Courtney Owens, Lindsey Chaudoin – An 11-year-old postmenarchal female presented to the pediatric emergency department (ED) with 2 days of periumbilical and right lower abdominal pain. Radiology-performed ultrasound (RADUS) did not visualize the appendix, and there was a plan for surgical consultation to decide between serial abdominal exams versus computed tomography (CT) scan.
Alisha Ching, Charles William Kropf – Application of ultrasound to evaluate pediatric respiratory disease in the emergency department setting is rapidly growing, particularly as we often weigh the risks of exposure to radiation with other readily available imaging modalities in the acute care setting.
Sivasenthil Arumugam, Hari Kalagara – Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are frequently used for diabetes and weight loss management. The GLP-1 RA drugs delay gastric emptying and are a concern for increased risk of aspiration in the perioperative period. Current recommendations to hold these medications before surgery are consensus based.
Wei Ven Chin, Mae Jane Khaw – Dengue fever is an arthropod-borne viral disease that is widespread throughout the world. We report a case of dengue cardiomyopathy that was detected and treated to best effect using point of care ultrasound (POCUS) and the VExUS score.
Mohannad Wazirali, Paul M. Shaniuk – Point of Care Ultrasound (POCUS) is used to evaluate many clinical scenarios. Chest POCUS has been integrated as a part of a clinical protocol to assess patients with lung pathology [1].
Marwa L. Ali, MD; Sean Beckman, DO; Stephen Alerhand, MD – A pseudoaneurysm results from a tear in a vessel wall. This leads to extravasation of blood into adjacent tissue and eventual formation of a fibrous sac that maintains continuity with the lumen. These vascular injuries very rarely occur in deeper vessels of the face (e.g. maxillary artery) due to protection from structures like the bony mandible and parotid gland. If left untreated, these pseudoaneurysms can lead to infection, thromboembolism, hemorrhage, and compression of surrounding structures such as facial nerve branches
Heather Andrade, MD; Julie Carroll, MD; Evan Tomkiewicz, MD; Edwin Jackson, DO MBA RDCS – Catheter-associated right atrial thrombus (CRAT) is a potential complication of central venous catheter placement and is associated with an increase in morbidity and mortality. The precise incidence of CRAT is unknown, and there is a lack of clear screening and management guidelines for this condition. Additionally, the diagnosis is often missed when using transthoracic echocardiography (TTE) alone. Here, we present a case of a 64-year-old female admitted to the medical intensive care unit with multiorgan dysfunction who was diagnosed with hemodialysis catheter-associated right atrial thrombus (HDCRAT) via intensivist-performed point of care transesophageal echocardiography (TEE) after an initial TTE was negative.
Zahraa Y. Alqallaf, Ossama S. Maadarani, FRCP; Mohamed E. Elhabibi, MD; Mohamad Abdelfatah, MD; Zouheir I. Bitar, FRCP EDIC EDEC – Point of care ultrasound (POCUS) can make an expedited diagnosis, which might lead to early correct management. POCUS should be used in a systemic and integrated approach to evaluate multiple organs in patients with sepsis and septic shock. We present a rare case of sepsis due to nontyphoidal Salmonella endocarditis with splenic abscess in which a multiorgan POCUS examination led to expedited treatment.
Daniella Lamour, DO; Robert A. Farrow, DO; Jean Pierre; Daniel Puebla, MD; Paul Khalil, MD – Larva migrans is a cutaneous parasitic infection that occurs when an immature hookworm larva inadvertently penetrates the dermis of a human, typically on the extremities. Traditionally, a clinical diagnosis is made when a tortuous/serpiginous eruption is seen superficially in the skin with complaints of intense pruritus. Point of care ultrasound (POCUS) is a useful diagnostic tool for soft tissue complaints in the emergency department (ED). We describe a case of an 18-year-old woman who presented to the ED with foot pruritis four days after walking on the beach barefoot.
Mark Johnson, MRCP MBBCh BSc – In acute care environments, accurately assessing complications of intracranial pathology can be challenging. Ocular complications in acute intracranial disease are not consistently evaluated despite their high morbidity. We report on a case of monocular diplopia in a 63-year-old man with subacute traumatic brain injury with localized subarachnoid hemorrhage.