POCUS And Its Utility in the Rapid Diagnosis of Acute Cholecystitis

A 48-year-old female with a past medical history of hypertension and hyperlipidemia and no past surgical history presented to the ED with constant, sharp, and burning epigastric pain. The pain started two weeks ago and was initially intermittent, centered in the epigastric region. Over the past day or so, the pain worsened and began traveling to the right side of her chest and around to the back. The pain was daily, usually after meals, and made worse by fatty foods. The patient felt slightly better after taking antacids. She reported the pain was 8/10 at worst, typically lasting several hours at this intensity, and receded to 3/10 at its best. She had some nausea but no vomiting. She denied changes in stool consistency/frequency or dark or bloody stools. She denied chest pain, sweating, or palpitations. She reported a subjective fever last night and into this morning, but no chills or change in weight. She had been compliant with her home medications.

Ultrasound, RadiologyToby NicholsonJanuary 15, 2021Cholecystitis, Bedside UltrasoundComment

Brown Sound: (Almost) Scared to Death by Takotsubo Cardiomyopathy

A 75 year-old female with a past medical history of hypertension, hyperlipidemia, SVT, chronic kidney disease, diabetes, lung cancer status post partial right lung resection, and remote history of breast cancer status post resection presented with chest pain. She awoke in the middle of the night after hearing a loud crash and found her husband lying on the ground unresponsive. She thought he was dead and felt an overwhelming sensation of fear, followed immediately by the onset of substernal chest pain radiating to the back associated with some shortness of breath. She denied fever, diaphoresis, nausea, vomiting, or palpitations. She denied any history of angina. Upon arrival to the emergency department she was given nitroglycerin with a subsequent improvement in her chest pain…

Cardiology, UltrasoundDanielle KerriganJanuary 5, 2021ultrasound, echocardiography, Takotsubo, cardiomyopathyComment

Bround Sound: Ultrasound to Assess Extraocular Movements and Pupillary Light Reflex

The assessment of extraocular movement (EOM) and pupillary light reflex can be used to evaluate for ocular injury post-trauma. However, many patients with ocular trauma can present with significant orbital edema or pain that limits assessment due to the physician being unable to retract the eyelids. Ocular ultrasound provides a unique way to assess the eyes in the event of a trauma without causing significant pain or harm to the patient. This blog post provides techniques on how to perform ocular ultrasound to assess EOM and pupillary light reflex…

Opthalmology, UltrasoundMeagan KozhimalaDecember 22, 2020ultrasound, ocular, traumaComment

An Uncommon Cause of Shortness of Breath in the Emergency department: Acute Mitral Regurgitation

By: Russell Prichard MD and Melanie Lippman MD

CASE

The patient is a 52 year-old female with a past medical history of hypertension, hyperlipidemia, hypothyroidism, and a 2 pack a day smoking history who presented to the emergency department in respiratory distress.

When EMS arrived to the patient’s home, she was hypoxemic with a pulse oximetry reading of 70s on room air and hypotensive with systolic blood pressures in the 80s. She was placed on nasal cannula with improvement in her saturations and she was given aspirin, fentanyl, and nitroglycerin without relief.

Upon arrival her vitals were significant for respiratory rate of 34, pulse oximetry of 98% on 6L NC. She was noted to be in acute distress.

The patient was placed on positive pressure ventilation via BiPAP and broad blood work, chest X-ray and electrocardiogram (ECG) were obtained.

Critical Care, Community EM, Respiratory, Resuscitation, Ultrasound, CardiologyGuest UserDecember 18, 2020cardiology, Critical Care, RespiratoryComment

Rounding Out A Case of Acute Pancreatitis

An otherwise healthy 6 year-old female presented with lower abdominal pain and non-bloody, non-bilious emesis since 11:00 PM the previous night. Several hours prior to the onset of her symptoms, she was playfully thrown into a pond where she was swimming. She subsequently had take-out brown rice and vegetables with her family. Nobody else developed symptoms. Her pain was worse with ambulation and bumps in the road. She has had no diarrhea, constipation, fevers, urinary symptoms, or other acute complaints. She had similar but less severe episodes of these symptoms in the past. The patient’s father had a history of a “blood disorder” requiring abdominal surgery…

Pediatrics, UltrasoundSean ReidOctober 26, 2020pancreatitis, pediatrics, spherocytosisComment

CASE

Contact

Subscribe