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Cases

Gamers love POCUS!

June 4, 2015 0 Comments
Gamers love POCUS!

We teach femoral and forearm nerve blocks at EDE 2 and a bunch more nerve blocks at EDE 3. The forearm blocks are easier than the femoral block but the indication doesn’t come up as often. At EDE 2, we often get asked about the clinical scenarios in which we would use a forearm block. […]

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Fewer admissions with Hip POCUS: Part Two

May 31, 2015 0 Comments
Fewer admissions with Hip POCUS: Part Two

In part two of our discussion regarding hip POCUS-guided arthrocentesis and injections we have just received this case from Dr. Chris Keefer from Brantford General Hospital’s emergency department. A patient in her late 30s presented with severe hip pain of rapid onset.  No recent trauma.  Recent flu-like illness.  Otherwise healthy with no significant medical conditions. He […]

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Fewer admissions with Hip POCUS

May 30, 2015 0 Comments
Fewer admissions with Hip POCUS

The Canadian healthcare system is perfect, eh? Uh, no not really. One of the more well-publicized and frustrating ways in which this imperfection manifests itself is the wait list for orthopedic consultation and elective surgery, the most notorious being joint replacement. All Canadian EDs probably see patients with some frequency who present with osteoarthritis of […]

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Why I prefer LOOKING at hearts

May 5, 2015 1 Comment
Why I prefer LOOKING at hearts

Seriously, if you haven’t yet learned how to LOOK at hearts with bedside ultrasound you are doing your patients a disservice.  The amount of critical information you are likely missing with auscultation is scary. I saw a 48 year old female currently receiving chemotherapy via portacath for metastatic colon CA.  Presents in the middle of […]

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Unexpected PCE

April 26, 2015 0 Comments
Unexpected PCE

If you only look for PCE when you expect it, you will probably miss some. The first patient had some sort of unexplained febrile illness with a left shift and a creatinine of ~540 or so. Her IVC didn’t indicate marked hypovolemia. I looked at her heart to see the chamber function and found a […]

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Appendicitis-perforated

April 21, 2015 0 Comments
Appendicitis-perforated

This patient gave a fairly convincing story for appendicitis. POCUS revealed a “pocket o’ pus” around the caecum (now->perforated appendicitis). I couldn’t see the appendix and the CT showed it hiding underneath the caecum. [Ed. note:  Free fluid around the bowels in the RLQ in someone with a history suspicious for appendicitis should always prompt […]

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Immediate diagnostic and therapeutic feedback with POCUS; one testicle at a time!

April 10, 2015 1 Comment
Immediate diagnostic and therapeutic feedback with POCUS; one testicle at a time!

Dr. Joel Turner, the emergency medicine ultrasound director at McGill University and staff at the Jewish General Hospital in Montreal sends another fantastic case of ultrasound guided testicular torsion reduction.  Is it time for every ED physician to learn this skill?  Time-critical care is our job! [ed]   Case: Immediate diagnostic and therapeutic feedback with POCUS; […]

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Clavicle Fracture-Do we need to Xray all of them?

April 6, 2015 0 Comments
Clavicle Fracture-Do we need to Xray all of them?

This young man was body checked. His clavicle was not obviously deformed. POCUS easily showed the fracture. I guess at some point we might not feel the need to do the X-ray.

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Send the right patients home with POCUS

April 4, 2015 0 Comments
Send the right patients home with POCUS

Dr. Tim Van Aerde sent us this great case which illustrates some important points. This lady came in with vaginal bleeding, hCG 2500 and very minor left flank pain. Vitals normal. Hemoglobin normal. In the past I would have sent this patient home with an ultrasound in the morning. Threw on the probe and saw […]

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Swollen finger? Take a bath!

March 31, 2015 2 Comments
Swollen finger? Take a bath!

Dr. Gordon presents a case of a swollen finger worth reviewing. POCUS is becoming extremely useful at investigating these patients as it allows great visualization of the tendon and sheath showing lacerations, foreign bodies and infection.  Being a dynamic exam, you can have the patient move their digits and watch the tendons slide. An important trick is […]

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