to advanced level can benefit from them.

We have his whole collection here, categorised as far as we can.

What I love about his clips, are that most of his personal ones originate from our great and trusty friend the Butterfly iQ+:

Click here to see my review of this probe!

Enjoy!

Whole body ultrasound….the tool for the job!?

Some of the features on the @ButterflyNetInc are truly incredible for a handheld! Such a useful tool for multi-system #POCUS at the bedside. @Wilkinsonjonny @nachkontrolle @CriticalCareNow @coreultrasound @daniel_opazo @askpocus pic.twitter.com/nfErKJC7j9
— Manoj Wickramasinghe (@Manoj_Wickram) February 3, 2021

General Images

A good day for POCUS in acute medicine!

Increased SOB on background of malignancy. Plankton sign! Safe window for aspiration identified pic.twitter.com/v2H7tG1s7a
— Manoj Wickramasinghe (@Manoj_Wickram) December 19, 2020

Fluids and VEXuS

So what does a #POCUS guided fluid assessment look like? #tweetorial #askpocus @IMPOCUSFocus @DRsonosRD @KalagaraHari @SonoSerious @tsquaredmd @jaffa_md @nick_wroe @EM_RESUS @coreultrasound @kyliebaker888 pic.twitter.com/hQwTJTlCjf
— Manoj Wickramasinghe (@Manoj_Wickram) March 5, 2021

Heart

Tamponade!

Train the eye – part 3. Cardiac tamponade! #askpocus #echofirst #pocus @NephroP @Wilkinsonjonny @icmteaching @IMPOCUSFocus @dr_benoy_n_shah @cianmcdermott @EmergencyEcho @KalagaraHari @RJonesSonoEM @DRsonosRD @SonoSerious @iceman_ex @daniel_opazo https://t.co/EoYsfWjlQM
— Manoj Wickramasinghe (@Manoj_Wickram) February 4, 2021

Don’t leave me hanging!

#FICE and possibly a bit beyond. Thoughts for #POCUS learners? ⁦@nick_wroe ⁦@icmteaching⁩ ⁦@IMPOCUSFocus⁩ ⁦@NephroP ⁦@cianmcdermott⁩ ⁦@iceman_ex⁩ ⁦@Wilkinsonjonny⁩ Answer to follow. https://t.co/DvNjuvpzAW pic.twitter.com/1KHGUEmvYS
— Manoj Wickramasinghe (@Manoj_Wickram) November 30, 2020

Don’t miss those veggies!

A short Tweetorial. Patient with sepsis and big right sided pneumonia in resus. T1RF. What do we think is going on? pic.twitter.com/YbETUrApeS
— Manoj Wickramasinghe (@Manoj_Wickram) December 7, 2020

Don’t discount that subcostal…particularly when they’re ventilated!

#POCUS #tweetorial Adapted subcostal views! An incredibly useful set of views to utilise – particular in your ventilated/COPD and narrow ribbed patients. #askpocus #echofirst @KalagaraHari @NephroP @DRsonosRD @iceman_ex @Wilkinsonjonny @kyliebaker888 @IMPOCUSFocus @daniel_opazo pic.twitter.com/H7x1aWiHX9
— Manoj Wickramasinghe (@Manoj_Wickram) February 24, 2021

You clot!

67 fit and well. COVID positive. Worsening hypoxia in resus then dropped BP (see thread) pic.twitter.com/2IkZQAD82p
— Manoj Wickramasinghe (@Manoj_Wickram) November 19, 2020

McConnel’s selection!

Train the eye – part 4. McConnell’s sign! #askpocus #echofirst #pocus @NephroP @Wilkinsonjonny @icmteaching @IMPOCUSFocus @dr_benoy_n_shah @cianmcdermott @EmergencyEcho @KalagaraHari @RJonesSonoEM @DRsonosRD @SonoSerious @iceman_ex @daniel_opazo https://t.co/koQTf3ruhl
— Manoj Wickramasinghe (@Manoj_Wickram) February 13, 2021

More to the PLAX!

Start of with a standard PLAX view. From here it is a subtle movement: tilt the tail down towards the left shoulder so that the transducer is pointing more towards the right hip. Here is the movement. pic.twitter.com/MGg9a2DQNa
— Manoj Wickramasinghe (@Manoj_Wickram) January 2, 2021

The walls are out!

