Melody Herman, MD @anesthesiadocmd Twitter profile | Pikagi

Pikagi

Melody Herman, MD

@anesthesiadocmd

5,472

Followers

633

Following

775

Media

4,958

Statuses

Director of Regional Anesthesiology at Atrium Health Carolinas Medical Center ❤️ blocks💉and POCUS 🫀🫁

Charlotte, NC

https://t.co/3YERiUlgmO

Joined March 2012

Don't wanna be here? Send us removal request.

Pinned Tweet

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

3 years

✨RAAPM, chronic pain, and PoCUS bubble✨Submit your educational videos directly to asraeditor @asra .com for #ASRABest consideration. If this is your 1st educational video or you don’t have a large viewership established, this is the best way for us to find your work @ASRA_Society

Tweet media one

5

24

81

Last Seen Profiles

@sobredxsis

@deportesDDS

@Goingparadisee

@Elizeud72248412

@Hoshino_Fox

@TheRealRynnstar

@MrsParkOTHS

@Queenofpride2

@stwmaniax

@ungeorgia

@bokeplokalmalam

@Billtrust

@stw_pdg

@KaiTheFlower1

@michal_salat

@bokeplokalmalam

@stwmaniax

@BinorRaja

@Safia_Alsnaani

@stw_pdg

@SafetyBlade_HS

@AmandaDebb92020

@stw46

@eugenechung01

@OgDog_

@Imhana_lol

@hellofromthegut

@FernandoCheung2

@bokeplokalmalam

@cadenceviolin

@tinyxieli

@AnikaSwenson

@ui3o_

@NationalNewsTV

@DegendersNFT

@stw46

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

GA on a horse 🤯 I need to know if this could be done under epidural/caudal + sedation similar to cattle 💉🐴 @baby_blocks @BlockIt_Hot_Pod @thisgirlblocks

46

135

713

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Short (79 seconds) video on using US to identify the lumbar spine midline & interspace @ESRA_Society @ASRA_Society @KalagaraHari @Nadia_Hdz_MD @jeffgadsden @HoltzMaggie @AmandaKumarMD @EMARIANOMD @SonyaRandazzoMD @NarouzeMD @nelkassabany @amit_pawa @megrosenblatt @DrJeniMD

8

159

417

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Sometimes when I need to place an ultrasound-guided peripheral IV I’m amazed that we routinely place these blindly

21

28

241

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Lateral sciatic nerve block in 72 seconds 💉🦵 @TexasUltrasound @ASRA_Society @ESRA_Society @RegionalAnaesUK @AoraIndia @AtriumMSKI @CMCEM @baby_blocks @BlockIt_Hot_Pod

10

72

239

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Regional anesthesia for a polytrauma patient. Figure out mg/kg of local and select blocks that match the injuries. Whatever hurts the most will get a catheter.

Tweet media one

10

16

226

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

A 4-hour timespan on our regional anesthesia service 🔥💉We are a very new, but much needed service for our hospital. If a block exists we probably do it #trauma #regional @ASRA_Society @ESRA_Society @KalagaraHari @Nadia_Hdz_MD @EMARIANOMD @NarouzeMD @jeffgadsden @HoltzMaggie

15

40

174

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Lumbar neuraxis sonoanatomy medial ➡️lateral,narrated by my 3 yr old son. It’s a little apocalyptic🦈 🐢 🌊 @ASRA_Society @ESRA_Society @AmandaKumarMD @James_Kim_MD @HoltzMaggie @claralexlobo @Nadia_Hdz_MD @amit_pawa @KalagaraHari @NarouzeMD @dr_tgro @jeffgadsden @garyschwartzmd

10

37

160

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

4 years

Thoracic ESP block sonoanatomy (24 sec) per request of UPenn anesthesiology residents 🤗 @PennAnesthesia @dr_tgro @James_Kim_MD @nelkassabany @KalagaraHari @amit_pawa @jeffgadsden @ASRA_Society @ESRA_Society @Nadia_Hdz_MD @AminaBenyoucef5 @PeterMerjavy @HoltzMaggie #FOAMed

7

65

156

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Recently learned how to obtain short axis views from subcostal & I’m obsessed ❤️🫀 Many times subcostal is only view obtainable intra-op, during code, or if pt has not ideal anatomy & can’t roll @ASRA_Society @ESRA_Society @RegionalAnaesUK @KalagaraHari @Nadia_Hdz_MD @NephroP

9

38

149

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

4 years

Short (<15 sec) sonoanatomy videos of the cutaneous nerves of the forearm. May be used as rescue for incomplete brachial plexus blocks or primary motor-sparing blocks for minor surgery. These nerves travel superficially, making them susceptible to injury @CEgeler2 @ASRA_Society

5

50

146

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

@AAOS1 guidelines for elderly hip fracture recommends regional anesthesia with strong evidence. Excited to work with @JosephHsuMD and @fraga_rock on this initiative for our hip fracture patients. This is just the beginning!

