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.[...]
Author Archive: Lloyd Gordon
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 […]
Epididymitis
This patient had acute onset of severe L testicular pain and could hardly walk. I thought he was a torsion for sure. However the flow was fine. I moved up to the epididymitis and sure enough it was enlarged and with increased flow. [ed. note] With any patient that has a high pretest likelihood of […]
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 […]
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 […]
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 […]
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 […]
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.
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