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Cases

My twinkle is better than yours

November 16, 2015 0 Comments
My twinkle is better than yours

Case courtesy of Dr. Joel Turner, Fellowship Director EM Ultrasound, McGill University: 59 year old male with a previous history of renal colic presents with severe LLQ pain, and mild dysuria. He had no fever, no GI symptoms, and was a non-smoker. His urine dipstick was positive for red blood cells. No gross hematuria. While […]

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Troubleshooting Foley catheters

October 20, 2015 1 Comment
Troubleshooting Foley catheters

I firmly believe nurses should be trained to use POCUS to trouble shoot Foley catheters.  It is not that rare for a difficult Foley insertion to result in a small amount of urine return and then no further drainage or the balloon fails to inflate easily.  More often than not, the Foley is still in […]

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Epididymitis

October 14, 2015 0 Comments
Epididymitis

This patient had acute onset of severe L testicular pain and could hardly walk. I thought he was a torsion for sure. However the flow was fine. I moved up to the epididymitis and sure enough it was enlarged and with increased flow. [ed. note]  With any patient that has a high pretest likelihood of […]

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Floaters and Partial Visual Field Loss

October 4, 2015 0 Comments
Floaters and Partial Visual Field Loss

A fairly classical history. The patient had looked it up on the internet and told me he had a retinal detachment. He was right.   [ed. note] The thicker, more echogenic line and tethering near optic disc are classic hallmarks of RD on POCUS.  Don’t forget to always have your patient move their eyes back […]

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How often do you use POCUS?

September 27, 2015 0 Comments
How often do you use POCUS?

Dr. Gordon shares the findings from just three recent ED shifts.  There are many negative and indeterminate scans here but it provides a glimpse into how POCUS is included in the thought process for risk stratification and clinical decision making. This patient complained of R flank pain. POCUS revealed a normal kidney, uterus and pelvis. […]

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Infectious Mononucleosis? Measure that spleen!

September 20, 2015 1 Comment
Infectious Mononucleosis? Measure that spleen!

A reminder that POCUS can improve your sensitivity for diagnosing diseases, even in your low acuity patients.  We all know the Monspot test can be negative for Mono patients depending on when they present to us.  Don’t forget to have a quick look at the spleen if the rest of the clinical presentation points towards […]

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Lung EDE

August 20, 2015 0 Comments
Lung EDE

This patient had fallen on the bathtub and injured his left ribs. CXR 5 days ago showed a slight infiltrate in his LLL. He was sent back with pain and splinting. POCUS showed the diaphragm all around the spleen (you shouldn’t be able to see it above 9 o’clock), with a pleural effusion. It looked […]

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Dislocated? POCUS improves clinical exam

August 12, 2015 0 Comments
Dislocated? POCUS improves clinical exam

The first patient had a shoulder injury and fairly unhelpful X-rays. POCUS revealed both Humeral heads to be in proper postition. The second patient by history had a first dislocation which spontaneously reduced. He was feeling fine when I saw him. POCUS revealed a Hill–Sachs lesion confirming he had dislocated his shoulder and it was […]

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Ultrasound for skull fractures

June 13, 2015 0 Comments
Ultrasound for skull fractures

Go to Ken Milne’s The Skeptic’s Guide to Emergency Medicine to see his podcast on using ultrasound to diagnose skull fractures featuring yours truly as a guest. Ken leads the charge for using social media to educate the medical masses.  Not only does he run the SGEM podcast but is a member of the Best […]

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The Power of POCUS with clinical change

June 5, 2015 2 Comments
The Power of POCUS with clinical change

Do you ever feel your POCUS is unnecessary or somehow not as good as the “formal” ultrasound? I sort of wondered what I was going to find as this patient had been to hospital a number of times recently with 2 recent ultrasounds. Probably nothing to find? Well think again. She was able to localize […]

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