Subscribe via RSS Feed

Do your consultants believe your scans?

November 8, 2015 4 Comments
Do your consultants believe your scans?

I would like a show of hands, or emoji hands, as to how many of you have consultants who will act on your findings without further imaging. There is a learning curve and a trust that has to evolve in most consultative processes.  You get enough calls correct and the trust hopefully begins to grow. […]

Continue Reading »

Dipping sauce

November 3, 2015 0 Comments
Dipping sauce

EDE 3 is coming up this weekend at Sunnybrook. Ben, Greg, and the gang will be teaching a bunch of new nerve blocks. When doing these and other sterile ultrasound-guided procedures, the setup is key. To use a term from Dr. Scott Weingart (@emcrit), many microskills come up…right down to the ultrasound gel. Instead of […]

Continue Reading »

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 […]

Continue Reading »

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 […]

Continue Reading »

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 […]

Continue Reading »

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. […]

Continue Reading »

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 […]

Continue Reading »

Do you use M-mode much?

September 10, 2015 2 Comments
Do you use M-mode much?

  There are two types of EM POCUS users, those that use M-mode all the time and those that rarely use it. As a POCUS educator I teach M-mode for various applications but admit that I apply it sparingly, often using the “eye-ball” technique for cardiac and pulmonary scans.  When it comes to impact on […]

Continue Reading »

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 […]

Continue Reading »

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 […]

Continue Reading »