15

41

146

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

4 years

Short (36 sec) QL3 sonoanatomy video requested by @ruthi_landau 🤗 @ASRA_Society @ESRA_Society @jeffgadsden @dr_tgro @KalagaraHari @amit_pawa @Nadia_Hdz_MD @mariapsebastian @EMARIANOMD @AminaBenyoucef5 @CEgeler2 @James_Kim_MD @HoltzMaggie @PeterMerjavy @alifitmd #FOAMed

13

44

137

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

4 years

Short (18 sec) video on tracing brachial plexus nerve roots at interscalene level to respective transverse processes. I do this to confirm nerve identity when I have an ISB with challenging anatomy. @ASRA_Society @jeffgadsden @dr_tgro @AminaBenyoucef5

7

39

125

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

3 years

Serratus anterior plane short video @ASRA_Society @ESRA_Society @EMARIANOMD @amit_pawa @PeterMerjavy @claralexlobo @Steve_Coppens @jeffgadsden @HoltzMaggie @nelkassabany @AminaBenyoucef5 @KalagaraHari @AmandaKumarMD @Nadia_Hdz_MD @dr_rajgupta @James_Kim_MD @dr_tgro @docmorne

9

39

131

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Posterior approach to anterior QL is a game changer. Much easier to orient from bone on patients with challenging anatomy & only need to roll lateral 1 time @ASRA_Society @ESRA_Society @nelkassabany @jeffgadsden @AmandaKumarMD @PeterMerjavy @HoltzMaggie @KalagaraHari @NarouzeMD

8

40

131

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Paravertebral transverse in-plane approach for lobectomy - my favorite block! @ASRA_Society @ESRA_Society @KalagaraHari @amit_pawa @Nadia_Hdz_MD @HoltzMaggie @AmandaKumarMD @NarouzeMD @nelkassabany @dr_tgro @jeffgadsden @galusweegie @EMARIANOMD @shaskinsMD @RegionalAnaesUK

11

28

125

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Easy vs Not-So-Easy Central Lines

6

26

122

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

Confirming central line position with TTE is almost as satisfying as regional anesthesia. Almost.

3

23

120

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

Impressive! I’m cheering these kids on like their mine 😅 Regional anesthesiologists class of 2039 🧑‍🎓👩‍🎓

13

26

125

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Honored to create this video on different approaches to PVB for #aoraaosra22 🙏 It’s a beautiful block & I think underutilized. Thank you @KalagaraHari for this opportunity! @AoraIndia @ASRA_Society @ESRA_Society @NarouzeMD @EMARIANOMD @SreeHPraveenKO1 @Ropivacaine @jeffgadsden

@pritanand

Dr Prit Anand Singh

2 years

Paravertebral- how to @KalagaraHari #aoraaosra22 . Excellent tips on where to put the needle- near the IAP ( careful abt the foramen/ nerve root). @KiJinnChin - your slides excellent . And @anesthesiadocmd - your video was there!

Tweet media one

Tweet media two

Tweet media three

Tweet media four

2

16

38

8

37

113

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

“Unzippering”suprainguinal fascia iliaca block.✨So satisfying ✨ @ASRA_Society @ESRA_Society @KalagaraHari @Nadia_Hdz_MD @HoltzMaggie @dr_rajgupta @garyschwartzmd @AmandaKumarMD @shaskinsMD @amit_pawa @EMARIANOMD @nelkassabany @dr_tgro @PeterMerjavy @megrosenblatt @James_Kim_MD

11

21

111

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

SIFI block & post-block scan.90 yr old prox femur fx. Many comorbidities, coagulopathy, difficult airway. OR for IMN. Block as primary & low dose propofol for the win🙏 @ASRA_Society @KalagaraHari @Nadia_Hdz_MD @HoltzMaggie @EMARIANOMD @CMCEM @PeterMerjavy @jeffgadsden @amit_pawa

