Issues: Vol 09 Iss 01 – APR 2024

POCUS Journal Volume 09, Issue 01, released April 2024

Terson Syndrome Diagnosed by Ocular Point of Care Ultrasound on the Medical Floor 

Mark Johnson, MRCP MBBCh BSc – In acute care environments, accurately assessing complications of intracranial pathology can be challenging. Ocular complications in acute intracranial disease are not consistently evaluated despite their high morbidity. We report on a case of monocular diplopia in a 63-year-old man with subacute traumatic brain injury with localized subarachnoid hemorrhage.

Gas Forming Pyogenic Liver Abscess Diagnosed by Point of Care Ultrasound 

Wei Ven Chin, MD MRCP; Mae Jane Khaw, MD MRCP – Gas-forming pyogenic liver abscess (GFLPA) carries a high mortality rate. Early identification of the source of infection in sepsis results in better survival. Bedside point of care ultrasound (POCUS) can be used to help localize a source of infection. A 59-year-old man presented with systemic inflammatory response syndrome (SIRS) and was diagnosed with GFLPA on the initial encounter via clinical assessment and POCUS examination.

Resolution of Sonographic Appendicitis in Pediatrics: a Point of Care Ultrasound Case-Series 

Eric Scheier, MD; Benjamin Taragin, MD – Studies of pediatric appendicitis treated conservatively show a considerable rate of recurrence. Point of care ultrasound (POCUS) imaging at our facility is routinely performed for abdominal pain and may be more likely than radiology-performed ultrasound to encounter cases that then self-resolve. We present a case series collected from a POCUS quality assurance review from 2019 through 2022.

Return of the Living Dead Gut – A Case Report of Ischemic Colitis Identified on Point of Care Ultrasound 

Kandria Ledesma, MD; Joseph Kim, MD; Allison Cohen, MD; Nicholas Bielawa, PA-C; Mathew Nelson, DO – Ischemic colitis is the most common form of gastrointestinal ischemia [1]. The diagnosis of ischemic colitis is made by clinical data and computed tomography (CT) imaging of the abdomen and pelvis [1]. While colonoscopy is considered the gold standard for diagnosis, this is not performed in the emergency department (ED) [2]. Few studies have been performed to describe the sonographic findings of ischemic colitis using point of care ultrasound (POCUS). We report a case that highlights the sonographic findings of ischemic colitis in a patient who had two separate visits to the ED, showcasing the utility of POCUS in making this diagnosis.

Testicular Torsion with Intact Blood Flow: A Point of Care Ultrasound Case-Series 

Eric Scheier, MD – Studies have demonstrated the high sensitivity and specificity of pediatric emergency department (PED) point of care ultrasound (POCUS) in the evaluation of testicular torsion. Rarely, testicular torsion may present with intact blood flow. Here, we present a case series of four children with testicular torsion confirmed intraoperatively, who had intact blood flow on POCUS.

Point of Care Ultrasound as a Key Tool in the Evaluation of a Woman with Syncope 

Jenniffer Katherine Guío Rodríguez, MD; Jenny del Pilar Rico Mendoza, MD; Elkin René Barrios Peralta, MD – Using point of care ultrasound (POCUS) to evaluate patients with syncope in the emergency department facilitates the timely diagnosis of life-threatening pathologies. Case: A 56-year-old woman presented to the emergency department of a hospital in Bogotá, Colombia, for a syncopal episode. Vital signs, physical examination, electrocardiogram, and routine laboratory tests were normal. Cardiac POCUS was performed, which identified an echogenic mass located in the left atrium, measuring 35x28mm, which in left atrial systole appeared to occupy the entire chamber.

Diagnostic Accuracy of Abdominal Point of Care Ultrasound in Primary Care: Study Design and Protocol 

Antonio Calvo Cebrián, MD; Rafael Alonso Roca, MD; Ignacio Manuel Sánchez Barrancos, MD – The aim of this study is to estimate the diagnostic accuracy of abdominal point of care ultrasound (POCUS) performed by family physicians (FPs) in primary care (PC), in comparison with the findings in the medical record (MR) at 12 months of follow-up. This study is conducted entirely in PC healthcare centers in Spain. Abdominal ultrasound scans performed by FPs (selected on the basis of their ultrasound knowledge and experience) are compared with the findings, or not, in the patient’s MR after a 12-month follow-up period.

Effectiveness of a Brief Point of Care Ultrasound Course at a National Nephrology Conference 

Abhilash Koratala, MD; Nilam J. Soni, MD MS; Rupal Mehta, MD; Nathaniel Reisinger, MD – The rising demand for point of care ultrasound (POCUS) instruction during nephrology fellowship has been limited due to a shortage of trained faculty and courses designed specifically for nephrologists. A hands-on POCUS pre-course was organized during the April 2023 National Kidney Foundation (NKF) Spring Clinical Meeting to address this challenge. The course consisted of pre-recorded lectures and a 4-hour hands-on workshop guided by multidisciplinary POCUS experts.

Emergency Physician Performed Ultrasound-Guided Abdominal Paracentesis: A Retrospective Analysis 

Brandon M. Wubben, MD; Jad Dandashi, MD; Omar Rizvi, MD; Srikar Adhikari, MD – Emergency physicians commonly perform ultrasound-assisted abdominal paracentesis, using point of care ultrasound (POCUS) to identify ascites and select a site for needle insertion. However, ultrasound-guided paracentesis has the benefit of real-time needle visualization during the entire procedure. Our objective was to characterize the performance of emergency physician-performed ultrasound-guided paracentesis using POCUS, their ability to achieve good in-plane needle visualization, and factors associated with procedural success.

Trends in Point of Care Ultrasound Familiarity Among Undergraduate Medical Clerkship Educators 

Nilan Schnure, MD; Mahmoud Mohamed Elfadil, MD; Wilma Chan, MD MSCE; Cameron Baston, MD MSCE; Frances Shofer, PhD; Nova Panebianco, MD MPH – Despite growing use of point of care ultrasound (POCUS), there remains a paucity of data about familiarity with POCUS among educators who dictate curricular content in undergraduate medical education. This paper aims to longitudinally characterize the level of comfort and frequency of POCUS use among faculty involved in undergraduate clerkship education.