Nice example of RWMA within an already impaired heart. Poll below. @NephroP @zedunow @Wilkinsonjonny @msiuba @iceman_ex @IMPOCUSFocus @DRsonosRD @Pocus101 @nick_wroe pic.twitter.com/MYkFuwKx7w
— Manoj Wickramasinghe (@Manoj_Wickram) January 10, 2021

Crikey…that’s a beast!

Biggest LV I've scanned (N = 731). Measuring around 8.5cm. Patient in his 30's! #echofirst #askpocus @iceman_ex @RJonesSonoEM @Wilkinsonjonny @NephroP @IMPOCUSFocus @EmergencyEcho @The_echo_lady @CriticalCareNow @coreultrasound @tsquaredmd @UltrasoundJelly @cianmcdermott pic.twitter.com/5id3rnlBZx
— Manoj Wickramasinghe (@Manoj_Wickram) January 29, 2021

Tricuspid trouble!

Patient with background of pulmonary fibrosis.

Presenting complaint: Increased SOB

Yup, sounds about right. #POCUS #echofirst #FICE @NephroP @icmteaching @ICUltrasonica @iceman_ex @nick_wroe @RJonesSonoEM @IMPOCUSFocus pic.twitter.com/N3iVQos1L0
— Manoj Wickramasinghe (@Manoj_Wickram) January 16, 2021

Akey, shakey heart!

Probably the coolest clip showing ROSC too https://t.co/nMG2Fwm0xS
— Manoj Wickramasinghe (@Manoj_Wickram) January 28, 2021

To PE or not to PE….that’s the question!

Young patient with collapse and SOB. McConnell's sign, with a good pre-test probability, is virtually diagnostic of PE. (Excuse the views – patient upwards on 150kg and handheld!) #POCUS #askpocus @askpocus pic.twitter.com/doz2qgWEyf
— Manoj Wickramasinghe (@Manoj_Wickram) February 15, 2021

Caught the Octopus???

Young patient, unwell, pH 7.1. Unclear cause. History of alcohol excess. No cardiac Hx. ECG sinus tachy. 🐙 ? Alcohol related cardiomyopathy?? #echofirst #askpocus @iceman_ex @Wilkinsonjonny @NephroP @IMPOCUSFocus @EmergencyEcho @The_echo_lady @cianmcdermott @askpocus pic.twitter.com/95eLG4Xtt8
— Manoj Wickramasinghe (@Manoj_Wickram) February 8, 2021

Spot diagnosis? See thread for more history if needed. @NephroP @Wilkinsonjonny @iceman_ex @nick_wroe @icmteaching @KalagaraHari @IMPOCUSFocus @notSOemergency pic.twitter.com/6Oo7kCveil
— Manoj Wickramasinghe (@Manoj_Wickram) January 1, 2021

Also known as stress induced cardiomyopathy/takutsubos syndrome/broken heart syndrome https://t.co/hhzJjEvmJl
— Manoj Wickramasinghe (@Manoj_Wickram) February 2, 2021

Troponin up up and away!

So why was troponin so raised? Bedside echo! Not the greatest of views but enough to comment. PLAX… pic.twitter.com/vvwxeUbmBK
— Manoj Wickramasinghe (@Manoj_Wickram) February 6, 2021

Lung

Apparently the sun never sets here!

Inspired by @RJonesSonoEM recent post.. train the eye part 5 (first non echo!) -> empyemas/loculated effusions! #askpocus @askpocus @NephroP @IMPOCUSFocus @iceman_ex @tsquaredmd @icmteaching @Wilkinsonjonny @DRsonosRD @coreultrasound @nick_wroe https://t.co/6Q9r0MP8v4
— Manoj Wickramasinghe (@Manoj_Wickram) February 23, 2021

Holy chest!

Interesting #POCUS case! Try working your way through it and see if you can guess the diagnosis. Follow the thread and see explanation. #FUSIC @NephroP @iceman_ex @Wilkinsonjonny @IMPOCUSFocus @Pocus101 @DRsonosRD @kyliebaker888 @KalagaraHari @CriticalCareNow @icmteaching pic.twitter.com/cKA89DyiCG
— Manoj Wickramasinghe (@Manoj_Wickram) January 6, 2021

Abdominal

Fit to pop!

What two signs are seen in this clip? What is the likely diagnosis? @IMPOCUSFocus @Pocus101 @DRsonosRD @NephroP @iceman_ex @Wilkinsonjonny @kyliebaker888 pic.twitter.com/e9tNUgAIJu
— Manoj Wickramasinghe (@Manoj_Wickram) January 5, 2021

Tap it!