5

26

111

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

Anyone else ever have issues w A-line clearly in lumen, but 🚫🩸return? 🤔 Same issue with short access in this example. Switched to long access for better visualization @KalagaraHari @Nadia_Hdz_MD @shaskinsMD @Steve_Coppens @EngySaid_MD @HoltzMaggie @amit_pawa @rishikumarmd

27

16

112

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Sciatic and saphenous nerve blocks with one needle pass for ankle ORIF. Inspired to do this by @Nadia_Hdz_MD . Learn how at Texas Ultrasound Extravaganza! Only one month away 🗓️ Registration 🔗 below @TexasUltrasound @JohnHagenMD @SudiptaAthreya @EngySaid_MD @HoltzMaggie

11

36

114

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

Who else prefers placing ultrasound-guided peripheral IVs like an in-plane block? #sosatisfying

25

8

113

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Blocking distal lower extremity fracture without moving the leg is a game changer @Nadia_Hdz_MD taught me last year. Learn lateral approach to sciatic block mid-femur at @TexasUltrasound in 2 weeks! @baby_blocks @BlockIt_Hot_Pod @thisgirlblocks

10

21

103

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

So satisfying 😌💉…learn how to do this at many exciting 2023 RA/POCUS conferences! Houston Ultrasound Extravaganza, #ASRASpring23 , #WCRAP23 , #RAUK23 , #AORA23 @ASRA_Society @ESRA_Society @RegionalAnaesUK @AoraIndia @Nadia_Hdz_MD @baby_blocks @BlockIt_Hot_Pod @thisgirlblocks

4

27

104

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Thank you Dr. Denise Fraga @fraga_rock for teaching me how to obtain this beautiful PSAX: Right Ventricular Outflow Tract View 🤗🫀 #POCUS @CMCEM @ASRA_Society @KalagaraHari @Nadia_Hdz_MD @NephroP @RJonesSonoEM @dr_tgro @dr_melissabyrne @jblairdehaan

3

24

102

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

Anterior quadratus lumborum block, posterior approach in 64 seconds @ASRA_Society @ESRA_Society @RegionalAnaesUK @baby_blocks @BlockIt_Hot_Pod

6

23

101

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

BMI 70 pt for blood patch. PDPH from labor epidural 7 days prior. Initial epidural attempts at OSH took about 2 hrs. @SonyaRandazzoMD called me, we found midline & interspace w US guidance, Dr. Randazzo achieved LOR at 11cm on ✨1 attempt✨ @SOAPHQ @ASRA_Society @ruthi_landau

11

20

100

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Anterior approach to sciatic. Leg in traction, pt couldn’t roll @ASRA_Society @KalagaraHari @Nadia_Hdz_MD @HoltzMaggie @AminaBenyoucef5 @PeterMerjavy @claralexlobo @jeffgadsden @AmandaKumarMD @nelkassabany @NarouzeMD @Jerryblocksthat @amit_pawa @DrJeniMD @SylviaHWilson @dr_tgro

19

12

98

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

#Blocktober22 #ANES22 @jeffgadsden @HoltzMaggie @alifitmd @Nadia_Hdz_MD @EngySaid_MD @Ropivacaine @SreeHPraveenKO1 @Steve_Coppens

9

22

97

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Pt w distal tib/fib fx for ORIF. Wants blocks but refuses to move leg. Fortunately @Nadia_Hdz_MD taught me lateral approach to sciatic with curved probe. Went from crying to sleeping 15 minutes post-blocks 😴 #Blocktober22 @jeffgadsden @KalagaraHari @KiJinnChin @ASRA_Society

14

21

97

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Locating DCIA is very useful when identifying SIFI block anatomy on patients with muscle atrophy and unclear fascial planes

9

24

96

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

It never gets old ❤️💉🎶 #fasciailiaca #fleetwoodmac @ASRA_Society @ESRA_Society @CMCEM @KalagaraHari @Nadia_Hdz_MD @NarouzeMD @nelkassabany @PeterMerjavy @amit_pawa @jeffgadsden @AmandaKumarMD @fraga_rock @claralexlobo @HoltzMaggie @Jerryblocksthat @AminaBenyoucef5

