POCUS Evaluation in Acute Kidney Injury

Vanessa A. Hoytfox, MD; Brittney C. Ward, DO; Emily J. Cox PhD; Kang X. Zhang MD FACP – Acute kidney injury is a common clinical problem encountered in general internal medicine. The evaluation of acute kidney injury is mainly driven by the patient’s clinical history, physical exam, and laboratory investigation including urinalysis and urine sediment examination. Point of care ultrasound (POCUS) may be a useful tool to help clinicians to narrow and/or prioritize differential diagnosis in patients presenting with acute kidney injury.

Real-time Point-of-care Ultrasound for the Diagnosis and Treatment of Testicular Torsion

Rahul V. Nene, MD, PhD; Rachna Subramony, MD; Michael Macias, MD; Colleen Campbell, MD; Amir Aminlari, MD – Testicular torsion is a surgical emergency that needs prompt diagnosis and treatment. Point-of-Care ultrasound (POCUS) can not only establish the diagnosis but also guide the Emergency Physician in evaluating the response to manual detorsion.

Diagnosis of Central Retinal Artery Occlusion in the Emergency Department Using POCUS: A Case Series

Nicholas Cozzi, MD, MBA; Kendall Stevens, BS; Yeoshina Pillay, MD; David Moore MD; Matthew Flannigan, DO; Mariah Barnes, MD; Matthew Singh, MD; Melisa Gagrica, MD; Christian Kolacki, MD; Jennifer Bach, DO; Dale McNinch, MD; Drue Orwig, DO; Jeffrey Jones, MD – Central Retinal Artery Occlusion is a cause of vision loss that warrants emergent evaluation. Ocular Point of Care Ultrasound (POCUS) is a non-invasive, inexpensive, and rapid modality to establish diagnosis with reduced time to consultation and treatment.

How Point-of-Care Ultrasound Led to a Diagnosis of May-Thurner Syndrome

Daniel L. Belkin, BFA; Mitchell D. Belkin, BA; Maedeh Ashrafi, MD; Charan Vegivinti, MD; Yung-Hsien Wang, MD; Leonidas Palaiodimos, MD – A 65-year-old man with a history of a left-sided inguinal hernia presented with three days of left-sided groin pain worsened with exertion and fatigue. The patient was afebrile but tachycardic, and physical examination revealed a tender, erythematous immobile bulge in his left groin.

Use of point-of-care ultrasound to diagnose spontaneous rupture of fibroid in pregnancy

Stephen Lammers, MD; Christopher Hong, MD; Jared Tepper, MD; Christy Moore, BS, RDMS, RVT; Cameron Baston, MD, MSCE; Cara D. Dolin, MD, MPH – Complications of fibroids in pregnancy are well known, including postpartum hemorrhage, labor dystocia, and cesarean delivery. Outside of pregnancy and labor, the rare occurrence of spontaneous fibroid rupture has been documented.

Postpartum reverse-Takotsubo from pheochromocytoma diagnosed by bedside point-of-care ultrasound: A case report

Jordan K. Leitch, MD, FRCPC; Anthony M.-H. Ho, MD, FRCPC, FCCP; Rene Allard, MD, FRCPC; Glenio B. Mizubuti, MD, MSc – Point-of-care ultrasound is invaluable in the setting of obstetric anesthesia, where the differential diagnosis for dyspnea, hypoxemia and/or hemodynamic abnormalities is broad. This report describes a previously apparently healthy parturient with an uncomplicated pregnancy at 35-weeks gestation who underwent an emergency cesarean section under general anesthesia due to severe acute abdominal pain and fetal bradycardia.

Interscalene Block in an Anesthetized Adult with Hypertrophic Obstructive Cardiomyopathy Undergoing Clavicle Fracture Reduction

Anthony M.-H. Ho, MD, FRCPC, FCCP; Joel Parlow, MD, FRCPC; Rene Allard, MD, FRCPC; Michael McMullen, MD, FRCPC; Glenio B. Mizubuti, MD, MSc – Whether regional anesthesia procedures should be performed in heavily sedated/anesthetized adults remains controversial. One of the purported advantages of performing regional nerve blocks in conversant patients is early warning against major nerve injury and, arguably, early detection of local anesthetic systemic toxicity.

Postpartum Hemorrhage Emergency Management Using Focused Assessment With Sonography For Obstetrics (FASO): A Case Report

by C. Rincón ; J. Cubillos; C. Arzola
Postpartum hemorrhage is the leading cause of maternal death around the world according to World Health Organization [1]. While cesarean delivery is a risk factor, uterine atony is the main etiology [2]. Cesarean delivery and concomitant tubal sterilization are a known risk of postoperative intra-abdominal bleeding, which can be insidious and difficult to diagnose in the recovery period. Furthermore, a late diagnosis can lead to a less than optimal management. Point-of-care ultrasonography is an available technique that can contribute to a prompt diagnosis and accurate decision-making [3]. We present a case of a patient in postoperative care after cesarean delivery and tubal sterilization who developed hypovolemic shock symptoms, without any sign of uterine atony or vaginal bleeding. Focused assessment with sonography for obstetrics (FASO) was quickly performed in the recovery room to diagnose intra-abdominal bleeding and decision-making to perform an emergency surgical intervention.