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.[...]
Tag: abscess
Abscesses, hematomas, and cellulitis, oh my!
I used to think that hematomas and abscesses were pretty straightforward to diagnose clinically. But I have had several cases that proved my initial suspicion to be wrong. Certainly the literature suggests we could do better differentiating cellulitis, DVT, and abscesses. I saw a patient who presented after knee surgery with a hot, swollen and […]
Scan a hernia
Dr.Lloyd Gordon discusses two cases of umbilical lumps that were easily sorted out with POCUS: This patient had a history of a umbilical hernia which had become larger and painful for a few hours. The patient’s habitus made a manual exam difficult. POCUS showed that there was some small bowel at the tender area […]
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. […]
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 […]
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 […]
Dr. Richard on Armpits, Metal Rods, Pus, and T-shirts
Here’s a neat case from Dr Bernard Richard from Valleyfield in la belle province… A 30 y.o. man fell on a metal rod a week ago. He was seen in the ED and had his 10 cm right axillary wound sutured. I saw him a week later for 4 cm lump that was located 15 […]
Nobody expects the liver abscess
I reviewed the computer charting, elderly lady with one day history of fever, vomiting, diarrhea and confusion. Sounded like a boring old gastro, give her fluids, take cultures and refer. No need to drag the U/S to the room when I’m already behind and pressed for time. Still, spare the probe and spoil the patient. […]
Gas Gangrene
An elderly woman was sent to the ER by her senior’s residence in the middle of the night for bloody stools. The triage nurse found out that there was no blood but there was pus coming from her rectum. There was a very red and swollen area starting from the anus and extending onto her […]
Pilonidal Abscess: Hair today, gone tomorrow
This may seem like overkill; POCUS for an obvious abscess. Still it was interesting to see the ingrown hair inside the abcess. Also the point of maximal induration was not where the actual abcess was, strangely enough. So in the end the POCUS showed not only that the abscess was ready to be drained but where […]
What’s that red thing doing in an abscess??
At the course and in the book, we suggest that physicians should be wary of important neighboring structures. Even with EDE/POCUS guidance for abscesses, this is still a pitfall. I recently saw a young male who is an IV drug abuser. Yes, we do have those in Sudbury! He had injected himself and developed an […]
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