6

13

89

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

100 second video on utility of #POCUS & regional anesthesia for thoracic surgery 💉🫁 @ASRA_Society @ESRA_Society @KalagaraHari @Nadia_Hdz_MD @NarouzeMD @shaskinsMD @jeffgadsden @nelkassabany @dr_rajgupta @NephroP @EMARIANOMD @AmandaKumarMD @TallRoundsTM @IM_Crit_

3

31

92

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

3 years

Anesthesia for hip fracture

Tweet media one

4

15

91

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Sisterhood of the traveling regional anesthesiologists 👸👸👸👸💉💉✈️ #ANES22 #Blocktober22 @ASALifeline @ASRA_Society @alifitmd @HoltzMaggie @Nadia_Hdz_MD

Tweet media one

8

7

89

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

🔗 to short (54 sec) video on intermediate cervical plexus block. We do this block for prox clavicle fractures, 1st rib resections (+ PVB), & carotid endarterectomies

Tweet media one

5

22

88

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

Bilateral deep parasternal blocks for analgesia, resection thymoma anterior mediastinum via sternotomy, Shared w consent. Join @SreeHPraveenKO1 & me for our live demonstration of the most important fascial plane blocks at #ESRAWorld2023 !

Tweet media one

2

20

87

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

3 years

Tracing sciatic from popliteal level to subgluteal level. Sound on to hear Fleetwood Mac 🎶 @ASRA_Society @ESRA_Society @HoltzMaggie @jeffgadsden @Nadia_Hdz_MD @AmandaKumarMD @James_Kim_MD @amit_pawa @KalagaraHari @Ropivacaine @nelkassabany @dr_tgro @dr_rajgupta @AminaBenyoucef5

8

15

81

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Scanning spread of local to fem n. and LFCN s/p SIFI block. 🎶 selection Notorious B.I.G. bc every time I hear/see sartorius I think of Biggie Smalls @KalagaraHari @amit_pawa @Nadia_Hdz_MD @jeffgadsden @James_Kim_MD @dr_tgro @NarouzeMD @AmandaKumarMD @PeterMerjavy @ASRA_Society

4

30

86

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

3 years

Bringing regional anesthesia education to the public one TikTok at a time @ASRA_Society @dr_tgro @amit_pawa @jeffgadsden @AmandaKumarMD @HoltzMaggie @KalagaraHari @Nadia_Hdz_MD @jeffgadsden @PeterMerjavy @claralexlobo @nelkassabany

5

12

80

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Love this single pass technique for infraclav! Block set up nicely without driving needle back through pec minor to touch up the medial cord @Steve_Coppens @PeterMerjavy @VeenaGraffMD @DrNavSidhu

8

15

82

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

Anterior QL block 💉💉Our go-to for ex-lap, nephrectomy, cystectomy with ileal conduit. Intermittent bolus catheters. Follow @ASRA_Society anticoagulation guidelines for neuraxial since this is a deep, perineuraxial block. The analgesia is soooo good….

4

14

81

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

#ASRA23 #ASRA100 was amazing!! @shaskinsMD did a phenomenal job planning this once in a century event 👏👏Looking forward to #ASRA24 #ASRA101 ! @ASRA_Society @NarouzeMD @EMARIANOMD @KiJinnChin @dr_rajgupta @nelkassabany @KalagaraHari @Nadia_Hdz_MD @HoltzMaggie @EngySaid_MD

6

14

81

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

4 years

Here’s the ultrasound-guided forearm block series! May be used as rescue blocks or primary blocks. Music is from TikTok, but the content is for the Twitter regional folks. Enjoy! @jeffgadsden @dr_tgro @ASRA_Society #regionalanesthesia #FOAMed

6

21

75

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

3 years

Per the suggestion of @dr_tgro , I made a website for my short sonoanatomy videos (aka “Block TikToks”). Enjoy! @ASRA_Society @ESRA_Society @jeffgadsden @Nadia_Hdz_MD @KalagaraHari @amit_pawa @James_Kim_MD @AminaBenyoucef5 @PennAnesthesia @EMARIANOMD

Melody Herman, M.D.

