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
Viral Parotitis
A 9 month old child presented to the ED. URTI symptoms, fever and swelling below the left ear. The child looked well with a fullness near the left angle of the jaw. POCUS revealed a swollen parotid with a Swiss-cheese like appearance. I checked the other side for a control but it looked the same. […]
Lots of Gallbladder views for the album
One of my colleagues found a nice gallbladder. I took some pictures of it after my shift was over-clearly I’m getting a bit obsessed here. It illustrates a number of findings suggestive of cholecystitis. There are a number of views here. Some from under the right ribs anteriorly, some from through the chest wall […]
Colles and POCUS
I like to use POCUS for hematoma blocks and Colles fractures. Here’s one. I first mark the most obvious area of the radial fracture. Then I aim from slightly cephalad at a 45 degree angle to inject the fracture. By the way, I’ve never actually seen the hematoma in the “hematoma” block. I then follow […]
Staghorn Calculus
This fellow had a chronic history of renal stones (also a stent). The POCUS showed his collecting system filled with calculus. The entire calyceal system and pelvis was packed with stones.
Take the appendix challenge
Do you want to improve your imaging skills safely? Then take challenges like this case from Dr. Gordon. When you have someone waiting to get a CT for appendicitis, look for the appendix yourself with POCUS. If you see it and still can’t convince your surgeon to go to the OR, then getting an elective […]
Don’t let bilious patients get you down
This patient complained of a really vague lateral LUQ discomfort, possibly post prandial (I got that history after I saw the GB on POCUS). She looked fine and the physical exam was unhelpful. I really didn’t know what was going on (doesn’t sound very inspiring) so I just looked around with the probe. Pleura/Lung/CVS/LKKS/IVC/Aorta all […]
I can’t feel a pulse! Why not look for it instead?
I love to watch colleagues carefully palpate for pulses and try to listen for bruits, use doptones, etc. all the while desperately hoping they are not dealing with a completely ischemic limb. Then I grab my ultrasound machine and throw some colour doppler on the subject and get a much better picture of what’s going […]
Arm DVT
Dr. Lloyd Gordon has a case of proximal arm DVT to share. Like doing a scan for proximal leg DVT, looking for lack of vein compressibility is key but in the majority of cases if you look carefully you will see some clot in the lumen with varying amounts of echogenicity. So while most of […]
Exploring airway pathology with POCUS
One of my colleagues suspected a subtle presentation of airway problems. A CXR was ordered which suggested something pushing the trachea over to the right. A previous CXR was similar but not as pronounced. A CT showed a mass, looking like a Thyroid Colloid Cyst. As predicted, it was pushing on the trachea. I […]
Scrotal U/S-infection
Another pearl from Dr. Gordon regarding scanning the testes: When one testicle shows no flow or much reduced flow on the painful side, torsion is likely. In this patient the presentation was not as acute as expected of torsion. Scrotal U/S showed increased flow on the painful side and the painful testicle was also larger […]
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