Takaaki Mori, MD, MRCPCH, MSc; Sung Shin Teng, MBBS, MRCPCH, FAMS – A previously healthy, 4-year-old boy visited our emergency department due to chest pain after a fall from a skate scooter. Physical examination revealed tenderness over the sternal body. Point of care ultrasound (POCUS) of the sternum demonstrated a discontinuation of a hyperechoic structure of the sternal cortex, suggesting a sternal fracture.
Helen J. Lu, MD; Edward H. Lee, MD; Stephen Alerhand, MD – Bladder rupture is an uncommon injury that leads to significant morbidity and mortality. Though occurring mostly due to trauma, this life-threatening pathology may also occur spontaneously or after a procedure such as transurethral resection of bladder tumor (TURBT). Computed tomography (CT) cystography is the standard imaging modality for diagnosis. However, this test is unlikely to be ordered in a patient with undifferentiated abdominal pain unless there is specific suspicion for this diagnosis.
Mariela Skendi , MD, MSc; Roxane Liard , MD, MSc; Charlotte Besacier , MD; Jean-Michel Correas , MD, PhD; Sohela Moussaoui , MD, MSc; Julie Chastang , MD, MSc; Gladys Ibanez , MD, PhD – The main objective of this study is the evaluation of the accuracy and reliability of a handheld point of care ultrasound device (POCUS-hd) for intrauterine pregnancy (IUP) detection compared to comprehensive reference transabdominal ultrasound (TU).
Ann Young, MD PhD; Benoit Imbeault, MD; Alberto Goffi, MD; Alireza Zahirieh, MD; Claire Kennedy, MD; Daniel Blum, MDCM; Ron Wald, MDCM MPH; William Beaubien-Souligny, MD PhD – In nephrology, point of care ultrasound (POCUS) has multiple applications including the rapid evaluation of acute kidney injury, enhancing the initial evaluation of chronic kidney disease, direct evaluation of vascular access, and improved fluid balance management in acute and chronic settings. Recently, the role of POCUS has been formally acknowledged by the American College of Physicians and curricula specific to nephrology have been proposed.
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.
Steven Fox, MD; Michelle Fleshner, MD MPH; Collin Flanagan, DO; Thomas Robertson, MD; Ayako Wendy Fujita, MD; Divya Bhamidipati, MD; Abdulrahman Sindi, MD; Raghunandan Purushothaman, MD; Thuy Bui, MD – A quality assurance system is vital when using point-of-care ultrasound (POCUS) to ensure safe and effective ultrasound use. There are many barriers to implementing a quality assurance system including need for costly software, faculty time, and extra work to log images.
Jeffrey Lam, MD; Sherwin Wong, BHSc MD; Nicholas Grubic, BScH; Salwa Nihal, MD(MBBS) MPhil MSc; Julia E. Herr, MSc; Daniel J. Belliveau, MD; Stephen Gauthier, MD; Steven J. Montague, MD; Amer M. Johri MD MSc FRCPC FASE – The ability of point-of-care ultrasound (POCUS) to provide rapid and accurate bedside assessment of both the heart and lungs allows it to be a powerful tool in the management of patients presenting with dyspnea. However, while ultrasound equipment is readily available even in remote healthcare settings in Canada, physicians lack effective training opportunities to develop expertise in this potentially life-saving skill.
by Maria Viviana Carlino MD; Costantino Mancusi MD; Alfonso Sforza MD; Giorgio Bosso MD; Valentina Di Fronzo MD; Gaetana Ferro MD; Giovanni de Simone Prof.; Fiorella Paladino MD –
A 74-year-old woman with history of hypertension presented to the Emergency Department (ED) with severe resting dyspnea and swelling in the feet, ankles and legs. She was on treatment with furosemide and a beta blocker. At the time of admission blood pressure was 145/88 mmHg, heart rate (HR) 99 bpm, regular, oxygen saturation was 89% (FiO2 21%) and respiratory rate was 17 breaths/min.
by Bill Ayach MD PhD; Aadil Dhansay MD1, Andrew Morris MD; James W. Tam MD; Davinder S. Jassal MD –
A 59 year old male presented with a 1 day history of non-exertional chest pain that was pleuritic in nature and aggravated by lying flat. His chest pain symptoms were preceded by a one week history of “flu-like” symptoms. Physical exam demonstrated a blood pressure of 114/55 mmHg, heart rate of 75 bpm, and a normal oxygen saturation on room air. Cardiac examination revealed a biphasic pericardial rub vs. to-and-fro murmur.
by Michael Cenkowski, MD; Amer M. Johri, MD; Raveen Pal, MD; Jennifer Hutchison, RDCS –
A 35-year-old male with a past medical history of end stage renal disease on hemodialysis and a chronic pericardial effusion secondary to dialysis presented to the Emergency Room (ER) with a 2-week history of a flu-like illness and pleuritic chest pain. He was compliant with dialysis three times per week. His blood pressure was 150/85 mmHg with a heart rate of 85 beats per minute and the remainder of his vital signs were stable. Pulsus paradoxus was not present.