Skip to main content

Posts

CONSIDER THE PROBE: McConnell's Sign (Courtesy Dr. Jia)

CONSIDER THE PROBE: McConnell's Sign (Courtesy Dr. Jia) COVID-10 presented many challenges to emergency departments.  Early on, an association between COVID and thrombo-emoblic disease was discovered.  As this was a novel infection, there were no evidence-based rules to assist a provider when deciding when to work up a patient with presumed COVID pneumonia for a concurrent thromboembolism.  Seems like a great time to CONSIDER THE PROBE! Dr. Jia summarizes a great case where bedside ultrasound detected a McConnell's Sign, helping to diagnose a significant acute pulmonary embolism.  He goes on to give a nice review of McConnell's Sign.  Enjoy!
Recent posts

CONSIDER THE PROBE: US4 OCULAR TRAUMA (Credit: Dr. Stephen Cooper)

 CONSIDER THE PROBE: US4 OCULAR TRAUMA (Credit: Dr. Stephen Cooper) If you have been practicing emergency medicine in recent years, hopefully you have become comfortable utilizing POCUS in the evaluation of painless vision loss (vitreous hemorrhage vs post vitreous detachment vs retinal detachment).  It is less likely that you have been implementing ultrasound in your evaluations of facial trauma.  Dr. Cooper gives us a nice summary of how POCUS can help make important diagnoses related to trauma.  As always, remember to CONSIDER THE PROBE!

CONSIDER THE PROBE: AN IMPORTANT "CAN'T MISS" DIAGNOSIS DURING FLU SEASON (Courtesy Dr. Debessai)

While the past year has been a rather unusual influenza season, most years from December through February in the emergency department we are tripping over patients with "influenza-like illness".  While the vast majority of patients do indeed have a fairly benign viral syndrome, there are a few "can't miss' diagnoses that should always be considered.   Dr. Debessai presents a case where his use of POCUS helped him make an important diagnosis and changed the therapeutic plan as well as the disposition.  So next flu season, consider bringing the ultrasound into the room with you when evaluating patients with ILI symptoms...

REGIONAL ANESTHESIA REMIX: Sciatic Nerve Block (Courtesy: Dr. Mikell)

            REGIONAL ANESTHESIA REMIX:  Sciatic Nerve Block (Courtesy Dr. Carlos Mikell) Green Team is just more fun when you are blocking out the pain!  Dr. Mikell introduces and summarizes the Sciatic Nerve Block, which he utilized to assist in the reduction of a complicated ankle fracture.   Consider this block for your next LE complex laceration, dislocation or fracture; and remember when on shift to always CONSIDER THE PROBE!

CONSIDERE THE PROBE: Should I give a fluid bolus? (Courtesy: Dr. Aceves)

 Dr. Aceves tickled my heartstrings with one of my favorite POCUS topics--US-guided resuscitation.  Dr. Aceves introduces some (sonographic!) tools to add to your repertoir (sp?)  to individualize your resuscitation to the patient in front of you.  A nice introduction to utilizing IVC, Carotid flow parameters, and ECHO to help identify which patients may be fluid tolerant (and perhaps even fluid responsive!).  This is one of critical care's most difficult questions to answer.  While there is no perfect solution or easy answer, these tools may prove helpful in making the decision: will you order another bolus or is it time to start pressors...

CONSIDER THE PROBE: POCUS4LP (Courtesy: Dr. Dickson)

  CONSIDER THE PROBE: POCUS4LP Not all spines were created equal.  When you are starting out, Lumbar Puncture can be an intimidating procedure to perform.  While some patient's have incredible surface anatomy to guide your procedure, for many others, it is extremely challenging.   Dr. Bradley Dickson reviews the techniques of ultrasound-guided lumbar puncture.  There is good evidence that utilization of ultrasound improves our overall performance of this procedure (especially in patients with a higher BMI...).   Enjoy and always remember on shift to CONSIDER THE PROBE!

REGIONAL ANESTHESIA REMIX: FOREARM BLOCKS (Courtesy: Dr. Koes)

   CONSIDER THE PROBE/REGIONAL ANESTHESIA REMIX:  FOREARM BLOCKS (Courtesy Dr. Joseph Koes) Another great review from our very own Dr. Koes on utilizing regional anesthesia in the forearm.  Whether it is a complicated hand laceration, a boxer's fracture needing reduction, or a large abscess, consider utilizing a nerve block to alleviate your patient's discomfort.   Enjoy and remember next shift to CONSIDER THE PROBE!