TikTok nerve block sonoanatomy Melody Herman

www.melodyherman.com

12

21

77

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

This crew makes regional anesthesia at a level 1 private practice setting possible 🥰💉 A surgeon watched us in action & said we are like the Navy SEALs #blockitlikeitshot 🔥 @ASRA_Society @HoltzMaggie @Jerryblocksthat @DrJeniMD @garyschwartzmd @Nadia_Hdz_MD @KalagaraHari

Tweet media one

10

6

77

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Anesthesia gods knew today was my last clinical day for the week and decided to squeeze about 3 days of work into 1 day 🥴 Almost #nola bound for #ANES22 @ASALifeline 🎉 💉💉

Tweet media one

4

2

73

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Regional and POCUS are game changers when anesthetizing very sick patients. Many workshops to choose from at @ASRA_Society annual meeting💉🫀🫁🏝️☀️ Registration 🔗 below! #ASRASPRING23 #ASRA100

4

20

73

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Polytrauma pt w sternal fx, difficulty breathing 2/2 pain, needs many days analgesia. Called @Jerryblocksthat to ask if superficial parasternal catheters are a thing. Turns out they are & work beautifully. Pain 10/10 to 4/10, NC O2 to RA 😎 @ASRA_Society @HoltzMaggie @jeffgadsden

5

13

74

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

Bilateral surgical paravertebral blocks for bilateral mastectomy completed by my colleague Dr. Naucika DeSouza. Shared with consent. @ASRA_Society @ESRA_Society @RegionalAnaesUK

6

18

72

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Patient with bowel obstruction, EF 10%, anticoagulated. Planned for lateral QL post-induction to ⬇️ GA requirement. Bowel so distended that QL not visible at posterior axillary line & patient too frail to roll lateral decubitus. TAP block it is…💉 #ASRASpring23 #ASRA100 💉

11

18

73

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Does anyone else think LFCN is just the cutest little nerve? @ASRA_Society @AmandaKumarMD @jeffgadsden @KalagaraHari @Nadia_Hdz_MD @HoltzMaggie @DrJeniMD @garyschwartzmd @Jerryblocksthat @dr_tgro @fraga_rock @NarouzeMD @nelkassabany @EMARIANOMD @KiJinnChin @AminaBenyoucef5

13

11

72

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

The Lego anesthesia machine episode 1 😭😭😭 @baby_blocks @BlockIt_Hot_Pod @thisgirlblocks @Nadia_Hdz_MD @JohnHagenMD @amit_pawa @dr_tgro @EngySaid_MD @HoltzMaggie

7

12

71

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

You probably already have ultrasound nearby to place central line…might as well confirm it’s in the SVC 🫀 Learn how at TX Ultrasound Extravaganza…just over a month away! 🔗 below @Nadia_Hdz_MD @JohnHagenMD @KalagaraHari @amit_pawa @baby_blocks @BlockIt_Hot_Pod @thisgirlblocks

3

17

71

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

💯 agree. Here’s supraclavicular BP block on pt with good respiratory function, 20 mL local. Post-block scan we see LA spread to interscalene level & phrenic n. medial to C5. Pt tolerated phrenic n. block well since 🫁 healthy. Would 🚫 block above clavicle if resp compromise

@jeffgadsden

Jeff Gadsden

1 year

@ASRA_Society @amit_pawa @EMARIANOMD @megrosenblatt @KalagaraHari @Steve_Coppens @ASA_Australia @L_D_White @Wilkinsonjonny @jon_bailey_anes @GongGasGirl @MKwesiKwofie @ajrmacfarlane @docmorne @rljohnsonmd @Duke_Anesthesia @claralexlobo @Assoc_Anaes @NagdevArun @DrNavSidhu @Ropivacaine @nelkassabany @zedunow @maffygirl @tmcraf001gracie @blockergirlMD @_anapatriciaper @ZeNicoLs @tsmurali @curromir @Jennythatcanbl1 @DrJeniMD @anesthesiadocmd @Nadia_Hdz_MD @garyschwartzmd @KiJinnChin @colinjmccartney @mail2vincechan @BlockIt_Hot_Pod A question that often comes up is: Can I do a block above the clavicle (eg superior trunk, anterior suprascap) and reliably spare the phrenic...my personal feeling is not worth it, I'll choose posterior suprascap. What do others think? Who like's costoclavicular? #Blocktober23

10

5

30

5

17

72

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

What block do you see in this latte? I’ll go first… @KalagaraHari @Nadia_Hdz_MD @HoltzMaggie @jeffgadsden @DrJeniMD @Jerryblocksthat @garyschwartzmd @PeterMerjavy @claralexlobo @amit_pawa @beckimarshRA @EMARIANOMD @AmandaKumarMD @VeenaGraffMD @dr_tgro @nelkassabany @dr_rajgupta

