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
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 […]
Common Bile Duct Measurements: Not very useful for emergency physicians
Editors note: Lloyd has provided several great biliary scans to the blog and in his previous CBD related post talked about how an incidental finding of dilated CBD helped guide him towards diagnosing a patient with pancreatic cancer. While all of us at the EDE blog are POCUS enthusiasts, we must acknowledge that there is […]
Ultrasound beats Xray for skull fracture
This asymptomatic 7 month old had fallen on New Year’s and the parents noted a dent in the head. There did seem to be a contusion in the left fronto-parietal area with maybe an associated “dent”. The child was normally squirmy (and very happy) so the area of interest would swim in and out of […]
Beats doing a rectal exam
I was looking at a patient’s kidney. There was clear hydronephrosis and proximal hydroureter. The picture I included isn’t that great because I was trying to get a good picture of the proximal ureteric stone (~ 7 mm on KUB). I was looking at the bladder for a […]
Ectopic & Left FAST
This patient who was known to be pregnant came in quite shocky. POCUS showed blood around the spleen only, none in Morison’s Pouch or in the pelvis. A bit weird? Maybe because the ectopic was in the left tube? The patient went right to the OR without any further imaging and did well. [Editor’s note: […]
Sternal Fracture
This fellow had an airbag/steering wheel injury. His sternum was tender over the fracture seen on POCUS. These are amazingly easy to find. Using a linear probe in the longitudinal plane, slide it cephalad and caudad along the sternum. I doubt this would have been seen on X-ray, the displacement is around 1 mm. [Editor’s […]
Scaphoid Fracture
This is from EDE2. You use the linear probe and slide up the lateral radius up to the snuff box looking for a sort of saddle back mountain shape (on the normal side). You can see the fracture discontinuity on the injured side. [Editor’s note: POCUS is good to rule in a scaphoid fracture. But […]
Common Bile Duct: How useful is it for us to image?
This patient initially gave a history of two months of upper abdominal pain. I was looking at his GB, which seemed normal when I came upon this tubular structure with no flow on Doppler. It certainly looked to be a (very dilated) CBD. Once I saw it, it was natural to ask […]
Localized PCE
I tend to think of pericardial effusions (PCE) as being very uniform around the heart. This one was very localized to the area noted on the image. The CT Abd. (I didn’t order it!) showed the same PCE. The history was severe diarrhea and weakness. I was a bit worried about the dilated right ventricle […]
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