POCUS Journal Volume 08, Issue 02, released November 2023
Zachary Boivin; Emily Mensel; Trent She – A 67-year-old female patient with a past medical history of hypertension presented to the emergency department (ED) with abdominal pain. She reported intermittent palpitations for the past three months, fevers for one week, and a recent admission three days prior for a pleural effusion and atrial fibrillation.
R. Haridian Sosa Barrios; V. Burguera Vion; E. Casillas Sagrado; D. Villa Hurtado; S. Jiménez Álvaro; I. Martín Capón; M. Fernández Lucas; Maite E. Rivera Gorrín – Renal artery stenosis of the kidney allograft is an infrequent finding, as is mechanical kinking of the artery. The right renal artery’s greater length in comparison to the vein, limited space within the iliac fossa, and post-operative shifting in graft components all increase the likelihood of kinking. Renal artery stenosis and kinking can either coexist or kinking can result in stenosis. Nevertheless, since both these abnormalities can be corrected with timely treatment, early diagnosis is crucial to prevent permanent to the renal allograft.
Angelina Voronina; Nachele Aurelien; Edward Bergin; Paula Roy-Burman – Paracentesis is a procedure routinely performed at the bedside in the evaluation and management of ascites. While point of care ultrasound (POCUS) assistance during paracentesis is known to reduce the risk of procedure-related complications, intraprocedural POCUS to overcome commonly occurring issues, such as obstructed flow through the centesis catheter, remain poorly described.
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).
Ysabella Esteban; Jackeline Rodriguez-Smith; Marie Tominna; Amy Cassedy; Arthur B. Meyers; Michael Henrickson; Tracy V. Ting; Patricia Vega-Fernandez – Point of care pediatric musculoskeletal POCUS scanning and scoring protocols for childhood arthritis have emerged in recent years. However, pediatric musculoskeletal POCUS curricula in rheumatology fellowship programs are limited due to availability of trained faculty and resources. This proof-of-concept study investigated the effectiveness of educational methods for a pediatric musculoskeletal POCUS scoring protocol among fellows and physicians of differing subspecialties.
Antonio Gonzalez Fiol; Pedro Acevedo Rodriguez; Xiwen Zhao; Robert Gaiser; Adriana Herrera; Aymen Alian – Despite its many cited benefits, ultrasound guidance for neuraxial procedures is not widespread in anesthesiology. Some cited limitations include device cost and accessibility. We test the hypothesis that a handheld and relatively inexpensive ultrasound can improve neuraxial proficiency (e.g., decreased needle manipulations and block time). This prospective study compared the number of needle passes, redirections, and procedural time between epidural placed with a handheld ultrasound versus landmarks.
Ammar Saati; Arthur Au; Aditi U. Joshi; Rebecca Davis; Frances Mae West; Resa E. Lewiss – The SARS-CoV-2 pandemic accelerated the use of telehealth with consumer adoption increasing from 11% in 2019 to 46% in 2020 [1,2]. A telehealth visit often replaced an in-person office visit for infection control and safety to the patient and healthcare team. Telehealth, the use of technology for remote medical encounters, can be an efficient way to connect doctor and patient synchronously or asynchronously. “Store and forward,” a form of asynchronous telemedicine utilizes uploaded pictures by patients for evaluation by a clinician. This aids the patient evaluation and improves the diagnostic capacity of a virtual examination.
Stephanie R. Davenport; Nadya Ben Fadel; Jorge Davila; Nick Barrowman; Vid Bijelic; Allan E. Shefrin – Over the last 15 years, point of care ultrasound (POCUS) has emerged as one of the most important and most utilized tools in pediatric emergency medicine (PEM) [1,2]. What was initially used as a screening tool in the assessment of major traumas to help determine the requirements for further investigation or management is now used in over 40 clinical applications including the assessment of intra-abdominal hemorrhage, cardiac views to assess function and fluid, the identification of testicular torsion and the evaluation of skull fractures [1], to list a few.
Alireza Nathani; Shekhar A. Ghamande; Sarita Kambhampati; Braden Anderson; Matthew Lohse; Heath D. White – Intracerebral hemorrhage (ICH) results in spontaneous bleeding into the brain. In the United States, it accounts for 10-15% of all strokes [1]. It is associated with very high morbidity and in-hospital mortality of 32.4% [2]. In adults, the intracranial compartment is protected by the skull. The contents of the intracranial compartment include brain parenchyma, cerebrospinal fluid, and blood. Homeostasis of all three components is required to keep intracranial pressure less than 15mmHg.
Thomas F. Heyne; Kay Negishi; Daniel S. Choi; Ahad A. Al Saud; Lucas X. Marinacci; Patrick Y. Smithedajkul; Lily R. Devaraj; Brent P. Little; Dexter P. Mendoza; Efren J. Flores; Milena Petranovic; Steven P. Toal; Hamid Shokoohi; Andrew S. Liteplo; Benjamin P. Geisler – Even as newer viral variants have proven less deadly than the initial waves, Coronavirus Disease 2019 (COVID-19) continues to affect our world. Although critical to mitigate the spread of disease, rapid and accurate diagnosis of COVID-19 can be challenging.