Archives

Infected Baker’s cyst, diagnosed in the emergency department using POCUS

by Joaquín Valle Alonso; F Javier Fonseca del Pozo; Eric Van der Bergh; Harriet Kinderman – 

Baker’s cyst is a closed collection of fluid that forms in the posterior aspect of the knee. Usually, it appears as a non-painful inflammation in the popliteal fossa. In adults, its aetiology is secondary to problems that cause distension of the knee joint. It is often associated with rheumatoid arthritis and osteoarthritis. Occasionally, the cyst may become oversized and rupture with the consequent leakage of synovial fluid into adjacent tissues, presenting a clinical course similar to acute thrombophlebitis.

Two cases of aortic emergency presenting with neurologic manifestations, aided by POCUS

by Muhammad Khidir, Mb Bch BAO; Nur Hanisah, Mb Bch BAO; Farah Alwi, Dr EmMed; Al-Hilmi Saim, MMed –

Acute aortic dissection and aneurysm are lethal vascular emergencies and may present with various clinical presentations including neurological manifestation. Thus, the diagnosis of aortic dissection and aneurysm can be challenging as it may mimic other disorders whereby misdiagnosis can be fatal. In district general hospitals where advanced radiological modalities are not widely available, Point of Care Ultrasound (POCUS) is a tool to diagnose aortic dissection and aneurysm rapidly and accurately.

Research: Emergency medicine residents’ acquisition of point-of-care ultrasound knowledge and their satisfaction with the flipped classroom andragogy

by Khalid Bashir MD; Aftab Azad, MD; Kaleelullah Saleem Farook, MD; Shahzad Anjum, MD; Sameer Pathan, MD; Zain Bhutta, MD; Stephen Hodges Thomas,MD –

One of the traditional approaches for knowledge transfer in medical education is through face-to-face (F2F) teaching. We aimed to evaluate the acquisition of knowledge about point-of-care ultrasound (POCUS) and learner’s satisfaction with the flipped classroom (FC) teaching approach.

Review: Paramedic POCUS, Turning Our Heads to the Prehospital Side of the Fence: A Narrative Review of Education, Training and Future Direction

by Cristina D’Alessandro PCP BA(Hons), Ian R. Drennan ACP  Phd (c), Joseph Newbigging MD CCFP (EM) FCFP, Amer M.  Johri MD MSc FRCPC FASE –

Portable ultrasound is a burgeoning technology with unrealized potential at a critical point in its evolution [1]. Francis Galton first generated ultrasound waves in 1876; however, it wasn’t until 1940 that ultrasound was first applied to clinical medicine [2]. Reaching a “tipping point”, ultrasound is being rapidly assimilated into many medical specialties beyond radiology, now in the hands of non-radiologist, non-cardiologist novel users [2].

Case Report: POCUS to FOCUS

by Maryam Al Ali, MBBS; Abeeha Gardezi, MBBsch; Michael Jalal, MBBS; Shihab Al Sheikh, MB.ChB. CABS. MRCS. PgCert medical ultrasound –

Point of care ultrasound (POCUS) plays an important role in the Emergency Department or in any Critical Care Unit. In our case, we present how a POCUS mnemonic guided us in diagnosing two fatal conditions in a single case.

Case Report: A cardiac mass diagnosed using Point-of-care ultrasound in a dyspneic patient. An integrated ultrasound examination of lung-heart-Inferior Vena Cava

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.

Case Report: Type 1 aortic dissection presenting as acute pericarditis: the roles of POCUS and transthoracic echocardiography

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.

Case Report: Early signs of tamponade may be detected by cardiac point-of-care ultrasound

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.

Case File: Point-of-care ultrasound should end the outdated practice of “marking for a tap”

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.