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
Why I prefer LOOKING at hearts
Seriously, if you haven’t yet learned how to LOOK at hearts with bedside ultrasound you are doing your patients a disservice. The amount of critical information you are likely missing with auscultation is scary. I saw a 48 year old female currently receiving chemotherapy via portacath for metastatic colon CA. Presents in the middle of […]
Unexpected PCE
If you only look for PCE when you expect it, you will probably miss some. The first patient had some sort of unexplained febrile illness with a left shift and a creatinine of ~540 or so. Her IVC didn’t indicate marked hypovolemia. I looked at her heart to see the chamber function and found a […]
Appendicitis-perforated
This patient gave a fairly convincing story for appendicitis. POCUS revealed a “pocket o’ pus” around the caecum (now->perforated appendicitis). I couldn’t see the appendix and the CT showed it hiding underneath the caecum. [Ed. note: Free fluid around the bowels in the RLQ in someone with a history suspicious for appendicitis should always prompt […]
Immediate diagnostic and therapeutic feedback with POCUS; one testicle at a time!
Dr. Joel Turner, the emergency medicine ultrasound director at McGill University and staff at the Jewish General Hospital in Montreal sends another fantastic case of ultrasound guided testicular torsion reduction. Is it time for every ED physician to learn this skill? Time-critical care is our job! [ed] Case: Immediate diagnostic and therapeutic feedback with POCUS; […]
Clavicle Fracture-Do we need to Xray all of them?
This young man was body checked. His clavicle was not obviously deformed. POCUS easily showed the fracture. I guess at some point we might not feel the need to do the X-ray.
Send the right patients home with POCUS
Dr. Tim Van Aerde sent us this great case which illustrates some important points. This lady came in with vaginal bleeding, hCG 2500 and very minor left flank pain. Vitals normal. Hemoglobin normal. In the past I would have sent this patient home with an ultrasound in the morning. Threw on the probe and saw […]
Swollen finger? Take a bath!
Dr. Gordon presents a case of a swollen finger worth reviewing. POCUS is becoming extremely useful at investigating these patients as it allows great visualization of the tendon and sheath showing lacerations, foreign bodies and infection. Being a dynamic exam, you can have the patient move their digits and watch the tendons slide. An important trick is […]
Good uterus gone bad
The first patient was a week post-partum with some midline pelvic pain. POCUS showed a hyperechoic line in the endometrial cavity: likely gas from endometritis. The second patient had post-menopausal bleeding for over a month. POCUS showed a very bulky post-menopausal uterus with a fluid collection cephalad to the uterus: likely endometrial Ca. [Ed […]
Yes, yes it is another scary neck case!
Look, we know you are probably tired of hearing us tell you about all the things you can find with POCUS that are missed on physical exam or other imaging modalities. Well too bad! Learn this stuff and make a big save yourself! Lloyd Gordon has another nice case involving the neck…[ed.] This fellow […]
What’s the diagnosis and what’s the gold standard for POCUS??
A man in his late 50s presented to an ED a while back during the summers months with a 3 day H/O multiple complaints including rhinorhea, sore throat, dry cough, vomiting, loose stool, right frontal headaches, dyspnea, dysuria, and dark urine. So, a mixed picture. Fever of 100.9 was measured at home. No contacts or […]
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