Check out the awesome lecture below by EM US Fellow Dr. Tina Sundaram. Read the Russell paperon the emergency ultrasound of acute scrotal pain while listening to the podcast. For more FOAMed fun check out the Echo page.
A 74 y/o F with pmhx of metastatic breast cancer, IDDM, HTN presents after a syncopal episode. The patient notes that for the past 2-3 days she has been experiencing some lightheadedness and shortness of breath with exertion. She is presently undergoing chemotherapy (I'd throw in some random chemo drus here, but lets face it, we wouldn't know them anyways...) and radiation. She notes that she hasn't been eating/drinking very well. She denies fever, cough, hemoptysis, leg pain/swelling. She has mild nausea but no abdominal pain. As you peek up at the monitor, you note that the patient’s HR is ~ 135 and her BP is 88/56 . Her O2 saturation is 99% and the nurse told you that she was afebrile. Taking a look at this patient, she looks ill-appearing and anxious. Her extremities are cool to touch. You quickly decide that Room 33 might not be the best place to manage this patient and that she would be better served in a RESUS station. As you wheel the patient to RE
49 y/o M with hx of HTN, HLD, IDDM presents with non-traumatic L-sided painless visual loss. The patient states that several hours prior to presentation he developed blurry vision in his L eye. On quick examination, there are no signs of trauma. Visual acuity is 20/120 on the L and 20/40 on the R with normal intraocular pressures bilaterally. Pupils are briskly reactive without any photophobia or consensual photophobia. The lids, sclera, conjunctivae are grossly normal and there are no corneal defects with fluorescein staining. Coming out of the room, you are concerned about this sudden-onset blurry vision. You remember a short lecture on visual acuity changes that Dr. Schindlebeck begrudgingly gave you in between his posting about sweater vests on Pinterest. Your differential brings concerning diagnoses including central retinal arterial occlusion (CRAO), central retinal vein occlusion (CRVO), retinal detachment, as well as vitreous hemorrhage. Now, our patien