Saving Brainspace with POCUS
February 8th, 2018
Here is a cool case that Lloyd Gordon recently sent us...
"A 60 year-old woman had a fever of 39.[...]
Cases
Floaters and Partial Visual Field Loss
A fairly classical history. The patient had looked it up on the internet and told me he had a retinal detachment. He was right. [ed. note] The thicker, more echogenic line and tethering near optic disc are classic hallmarks of RD on POCUS. Don’t forget to always have your patient move their eyes back […]
How often do you use POCUS?
Dr. Gordon shares the findings from just three recent ED shifts. There are many negative and indeterminate scans here but it provides a glimpse into how POCUS is included in the thought process for risk stratification and clinical decision making. This patient complained of R flank pain. POCUS revealed a normal kidney, uterus and pelvis. […]
Infectious Mononucleosis? Measure that spleen!
A reminder that POCUS can improve your sensitivity for diagnosing diseases, even in your low acuity patients. We all know the Monspot test can be negative for Mono patients depending on when they present to us. Don’t forget to have a quick look at the spleen if the rest of the clinical presentation points towards […]
Lung EDE
This patient had fallen on the bathtub and injured his left ribs. CXR 5 days ago showed a slight infiltrate in his LLL. He was sent back with pain and splinting. POCUS showed the diaphragm all around the spleen (you shouldn’t be able to see it above 9 o’clock), with a pleural effusion. It looked […]
Dislocated? POCUS improves clinical exam
The first patient had a shoulder injury and fairly unhelpful X-rays. POCUS revealed both Humeral heads to be in proper postition. The second patient by history had a first dislocation which spontaneously reduced. He was feeling fine when I saw him. POCUS revealed a Hill–Sachs lesion confirming he had dislocated his shoulder and it was […]
Ultrasound for skull fractures
Go to Ken Milne’s The Skeptic’s Guide to Emergency Medicine to see his podcast on using ultrasound to diagnose skull fractures featuring yours truly as a guest. Ken leads the charge for using social media to educate the medical masses. Not only does he run the SGEM podcast but is a member of the Best […]
The Power of POCUS with clinical change
Do you ever feel your POCUS is unnecessary or somehow not as good as the “formal” ultrasound? I sort of wondered what I was going to find as this patient had been to hospital a number of times recently with 2 recent ultrasounds. Probably nothing to find? Well think again. She was able to localize […]
Gamers love POCUS!
We teach femoral and forearm nerve blocks at EDE 2 and a bunch more nerve blocks at EDE 3. The forearm blocks are easier than the femoral block but the indication doesn’t come up as often. At EDE 2, we often get asked about the clinical scenarios in which we would use a forearm block. […]
Fewer admissions with Hip POCUS: Part Two
In part two of our discussion regarding hip POCUS-guided arthrocentesis and injections we have just received this case from Dr. Chris Keefer from Brantford General Hospital’s emergency department. A patient in her late 30s presented with severe hip pain of rapid onset. No recent trauma. Recent flu-like illness. Otherwise healthy with no significant medical conditions. He […]
Fewer admissions with Hip POCUS
The Canadian healthcare system is perfect, eh? Uh, no not really. One of the more well-publicized and frustrating ways in which this imperfection manifests itself is the wait list for orthopedic consultation and elective surgery, the most notorious being joint replacement. All Canadian EDs probably see patients with some frequency who present with osteoarthritis of […]
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