Blog

A ‘normal’ chest Xray

What do you see when you take a look at this Chest radiograph? It isn’t immediately noticeable (and was read as normal), and is a good reminder of why you should always check your own films, and why a systematic read is important.  If all you were looking for was “r/o PNA/PTX” you could easilyRead more

How Safe is Mechanical CPR?

Question – How safe is mechanical CPR compared to manual CPR? There are two devices used for mechanical CPR – the AutoPulse and LUCAS – neither of which has been demonstrated to show a survival benefit over manual CPR in recent studies (CIRC, LINC, PARAMEDIC). Could these devices be causing more injuries compared to manualRead more

Point-of-care ultrasound diagnosis of intravascular air after lower extremity intraossesous access

http://sinaiem.org/wp-content/uploads/2016/09/Video2.mp4 When you come across peripheral intravascular air, take steps to minimize further entrainment of air and migration of air to the heart and lungs.Read more

Aortic Dissection – A Covert Killer

Aortic dissections are insidious killers that are often undetectable by history and physical exam alone. Obviously, providers must have a high index of suspicion for these as their presentations are highly variable. CT angiography, and less often, transesophageal echocardiography are classically the diagnostic modalities that providers use to identify this rare, deadly diagnosis. However, gettingRead more

Retinal Detachment v Hemorrhage

By Dr. Raashee Kedia Acute vision change A 51 year old female with a history of diabetes presented to the ED with acute onset of left eye painless blurry vision. Vitals were within normal limits. Fingerstick was 450. On exam : Visual acuity was 20/30 in the right eye but could only count fingers in left eyeRead more

FAST five ways

The FAST exam is generally described as a trauma assessment (hence the acronym). But it is often used as a metanym to mean any assessment of the peritoneum for fluid. In fact when I was a resident folks would often say, “let’s FAST that gallbladder,” or “get the FAST machine so we can put thatRead more

What the Heck 3

So we are scanning the left thorax in a patient with shortness of breath, in an effort to assess for pleural effusion. The following video was obtained: https://gmep.org/media/11997 The operator correctly noted the presence of a pleural effusion, and a bit of lung tissue can be seen towards the left side of the screen floatingRead more

Case- vaginal bleeding

This young healthy woman presented in her first trimester of pregnancy with lower abdominal pain and vaginal bleeding. She had diffuse abdominal tenderness and was mildly tachycardic with a normal blood pressure. After IV access was established, labs and blood bank sample were sent, and the following ultrasound of the right upper quadrant was obtained:Read more

What the Heck 2

This patient presented with diffuse abdominal pain, tachycardia, and peritonitis on physical examination. A FAST exam was performed to assess for free intraperitoneal fluid, and the following view of was obtained transversely in the pelvis. First, just look at the still image and make your best guess. Then press play: Did the large anechoic structureRead more

Case- Abdominal pain

Patient with history of hypertension presents periumbilical abdominal pain radiating to the back. Minimal abdominal tenderness, no rebound or guarding, though  a pulsatile mass is felt. The following ultrasound is obtained: https://gmep.org/media/11742 As the title suggests, the patient was diagnosed with an abdominal aortic aneurysm and vascular surgery was consulted. We’re experimenting a bit withRead more