Med students & #POCUS
June 8th, 2017
Medical schools across the world are incorporating POCUS into their undergraduate curriculum. A natu[...]
Cases
Ectopic & Left FAST
This patient who was known to be pregnant came in quite shocky. POCUS showed blood around the spleen only, none in Morison’s Pouch or in the pelvis. A bit weird? Maybe because the ectopic was in the left tube? The patient went right to the OR without any further imaging and did well. [Editor’s note: […]
Sternal Fracture
This fellow had an airbag/steering wheel injury. His sternum was tender over the fracture seen on POCUS. These are amazingly easy to find. Using a linear probe in the longitudinal plane, slide it cephalad and caudad along the sternum. I doubt this would have been seen on X-ray, the displacement is around 1 mm. [Editor’s […]
Scaphoid Fracture
This is from EDE2. You use the linear probe and slide up the lateral radius up to the snuff box looking for a sort of saddle back mountain shape (on the normal side). You can see the fracture discontinuity on the injured side. [Editor’s note: POCUS is good to rule in a scaphoid fracture. But […]
Common Bile Duct: How useful is it for us to image?
This patient initially gave a history of two months of upper abdominal pain. I was looking at his GB, which seemed normal when I came upon this tubular structure with no flow on Doppler. It certainly looked to be a (very dilated) CBD. Once I saw it, it was natural to ask […]
Localized PCE
I tend to think of pericardial effusions (PCE) as being very uniform around the heart. This one was very localized to the area noted on the image. The CT Abd. (I didn’t order it!) showed the same PCE. The history was severe diarrhea and weakness. I was a bit worried about the dilated right ventricle […]
Smith’s Fracture
This patient had a displaced looking wrist. However the POCUS didn’t look particularly displaced at all. I was wondering about the discrepancy but not enough to get the old brain in gear (do U/S waves cause dementia in the operator?). I should have learned from my last POCUS on a Smith’s that they look very […]
Dr. Richard on Armpits, Metal Rods, Pus, and T-shirts
Here’s a neat case from Dr Bernard Richard from Valleyfield in la belle province… A 30 y.o. man fell on a metal rod a week ago. He was seen in the ED and had his 10 cm right axillary wound sutured. I saw him a week later for 4 cm lump that was located 15 […]
Nobody expects the liver abscess
I reviewed the computer charting, elderly lady with one day history of fever, vomiting, diarrhea and confusion. Sounded like a boring old gastro, give her fluids, take cultures and refer. No need to drag the U/S to the room when I’m already behind and pressed for time. Still, spare the probe and spoil the patient. […]
Time is testicle!
Scrotal EDE is one of the topics that Greg presents at EDE 3. While not a life-threatening entity (try telling that to an 18 y.o. male!), it still carries with it significant morbidity. Ultrasound is key to the diagnosis and can help assess the success of attempts at de-torsion. I recently saw an 18 y.o. […]
Weird Symptoms
This patient was in his 70s with the usual litany of diseases and medications. He actually looked quite well. He complained of pain from his R neck to his R flank. The physical exam was not helpful. I had no inkling of what was wrong. I POCUS’ed his carotids/jugulars/CVS/Aorta/Kidneys/liver/spleen/bladder and all looked fine. His GB […]
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