Derm Pearl

Posted on by sinaiem

A 36 year old male presents to your resus bay complaining of allergic reaction, took first dose of Bactrim last night, started having pruritis, chills, body aches last night and now entire face, chest and back are erythematous and warm. No respiratory symptoms. Exam is notable for tachycardia, blanching diffuse erythema to face, chest and […]

Pearl 12/17

Posted on by sinaiem

Thanks to Dr. Glassberg for this case: A middle aged patient with pmh of htn, remote cva with minimal left sided deficits is brought in by wife after fall while intoxicated. Wife is concerned because patient falls frequently x years but now is falling daily, seems withdrawn/angry and barely eats. Patient admits to being a daily […]

Lung Ultrasound Pitfalls

Posted on by sinaiem

Thoracic sonography is one of the most rapidly growing areas of emergency and critical care ultrasound. One very important emerging indication is to assess for lung consolidation. The characteristic appearance of consolidated lung is very sensitive and specific for pneumonia, but novices should heed some important pitfalls in making the diagnosis. Special thanks to Jim […]

Papilledema and the Crescent Sign
Posted on by Jvhuang

  What’s abnormal in this image?   Here’s a hint.  Here is an example of normal.   When evaluating for possible elevation in intracranial pressure, it has been shown that optic nerve sheath diameter (ONSD) measurements correlate with elevated intracranial pressures.(1,2)  The optic nerve attaches to the globe posteriorly and is wrapped in a sheath that […]

Jim Tsung publishes groundbreaking pneumonia POCUS study.
Posted on by phil

It truly is the year of ultrasound — and it isn’t even 2013 yet.  Groundbreaking article on lung ultrasound by our Jim Tsung who found point of care ultrasound to be 86% sensitive and 89% specific in detecting pneumonia up to age 21.  ePub is available ahead of print in JAMA’s Archives of Pediatric and Adolescent […]

Core-Renal Ultrasound
Posted on by sinaiem

This core didactic session recap is devoted to renal ultrasound. Point-of-care ultrasound uses focused clinical questions to guide management, and our didactic session use focused clinical questions to guide discussions of key literature. Discussants Vincent Roddy and Phillip Andrus led our group through a series of questions which bring the relevance of renal sonography home. […]

Optho
Posted on by sinaiem

Bonus Pearl – For the previously missed one… 70 y/o  M presents with flashing lights and floaters in R eye.   He also notes decreased vision in the same eye.  R eye is painless and not TTP.  No swelling noted.  Visual acuity is 20/200 in the R eye and 20/30 in the left eye.  You […]

NYC Resuscitative Ultrasound Rounds
Posted on by phil

Were looking forward to the first citywide critical care ultrasound meeting. The idea for this gathering grew out of discussions between ED and ICU folks interested in critical care ultrasound who wanted to share experiences, interesting cases and ongoing research that would benefit from multicenter study. Date: January 3, 2013 Time: 5pm Location: 3 E […]

Bubble test
Posted on by sinaiem

We already know it is helpful to use ultrasound to guide placement of central venous catheters. How can we use ultrasound to help confirm proper placement of an internal jugular catheter? There are several methods which have been described: Visualize the needle entering the vein (optimally in the long axis) Visualize the guide wire in the vein […]

Fractures and Nerves
Posted on by raashee

Board review: fractures/dislocations and associated nerve injuries: Acetabular fracture – sciatic nerve Anterior shoulder dislocation – axillary and musculocutaneous nerve Humerus – radial nerve Elbow dislocation – ulnar or median nerve Olecranon fracture – ulnar nerve Supracondylar fracture – median, radial or ulnar nerve Hip dislocation Anterior – femoral nerve Posterior – sciatic nerve Knee […]

Tox
Posted on by sinaiem

20 y/o M with PMHx of acne presents with severe HA.  Feels as though HA is behind eyes.  Family says that he’s been taking some new medicine for acne.  Labs notable for abnormal lfts and elevated calcium.  HCT was negative and lumbar puncture was done showing elevated pressure.  What drug was he taking and what […]

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