Patient with large volume ascites. LIF clip below pic.twitter.com/j0YiLr2tbe
— Manoj Wickramasinghe (@Manoj_Wickram) January 3, 2021

A snow storm!

Spot diagnosis? No history/probe position. #POCUS @NephroP @zedunow @Wilkinsonjonny @msiuba @iceman_ex @IMPOCUSFocus @DRsonosRD @Pocus101 @nick_wroe pic.twitter.com/kl2uN5LAHD
— Manoj Wickramasinghe (@Manoj_Wickram) January 8, 2021

What’s this in the RUQ?

Spot diagnosis? RUQ image. #askpocus #POCUS @askpocus @NephroP @iceman_ex @Wilkinsonjonny @DRsonosRD @IMPOCUSFocus @daniel_opazo @notSOemergency @tsquaredmd @RJonesSonoEM @HeyDrNik @tsquaredmd @KalagaraHari @kyliebaker888 @icmteaching (@nick_wroe – not allowed to answer!) pic.twitter.com/IOSKISaZP2
— Manoj Wickramasinghe (@Manoj_Wickram) January 31, 2021

Trouble in the pelvis?

Background of metastatic pelvic malignancy presenting with abdo distention and AKI. Awaiting CT. What do we think is going on? #POCUS #askpocus @kyliebaker888 @NephroP @iceman_ex @Wilkinsonjonny @IMPOCUSFocus @nick_wroe @cianmcdermott @icmteaching @daniel_opazo @UltrasoundJelly pic.twitter.com/ERQkaUOyEj
— Manoj Wickramasinghe (@Manoj_Wickram) January 30, 2021

Pesky Gallbladder!

2 ERCP’s and 33 stones removed. Representing with abdo pain… don’t think they got all the stones 😬 #POCUS #askpocus @askpocus pic.twitter.com/cQyGmOwU0O
— Manoj Wickramasinghe (@Manoj_Wickram) February 28, 2021

Taking the p**s?!

Always a satisfying one to treat!! #askpocus #POCUS #FOAMus @askpocus pic.twitter.com/WfcMBqyoW1
— Manoj Wickramasinghe (@Manoj_Wickram) February 9, 2021

Poly-cysto-views!

Spot diagnosis? Hint in thread if needed #askpocus #pocus @askpocus @NephroP @jamiekwillows @iceman_ex @Wilkinsonjonny @icmteaching @IMPOCUSFocus @daniel_opazo @nick_wroe @RJonesSonoEM @KalagaraHari @ButterflyNetInc pic.twitter.com/21N26XlN2C
— Manoj Wickramasinghe (@Manoj_Wickram) February 7, 2021

Lines and Vessels

DVT?

For lower limb DVT ultrasound start at the groin and find common femoral vein (CFV) and femoral artery. Remember your vein is typically medial. You will find the Mickey Mouse sign which consists of CFV, saphenous vein and CFA. pic.twitter.com/XCMV1vPOa5
— Manoj Wickramasinghe (@Manoj_Wickram) December 15, 2020

No pressure!

#FUSIC DVT scanning is very useful. Suspected PE? Do DVT scan – if you find a DVT in most cases you can avoid a CTPA (radiation, time, cost). Popliteal DVT in this case. ⁦@nick_wroe⁩ @Wilkinsonjonny⁩ @NephroP⁩ @Pocus101⁩ @iceman_ex⁩ https://t.co/gnf3MYxR8p pic.twitter.com/T8bpgKlHlD
— Manoj Wickramasinghe (@Manoj_Wickram) November 29, 2020

Blasted caustic antibiotics!

#askpocus @askpocus #pocus Extensive thrombophlebitis post IV clarithromycin. Around 40cm of cephalic vein non-compressible. Axillary compressible. Poll below. pic.twitter.com/kU4cQXYUbn
— Manoj Wickramasinghe (@Manoj_Wickram) February 17, 2021

You don’t see it…put on the pressure (gently!)

Effect of graded compression (firm constant probe pressure to displace gas) over 30 seconds on aorta (sped up for viewing pleasure!) Don't give up finding the abdominal aorta too fast! #askpocus #POCUS #FOAMus #FOAMcc @askpocus pic.twitter.com/l3T0hmFjWr
— Manoj Wickramasinghe (@Manoj_Wickram) February 12, 2021