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: POCUS
Necrotizing Fasciitis: Let’s scare you into using POCUS shall we?
Warning: Scary article ahead. Point-of-Care Ultrasound Diagnosis of Necrotizing Fasciitis Missed By Computed Tomography and Magnetic Resonance Imaging It’s one of those diagnoses that scares us. Hard to figure out clinically in many cases at initial presentation. Adjunctive tests can be false negative. How can we increase our sensitivity? Use your POCUS skills of […]
Don’t become Jaundiced about POCUS
This patient came in with jaundice and the LFTs were elevated. They had had a cholecystectomy in the past. POCUS revealed a large dilated fluid-filled structure in the RUQ. After looking at the kidneys/liver +/- Doppler it became clear it was a very dilated CBD. CT confirmed the biliary dilatation and obstructing mass. [Ed. note: […]
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 […]
Don’t be subtle: Use POCUS for hard to see fractures
A young man had clinically a distal radius fracture. The X-ray looked negative to myself and the radiologist. But with a little bit of fiddling I found the # on U/S. Before I would have said this was a Salter fracture through the epiphysis. POCUS clearly showed the # proximal to the epiphysis. Another fellow […]
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 […]
Glass FB in Palm
This guy got a glass FB in his hand a couple of weeks earlier. You could sort of imagine a little bump and a little mark. POCUS clearly showed it ~ 1 mm deep. I made an X and (luckily) fished it out. I took a lousy picture with my obsolete Palm Treo showing the […]
Purulent tenosynovitis on POCUS
This is from a fellow with the classic high pressure air/water injected in his hand a few days earlier. You can see the pus next to the tendon.
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. […]
POCUS Father’s Day
Not only am I an enthusiast for POCUS, my pre-teen daughters often get roped into being models for workshops and presentations. There was even an occasion when my (very young at the time) daughter claimed she didn’t have to use the washroom before going somewhere to play. I demonstrated to her what a full bladder […]
The emotional and visceral pain of a good POCUS call
Dr. Sean Ryan works in a rural hospital with no surgical coverage and in this case there was no access to ultrasound because it was a Saturday morning. As you know people aren’t supposed to have emergencies in rural communities on weekends requiring ultrasound. A 24 year old woman presents with RLQ pain and Dr. […]
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