Happy Monday everyone! Welcome to your weekly dose of POCUS (last week replaced by ultra-rounds). Before we get into the case I'd like to welcome our POCUS rotators for the month: Paul Cameron a CCW PGY4, and Erica Beatty a PGY4 Emergency Medicine resident from Laval. I'd also like to Thank everyone who made it out to POCUS Jeopardy last Thursday! The Case: A [...]
Before we get to this week's clip, I'd like to offer a brief congratulations to everyone who has completed the first step of their royal college examinations - including both of our current rotators Alice and Fu. This week we have some ED-POCUS team curated content. Not sure who took the clip, but thanks ED team! The Case: A 42M (was probably just minding [...]
The COTW: A young male with a collagen-vascular disorder presents with shock. Here is one view from his POCUS, what do you think? Leave a comment below! Answer from Last week: This young man has a very broken looking heart, and it wasn't because his true love crushed him on Valentine's day - he has a dilated cardiomyopathy. Vince Lau, our POCUS alumnus and echo-aficionado [...]
In this case a sudden deterioration in the emergency department prompts a TTE which shows some concerning physiology. It is not until the TEE is inserted, however, that the culprit disease can be identified. *Images courtesy of Dr. Drew Thompson, Division of EM, Western University https://www.youtube.com/watch?v=i8gAObUA-vY Case Highlights: *TEE in the ED is valuable for critically ill patients *TEE has advanced diagnostic potential, including the identification [...]
In this case you will see 2 echos from the same patient only 1 day apart. The patient had raging septic shock from a skin source and was requiring significant hemodynamic support. You can appreciate the cardiac dysfunction from a 2D point of view but also from a quantitative point of view. The next day - you will see significant changes, now off inotropes (epinephrine, milrinone [...]
By Rob Leeper, MD, FRCSC The Critical Care Outreach Team is called to asses a 64 year old male on the thoracic surgery floor complaining of increasing shortness of breath and hypotension. He is status post left upper lobectomy for non small cell lung cancer 1 year ago. He has been re-admitted for workup of a possible recurrence in his mediastinal nodes. In the 24 [...]
A 55 year old male presents to the emergency department with a 5 day history of increasing shortness of breath on exertion and recent leg “cramps”. In the 24 hours prior to presentation he had noticed increasing back pain and hyperventilation, with one episode of hemoptysis. The patient was tachycardic, transiently (30 minutes) hypotensive and had an oxygen saturation of 90% on non-rebreather mask with [...]
A 28 year old male presents with a painful right thigh. On exam you find a indurated, red area overlying the inguinal region of his right leg. He says it has been grumbling for some time with a few courses of antibiotics that have now stopped containing it. It is clearly infected. You are uncertain however, what the yield of an I and D will [...]
Case of the month #1 is that of a 66 male previously "healthy" presenting with progressive dyspnea for several days. Findings are consistent with what diagnosis? Leave your answers or questions in the comment area! http://www.youtube.com/watch?feature=player_embedded&v=0hRtlR9AKqw http://www.youtube.com/watch?feature=player_embedded&v=8mwjC0qcE8c Click HERE to compare your interpretation to the answer.