Tweet media one

Tweet media two

14

12

67

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

4 years

PVB in 23 sec. One of my favorite blocks. ⬆️risk (~0.5cm bw injection target & lung) with ⬆️reward (excellent analgesia) @PennAnesthesia @dr_tgro @James_Kim_MD @nelkassabany @KalagaraHari @amit_pawa @jeffgadsden @ASRA_Society @ESRA_Society @Ropivacaine @EMARIANOMD @Nadia_Hdz_MD

1

21

65

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

Two min 33 sec video on how we do bilateral anterior QL blocks with patient in one lateral decubitus position. YouTube link #blocktober23 #ANES23

Tweet media one

3

29

66

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

Just finished #eESRA2023 “The Role of Cutaneous Nerves in Mysterious Knee Pain After Surgery and Injury”. I knew nothing about IFCN & MFCN. Enlightened & will definitely change my practice. Fabulous session Jose De Andres, Siska Bjorn, Thomas Bendtsen, Thomas Dahl Nielsen 👏👏

Tweet media one

Tweet media two

Tweet media three

Tweet media four

4

19

66

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Anyone prefer parasagittal in-plane approach to paravertebral? If so,why? Gave it a try, had difficult time navigating between TPs, gave up & switched to transverse in-plane @ASRA_Society @KalagaraHari @amit_pawa @beckimarshRA @PeterMerjavy @Nadia_Hdz_MD @HoltzMaggie @NarouzeMD

16

20

65

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Attempted CVC via right IJ. 18Ga catheter placed easy but couldn’t advance guide wire past 7cm. Scanned distal & found large IJ valve just prox to clavicle. Switched to left IJ, easily placed #POCUS @ASRA_Society @KalagaraHari @Nadia_Hdz_MD @PeterMerjavy @AminaBenyoucef5

9

8

63

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

I mean….just sayin’… @Steve_Coppens @KalagaraHari @Ropivacaine @jeffgadsden @amit_pawa @RegionalAnaesUK @ASRA_Society @ESRA_trainees

6

5

63

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Might as well find another way to entertain myself if I can’t be at #ESRA2022 in person 😜 @ESRA_Society @ASRA_Society @KalagaraHari @claralexlobo @PeterMerjavy @amit_pawa @HoltzMaggie @Nadia_Hdz_MD @EMARIANOMD @shaskinsMD @jeffgadsden @ESRA_trainees @NarouzeMD @RJonesSonoEM

2

21

62

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

I often question if I’m present enough as a parent when 80% of my waking hours I’m working or contributing to regional anesthesia endeavors. My daughter brought her classwork home yesterday ❤️😭

Tweet media one

6

3

61

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

The reason we GPS track our machines 😜 💉🫀🫁 @amit_pawa @jeffgadsden @Nadia_Hdz_MD @KalagaraHari @fraga_rock @EMARIANOMD @EngySaid_MD @HoltzMaggie @dr_tgro @BucksUSGRA @BlockIt_Hot_Pod

5

10

60

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

3 years

Was not at my usual work location today, anticipated a difficult spinal, and found this old gal tucked away in a random hallway. The iPhone 6 of ultrasounds, but she worked like a charm 🪄💉 @ASRA_Society @SOAPHQ

Tweet media one

Tweet media two

7

2

60

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

BMI 70 pt w acute on chronic pain for lower ext surgery. Told block not possible, but impossibility is just an opinion. Sciatic best visualized w curved probe at pop fossa separated as tibial & common peroneal n. No opioids required intra-op or recovery #ASRASpring23 #ESRAWorld23

6

7

61

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

I made a deal with the most regional anesthesia resistant colleague in my practice. I’ll teach him US-guided paravertebrals & he’ll teach me landmark only subclavian central lines. That’s how confident I am that PVBs can be safely taught. Currently matched 1:1 in our exchange.

