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).
Anmol P. Shrestha, Wolfgang Blank, Ursula H. Blank, Rudolf Horn, Susane Morf, Sanu K. Shrestha, Shailesh P. Shrestha, Samjhana Basnet, Anjana Dongol, Raj Kumar DangalRoshana Shrestha – Emergency Medicine Point of Care Ultrasound (EM-POCUS) is a diagnostic bedside tool for quick and accurate clinical decision-making. Comprehensive training in POCUS is a mandatory part of EM training in developed countries.
Kandria Ledesma, MD; Joseph Kim, MD; Allison Cohen, MD; Nicholas Bielawa, PA-C; Mathew Nelson, DO – Ischemic colitis is the most common form of gastrointestinal ischemia [1]. The diagnosis of ischemic colitis is made by clinical data and computed tomography (CT) imaging of the abdomen and pelvis [1]. While colonoscopy is considered the gold standard for diagnosis, this is not performed in the emergency department (ED) [2]. Few studies have been performed to describe the sonographic findings of ischemic colitis using point of care ultrasound (POCUS). We report a case that highlights the sonographic findings of ischemic colitis in a patient who had two separate visits to the ED, showcasing the utility of POCUS in making this diagnosis.
Brandon M. Wubben, MD; Jad Dandashi, MD; Omar Rizvi, MD; Srikar Adhikari, MD – Emergency physicians commonly perform ultrasound-assisted abdominal paracentesis, using point of care ultrasound (POCUS) to identify ascites and select a site for needle insertion. However, ultrasound-guided paracentesis has the benefit of real-time needle visualization during the entire procedure. Our objective was to characterize the performance of emergency physician-performed ultrasound-guided paracentesis using POCUS, their ability to achieve good in-plane needle visualization, and factors associated with procedural success.
Alexis Salerno; Resa E. Lewiss – The transvaginal pelvic point of care ultrasound (POCUS) examination remains a patient-centered and relevant examination. Since 2008, emergency medicine physicians are required to learn, perform, and interpret POCUS examinations to deliver safe and patient-centered diagnostic and procedural care. Pelvic POCUS is one of these core applications in the emergency physician scope of practice. A pelvic POCUS examination seeks to answer the focused question, “Is there an intrauterine pregnancy (IUP)” and risk stratifies the patient when ectopic pregnancy is a clinical concern.
David Jerome; Matthew Stacey; Joseph Newbigging – An 81-year-old man presented to urgent care for assessment of an area of erythema and tenderness on his right thigh after recent travel to Belize. Point of care ultrasound (POCUS) revealed a hyperechoic structure with acoustic shadowing in the subcutaneous tissue. Colour Doppler assessment of the structure produced a twinkle artifact. The structure was removed and pathology identified the object as a Dermatobia hominis larva (human botfly).
Derrick Huang, MD; Jacob Ruzicka, MD; Leoh León, MD; Latha Ganti, MD, MS, MBA, FACEP – Upper extremity acute limb ischemia (ALI) is a limb-threatening and potentially lethal pathology that is most commonly caused by vascular embolization. Outcomes of limb ischemia are time-sensitive due to the correlation between a longer time from symptom onset to intervention with a vastly higher risk of amputation. In this report, point of care ultrasound (POCUS) was utilized to rapidly diagnose a patient with a proximal right brachial artery embolic occlusion, prompting expedited surgical consultation and successful embolectomy.
M. Bryan Dalla Betta, DO; Dasia Esener, MD; William Swanson, MD; Andrew Kaddis, MD; Felipe Aguayo Romero, MD; J. Matthew Fields, MD – Sepsis is a syndrome characterized by infection, widespread inflammation and organ dysfunction affecting millions of people in the United States and across the globe each year. Despite recent improvements in sepsis care, it is still associated with high rates of morbidity and mortality, accounting for nearly 270,000 deaths and treatment costs over $20 billion in the United States annually.
Brian Kohen, MD; Michael Halperin, MD MPH; Gloria Felix, MD; Trevor Dixon, MD; Michelle Montenegro, MD; Fenil Patel, MD – Necrotizing fasciitis is a life-threatening polymicrobial skin and soft tissue infection that requires prompt diagnosis and treatment. Delays in diagnosis and treatment can result in an increase in morbidity and mortality [1]. Necrotizing fasciitis has historically been a clinical diagnosis. Patients with a high clinical suspicion for necrotizing fasciitis generally receive antibiotics and undergo emergent surgical debridement.