Hypothermic Heart on POCUS
This never-ending winter reminded me of hypothermia case that I saw a number of years ago. It was an elderly female in her mid-70s with an unclear history. She was found on the ground at the entrance to her home by family one morning in the middle of winter. EMS was activated. She was found […]
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 […]
IVC Meta-Analysis Analyzed
One of the most interesting and controversial areas of POCUS/EDE is the IVC scan. In fact, it’s soooo controversial that I have have edited the PowerPoint for the course for each of the last 4 courses! Pierre Collin and I are alter-egos for IVC (I do the lecture in English and Pierre handles IVC in […]
Time-saving technique for difficult lumbar punctures
Lumbar puncture failure, although not a catastrophic event, is always frustrating and time consuming. Skin marking after identifying spinous processes with ultrasound is an interesting method to increase your success rate. However, real time ultrasound guided lumbar puncture is relatively easy to do and faster than skin marking. I personally use the abdominal probe with […]
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 […]
Scrotal ultrasound: it’s what’s inside that matters
Editor’s note: Testicular torsion is a scary condition that we can’t afford to miss. It cannot be diagnosed on history and physical alone in almost 50% of cases so ultrasound is crucial to decision-making. POCUS can be extremely helpful in detecting the torted testis but it is important to understand that a partially torted, […]
Widened symphysis on POCUS
A few of us (@thomas1973, @mikegreenway, @broomedocs) were discussing on Twitter the use of POCUS/EDE to look for a widened symphysis pubis in the setting of major trauma. We were wondering if there is any literature to back that up. I found one article in the EDE database. Bauman et al published their article titled […]
What’s that red thing doing in an abscess??
At the course and in the book, we suggest that physicians should be wary of important neighboring structures. Even with EDE/POCUS guidance for abscesses, this is still a pitfall. I recently saw a young male who is an IV drug abuser. Yes, we do have those in Sudbury! He had injected himself and developed an […]
Bootcamp EDE: Drop and give me 200
The biggest obstacle to beginners embracing POCUS is the initial effort required to master basic skills. Most learners complete an introductory course that takes a day or two. This is followed by supervised scanning sessions and examinations to meet the required numbers and proficiency to be “certified” to apply the skill independently. This can require […]
Dr. Gordon doesn’t like failed I&Ds
I really don’t like doing an I&D and then finding nothing or no pus anyway. I find it helpful to know just where the pus is, where it goes, if there’s something else besides pus, or if it needs serious surgical intervention. Once I looked at neck swelling that didn’t look too horrible but the […]
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