5

7

59

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

@KalagaraHari receives 2023 Excellence in Education award! He inspired me to learn #POCUS & my patients are better for it 🙏 #ASRASpring23 #ASRA100 @ASRA_Society @dr_rajgupta @Nadia_Hdz_MD @EMARIANOMD @NarouzeMD @shaskinsMD @AmandaKumarMD @megrosenblatt @EngySaid_MD @Ropivacaine

Tweet media one

Tweet media two

9

17

61

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

@fraga_rock and I ESP blocked each other today for a project. Both blocks T4, ropiv 0.2% 30mL. Decent posterior coverage but does not extend past posterior axillary line for either of us… @KalagaraHari @Ropivacaine @Nadia_Hdz_MD @jblairdehaan @jeffgadsden @ASRA_Society @CMCEM

10

7

60

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

The end of a conference has the same energy as the day after Christmas 🥲 #ESRAWorld2023 was better than I could have imagined. Grateful for opportunity to contribute & meet so many brilliant regional anaesthetists from across the globe. Next up, #ANES23 in San Diego Oct 2023!

Tweet media one

Tweet media two

Tweet media three

Tweet media four

5

10

59

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

On my way y’all!! 🇫🇷 #ESRAworld2023 @ESRA_Society @ASRA_Society @AoraIndia @aosra_pm @mokaeleni @Nadia_Hdz_MD @HoltzMaggie @claralexlobo @KalagaraHari @NarouzeMD @EMARIANOMD @nelkassabany @MarissaWeberMD @amit_pawa @ajrmacfarlane @PeterMerjavy @BridgetPulos @docmorne

5

10

59

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Officially ASA #POCUS certified! Grateful for the @ASRA_Society outstanding POCUS course for teaching the need-to-know basics and the mentorship of Dr. Denise Fraga @fraga_rock Charlotte POCUS queen👸 & fellowship director of @CMCEM ultrasound fellowship 🙏🫀🫁

Tweet media one

13

5

57

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Subcostal bicaval view of central line at SVC-RA junction immediately after placement. Experts at recent @ASRA_Society POCUS course taught me how to do this scan. Next course in San Diego Sept 2022🔗⬇️ @KalagaraHari @NarouzeMD @shaskinsMD @Nadia_Hdz_MD @RJonesSonoEM @NephroP

6

12

53

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Blocking sciatic supine without moving leg for distal lower extremity fracture is a game-changer. Grateful to @Nadia_Hdz_MD for showing me how to do this last year 🙏

5

9

58

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

I’m told by my friend and colleague Dr. Naucika DeSouza at @WakeAnesthesia they call this combo of 1. Sciatic & 2. Femoral catheters, 3. LFCN and 4. Obturator single shots a “Quadzilla”. I love it.

7

14

57

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

Finally done with my presentation 🤗 Only 2.5 weeks until @ESRA_Society #ESRAWorld2023 ! 🌍💉💉🫀🫁 @Nadia_Hdz_MD @HoltzMaggie @mokaeleni @claralexlobo @athmathottungal @Steve_Coppens @KalagaraHari @amit_pawa @ajrmacfarlane @NarouzeMD

Tweet media one

7

15

55

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

Look who is in Charlotte, NC visiting our regional anesthesia service at Carolinas Medical Center 😍 @athmathottungal Don’t miss her lectures/workshops at #ESRAworld2023 in a few short weeks 🌎💉💉 @ESRA_Society @RegionalAnaesUK @ASRA_Society

Tweet media one

2

8

54

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

Patient on anticoagulation, severe aortic stenosis, s/p fall with femoral neck fx. Anesthesia plan - SIFI block + sedation. Find anatomical variant…

7

11

54

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Blocks for 1st rib rxn & scalenectomy have ⬇️ LOS, ⬇️ opioids, ⬆️⬆️ pt satisfaction for our thoracic outlet syndrome patients. ISB (C5-7) & SCP (C2-4) blocks for scalenes (innervation C3-8). T1-2 for 1st rib if possible, otherwise somewhere bw T2-T4 (easier & still reaches T1).

4

17

51

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Subgluteal sciatic catheter (posterior approach) on BMI 52 patient for AKA. Paired with fem n. catheter. Post-op pain 0/10 🤗 @ASRA_Society @KalagaraHari @Nadia_Hdz_MD @HoltzMaggie @EMARIANOMD @PeterMerjavy @Jerryblocksthat @amit_pawa @jeffgadsden @AmandaKumarMD @nelkassabany

4

10

52

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

You will be amazed what you see when you put a probe on someone’s chest 🫀 @KalagaraHari @Nadia_Hdz_MD @NephroP @shaskinsMD @NarouzeMD @nelkassabany @RJonesSonoEM @EMARIANOMD @SonyaRandazzoMD @amit_pawa @galusweegie @Ropivacaine @ASRA_Society @ESRA_Society

5

11

53

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

4 years

Here is a revision with block labeled as anterior QL block (moving away from QL 1, 2, 3, etc) as suggested by @KalagaraHari . Also changed the orientation of the 2nd anatomy illustration so that it matches the sonoanatomy scan, as suggested by @amit_pawa .

