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.
by Anna Platovsky, MD and Benjamin T. Galen, MD –
A 55 year old man with a history of alcoholic cirrhosis decompensated by esophageal varices status post banding presented to the emergency room with abdominal pain. He also noted increased abdominal girth with associated poor oral intake and early satiety as well as a 10 lb. weight gain over 2 weeks. On examination, the patient was afebrile with stable vital signs and no respiratory distress. His abdominal examination revealed tense ascites with mild tenderness to palpation of the left upper quadrant. There was no jaundice or asterixis. Laboratory testing was significant for mild thrombocytopenia but no leukocytosis or abnormal liver tests. Liver synthetic function was preserved.
by Victor Istasy MD, FRCPC; Tim Lynch MD, FRCPC; Rodrick Lim, MD, FRCPC –
A healthy, four month-old female infant presented to a local emergency department with a 12-hour history of decreased activity, non-bilious vomiting and one episode of dark red blood in the stools. There was no history of fever. Telephone consultation was completed and the patient was transferred to a tertiary, pediatric centre for further evaluation. On arrival, the infant appeared pale and was lethargic during the exam.
by Rimi Sambi, MD and Heather Sawula, MD; Brent Wolfrom, MD; and Joseph Newbigging, MD –
As point of care ultrasound (PoCUS) becomes increasingly popular and a standard of care in many clinical settings, the interest for integration in medical undergraduate curriculum is also growing. This project aims to assess whether formal bedside Focused Abdominal Scan for Trauma (FAST) exam training of medical students increases their knowledge and comfort with the use of bedside ultrasound in a family medicine setting at Queen’s University.