Blog

Try ultrasound for your next lumbar puncture!

“Nobody travels on the road to success without a puncture or two.” -Navjot Singh Sidhu   Ultrasound can assist in determining the best site for lumbar puncture. Here is how to do it!   1. Palpate for the superior iliac spine as you would for any lumbar puncture, and find the approximate area of L3-L4Read more

52 in 52: POCUS in Trauma

Article Citation: Melniker LA, Leibner E, McKenney MG, Lopez P, Briggs WM, Mancuso CA. Randomized controlled clinical trial of point-of-care, limited ultrasonography for trauma in the emergency department: the first sonography outcomes assessment program trial. Ann Emerg Med. 2006 Sep;48(3):227-35. PMID: 16934640 Resident Reviewer: Courtney Cassella What we already know about the topic Trauma is anRead more

Imaging in Intussusception

Clinical Scenario: A 2-year-old female with no significant past medical history presents with vomiting and abdominal pain for 1 day. Among other entities in your differential diagnosis you are considering intussusception, however it is lower on your differential. How would you work-up this child?   Presenting Symptoms for Intussusception1 Sudden onset of intermittent, severe, crampy,Read more

Bedside Sono for DVT: Will it ever see the light of day?

Bedside sono for DVT: Ready for primetime? You got a patient with an enlarged, red, angry leg. It screams sono me for DVT! It is midnight and radiology tells you it cannot be done until the morning. Can YOU sono the patient? Technically yes…we have an ultrasound and bedside sono’s for DVTs are easy right?Read more

Diastology

It’s not just about the squeeze. You gotta think about the filling. Yes, today we’re talking about diastology (I didn’t make that word up) AKA diastolic heart failure AKA heart failure with preserved ejection fraction AKA that other heart failure.   Your patient with a history of CAD and HTN rolls in acutely short ofRead more

US-Guided Femoral Nerve Block for Hip Fracture

In light of a recent patient in our ED with a femoral neck fracture…   Rather than dose and re-dose opioids, consider an US-guided femoral nerve block for safer, longer, and more effective analgesia [1-3].   Courtesy of Robert J. Strony DO, RDMS, RVT via EMdocs.net:    FN: femoral nerve, SFA: superficial femoral artery, DFA:Read more

Ultrasound Water Bath

After pulling in a spectacular toe-tapping sideline-hugging outstretched 30-yard bomb just milliseconds before a crushing hit by multiple defenders (a Pearl unto itself), one of our own right-handed residents came down the next day with redness, swelling, and pain to the dorsal aspect of his right hand’s third metacarpophalangeal joint. A heated discussion in theRead more

Pocus Ruq

A 40 y/o G10P10 presents with RUQ pain worse with fatty foods. When evaluating for acute cholecystitis, what 5 sonographic findings do you look for? What is the Mickey Mouse sign? What is the mantle clock sign?Read more

Peek Through the Orbit

32 yo overweight female presents with a headache.  This headache is similar to prior headaches, which she gets frequently.  The rest of her story seems consistent with a migraine and her physical exam, including a through neuro exam, is normal.  However, you still feel concerned because she’s in the right demographic for idiopathic intracranial hypertension.Read more

Ultrasound is Your Friend

Pt is 54 yo M with PMH of DM, HTN, Crohn Disease presents with 2 days of worsening vomiting, had diarrhea initially that has now stopped and is no longer passing gas, also reports some slight abdominal distention. Patient has had several abdominal surgeries in the past, denies any fevers, any blood in the vomitRead more