3

20

50

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

10/10 recommend @ASRA_Society #POCUS course! I’ve POCUS scanned every clinical day since I took course last year. Hypotensive? Hypoxic? NPO status unclear? You’re gettin’ scanned! 🤓🫀🫁 @KalagaraHari @Nadia_Hdz_MD @BridgetPulos @WilliamMansonMD @dr_melissabyrne @MarissaWeberMD

@KalagaraHari

🩺 Hari (హరి 🇮🇳) Kalagara

1 year

#POCUS Join us @ASRA_Society #ASRAPOCUS course in Salt Lake City on September 23-24. 👉 @NarouzeMD @shaskinsMD @SonoStache @WilliamMansonMD @dr_melissabyrne @MarissaWeberMD @IyaboMuse @JanBoublikMDPhD @SreeHPraveenKO1 @Nadia_Hdz_MD @_Walid_01 @JohnHagenMD

Tweet media one

1

21

42

0

20

52

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

Honored for opportunity to serve as @ASRA_Society Ambassador at #ESRAWorld2023 Sept 6-9 in Paris 🇫🇷 alongside @aosra_pm Ambassador @BalavenkatSubr1 and @AFSRA10 Ambassador @BarrowCeleste 🙏 @Steve_Coppens @ESRA_Society

Tweet card media

We HAVE the world - ESRA

6

11

53

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

1 year

Lateral approach sciatic n. block in supine patient. Learn how to do this at #ESRAWorld2023 ! Registration 🔗

3

11

54

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

3 years

What is your favorite block to teach? #ASRASPRING22 #showmeyourneedle @ASRA_Society @KalagaraHari @NarouzeMD @EMARIANOMD @HoltzMaggie @AmandaKumarMD @Nadia_Hdz_MD @nelkassabany @dr_tgro @garyschwartzmd @Ropivacaine @amit_pawa @alifitmd @PeterMerjavy @amit_pawa @AmyPearsonMD

18

10

52

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Working on US ankle block video. Forgot about this scan I did of superficial peroneal n. post-block 🤩Traced it back distal towards ankle. Lights up like a Christmas tree 🎄 @ASRA_Society @ESRA_Society @RegionalAnaesUK @CASUpdate @thisgirlblocks @baby_blocks @BlockIt_Hot_Pod

5

8

52

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Stay tuned for more regional anesthesia #tiktoks at @ASALifeline Annual Meeting in 13 days! #ANES22 #blocktober @ASRA_Society @alifitmd @HoltzMaggie @Nadia_Hdz_MD @AmandaKumarMD @jeffgadsden @EngySaid_MD @KalagaraHari @amit_pawa @Steve_Coppens @PeterMerjavy @EMARIANOMD @dr_tgro

3

11

50

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

4 years

I joined TikTok as a joke during quarantine and ended up making many block TikToks 😆😆. Here’s the ultrasound-guided ankle block TikTok series (original target audience is medical & non-medical mix) #Blocktober @jeffgadsden @ASRA_Society

5

9

47

@anesthesiadocmd

Melody Herman, MD

@anesthesiadocmd

2 years

Five short years ago 0 blocks were done at Carolinas Medical Center. We now do the most paravertebrals in North Carolina. Excited for the next chapter of our regional program with Loran Soliman on our side. Also, I want your fellows @jeffgadsden & @AmandaKumarMD 🤗

@NarouzeMD

Samer Narouze,MD,PhD,MMM

2 years

@anesthesiadocmd @SreeHPraveenKO1 @ClevelandClinic @KalagaraHari @ChrisTroianos @MagedArgalious @Ropivacaine @ASRA_Society @EMARIANOMD @SretroPMD @kaohesham @galusweegie @amit_pawa @Nadia_Hdz_MD @BridgetPulos @dr_melissabyrne @VeenaGraffMD @KamalMaheshwar7 @nelkassabany @ajrmacfarlane @dr_rajgupta Yes. Loran Soliman is an amazing clinician and teacher. You guys will have an all star team 💫

0

0

7

3

1

50