POCUS Journal Volume 07 Issue 01, released April 2022
Sara Obeid, MD MPH; Benjamin Galen, MD; Trevor Jensen, MD MS – Point of Care Ultrasound (POCUS) has the potential to rapidly aide in diagnostic algorithms at the bedside, however POCUS users are often faced with the dilemma of appropriate management of incidental findings.
Jason T. Nomura, MD; Matthew Flannigan, DO; Rachel B. Liu, MD; Daniel L. Theodoro, MD MSCI – Point of Care Ultrasound (POCUS) use by emergency physicians has grown in both breadth and depth of clinical use [1-3]. POCUS workflow is different from a traditional imaging-based specialist workflow because a single clinician orders, obtains images, interprets, and reports the exam results.
Lianne J. McLean, MB BCh BAO, MHI; Resa E. Lewiss, MD – Point-of-care Ultrasound (POCUS) skills are required competencies for emergency medicine and paediatric emergency medicine training [1,2,3,4]. Over time, more specialties will require these skills of their graduates. Experienced physicians who completed their training before POCUS requirements may ask: How can I gain POCUS skills training and competency?
Alanna O’Connell, DO; Al’ai Alvarez, MD; Peter Tomaselli, MD; Arthur Au, MD; Dimitrios Papanagnou, MD MPH; Resa E. Lewiss, MD – A Medical Education (MedEd) fellowship provides emergency medicine (EM) residency graduates the structured and rigorous training to develop skills as educators. Although not accredited by the Accreditation Council for Graduate Medical Education (ACGME), MedEd fellowships have established minimum curriculum standards [1].
Jacob E. Sundberg, MD; Ankit Mehta, MD – Point of care ultrasound (POCUS) is a reliable diagnostic tool for the evaluation of a patient with dyspnea. This case provides an example of an acutely dyspneic patient in which standard evaluation failed to elucidate the true etiology of the patient’s dyspnea.
Melissa Bouwsema, MD; Colin Bell, MD – A 51-year-old man with a history of nephrolithiasis presented to the Emergency Department after a sudden onset of left-sided groin pain and syncope. At presentation, he described his pain as similar to prior renal colic episodes. At his initial assessment, point of care ultrasound (POCUS) was used, which revealed findings consistent with obstructive renal stones, as well as a substantially enlarged left iliac artery.
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.
Khaled Taha, MD, MSc, MRCP, MRCEM; Tomás Breslin, MD, MRCP, FRCEM; John M. Moriarty, MD, FSIR; Shammy Ali, MBBS, MD; Bernhard Louw, MBChB, DipPEC (SA) – Paget-Schroetter Syndrome, or effort thrombosis, is a relatively rare disorder. It refers to axillary-subclavian vein thrombosis (ASVT) that is associated with strenuous and repetitive activity of the upper extremities [1]. Anatomical abnormalities at the thoracic outlet and repetitive trauma to the endothelium of the subclavian vein are key factors in its initiation and progression. Doppler ultrasonography is the preferred initial test, but contrast venography is the gold standard for diagnosis [1,2].
Olusegun Oduyoye, MBBS, MSc, FHEA, FRCPE; Euan Thomas, BSc, MSc
– Pyomyositis is an acute bacterial infection of skeletal muscle that results in localised abscess formation presenting with symptoms, including pain, swelling, erythema, and fever. It is usually associated with tropical climates; however, there has been an increasing number of cases presenting with pyomyositis in patients with a history of intravenous drug use [1-3].
Josu López Libano, MD; Lorenzo Alomar Lladó, MD; Leire Zarraga López – Takotsubo syndrome is a cardiomyopathy that can mimic an acute heart attack, in terms of clinical presentation, electrocardiographic changes, and findings on echocardiogram. Point-of-care-ultrasound (POCUS) can be used to detect this condition, even though the definitive diagnosis is made angiographically.