The Importance of Serial POCUS Exams – Dual Pathologies in Play

Rahul Nair; Jonathan Zuo; Ariel L. Shiloh – Serial point of care ultrasound (POCUS) exams are essential to assess acute pericardial effusions which can rapidly evolve into cardiac tamponade. A typical presentation includes dyspnea, tachycardia, and chest pain. Importantly, serial cardiac exams in such high-risk patients can detect other concurrent pathologies. We present an unusual case of a patient who initially presented with an acute circumferential pericardial effusion and upon serial POCUS exams developed an unexpected Takotsubo cardiomyopathy in the setting of cardiac tamponade.

Exploring the Applicability of Pre-Anesthetic Cardiac POCUS in Unexpected Conditions: Could it be Helpful?

Rodolfo C. Sabogal – Formal preoperative echocardiography has traditionally been recommended when there is substantial cardiovascular disease without recent follow up, unexplained dyspnea, a functional class less than 4 METS or a Duke Activity Status Index less than 34. However, it is important to note that certain patients may present with a variety of cardiac abnormalities due to their preexisting condition or multiple treatments, and these individuals warrant consideration. The objective of pre-anesthetic cardiac POCUS is to provide clinical information in a timely manner.

POCUS Confirmation of Intraosseous Line Placement: Visualization of Agitated Saline within the Right Heart in a Critically Ill Infant

Inbar S.Y. Plaut, MD; Zachary W. Binder, MD – Intraosseous (IO) line placement can be a life-saving procedure in the management of critically ill patients.  Confirmation of correct IO line placement can be difficult. Prior studies have examined the use of point of care ultrasound (POCUS) to confirm IO line placement by using power Doppler over bone to detect flow within the intraosseous space. This case illustrates a novel use of POCUS in which agitated saline is visualized within the right heart as a means of confirming correct IO placement.