Ultrasound-Guided Nerve Blocks for Flexor Tenosynovitis

John M. Bowling, Erick Zoumberakis – Performing an ultrasound-guided nerve block (UGNB) is now common practice in many emergency departments (EDs) and is considered a core skill according to the American College of Emergency Physicians (ACEP). Nerve blocks are mostly utilized for fractures and laceration repairs, however, these blocks have many other applications. We present a case of utilizing an ulnar UGNB in a patient with flexor tenosynovitis and a history of intravenous drug use (IVDU) when parental opiates proved to be ineffective.

A Young Man with Chest Pain

Anderson Wang, Aalap Shah – A calculous cholecystitis is a life-threatening diagnosis that is more commonly associated with ill patients in the ICU. We present a case of acute acalculous cholecystitis (ACC) in an otherwise healthy 18-year-old man who presented to the Emergency Department (ED) with right-sided chest pain that was ultimately diagnosed with point of care ultrasound (POCUS).

Point of Care Ultrasound as a Key Tool in the Evaluation of a Woman with Syncope 

Jenniffer Katherine Guío Rodríguez, MD; Jenny del Pilar Rico Mendoza, MD; Elkin René Barrios Peralta, MD – Using point of care ultrasound (POCUS) to evaluate patients with syncope in the emergency department facilitates the timely diagnosis of life-threatening pathologies. Case: A 56-year-old woman presented to the emergency department of a hospital in Bogotá, Colombia, for a syncopal episode. Vital signs, physical examination, electrocardiogram, and routine laboratory tests were normal. Cardiac POCUS was performed, which identified an echogenic mass located in the left atrium, measuring 35x28mm, which in left atrial systole appeared to occupy the entire chamber.

E-Point Septal Separation Accuracy for the Diagnosis of Mild and Severe Reduced Ejection Fraction in Emergency Department Patients  

José Atilio Núñez-Ramos, MD, MSc; María Camila Pana-Toloza, MD, MSc; Sheyla Carolina Palacio-Held, MD – Chest pain, dyspnea and syncope are among the most common reasons to seek care in the Emergency Department (ED). Chest pain accounts for more than a thousand visits per year [1], dyspnea and syncope represent approximately 7 to 8% of ED consults [2,3]. At this moment, a thorough cardiovascular evaluation cannot be accomplished only with physical examination. Valvular disease and systolic dysfunction diagnosis improve when evaluated with a physical exam along with cardiac ultrasound [4].