Increased Sensitivity of Focused Cardiac Ultrasound for Pulmonary Embolism in Emergency Department Patients With Abnormal Vital Signs

Methodology: 2.5/5           Usefulness: 3/5 Daley JI, et al. Acad Emerg Med 26 (11), 1211-1220 Nov 2019 Questions and methods: In patients with abnormal vital signs, what is the sensitivity of FOCUS for the diagnosis of PE? Prospective, multicenter, observational study. Findings: 136 patients with pending CTPE, subdivided in (1) HR≥100 BPM and/or sBP <90 mmHg, […]

Protocol for lung ultrasound in COVID-19 patients

Lung PoCUS can rapidly diagnose the underlying etiology at the bedside of the acutely dyspneic patient. Lung PoCUS has excellent test characteristics for the diagnosis of pulmonary edema, pneumothorax and pleural effusions allowing the treating physician to rapidly start appropriate therapies. During the COVID19 pandemic PoCUS has other potential advantages of decreasing the need to transport a patient to further […]

Point-of-Care Ultrasound diagnosis of Endocarditis

A healthy patient presents to the Emergency Department (ED) where you are working one night. He complains of a four-day history of progressively worsening fatigue, constant and diffuse headache, neck stiffness, fever, chills and night sweats. There was no associated photophobia or phonophobia. He denies any infective symptoms, sick contacts or recent travel. He denies any past medical or surgical […]

Management of PEA: in need of resuscitation?

What is pulseless electric activity (PEA)? Pulseless electrical activity is diagnosed based on a patient having an organized, non-shockable rhythm and no palpable pulse.  However, PEA is not always a cardiac arrest state.  In many cases, patients with PEA have underlying cardiac activity and detectable arterial blood pressure.1 PEA is a spectrum of disease Imagine a spectrum, where on one […]

Focused Gallbladder Ultrasound – Enhance your Skills!

Point of Care Ultrasound (PoCUS) for the evaluation and diagnosis of gallbladder related disease is becoming commonplace in the Emergency Department. Here, we present a quiz to test your knowledge, some answers, and helpful tips and tricks to enhance your gallbladder PoCUS game! Gallbladder Ultrasound Quiz Click on the case to take the quiz before reading more about Gallbladder Sonography […]

Gallbladder Case 2

Case 2 34 year old female presenting with vomiting and abdominal pain for 3 days. She has required antiemetic therapy in the ED, and on your assessment she has a POSITIVE sonographic Murphy’s sign.                            

Gallbladder Case 4

Case 4 A 34-year-old male presents with nausea, vomiting and diarrhea for the past 24 hours. He has required antiemetics and fluids in the ED. On your sonographic assessment, you note that the patient did NOT have a sonographic Murphy’s sign.                          

Gallbladder Case 8

Case 8 A 54-year-old female with a history of liver cirrhosis presents with vomiting requiring antiemetics at triage. On your sonographic assessment, you note that the patient did NOT have a sonographic Murphy’s.              

Gallbladder Case 1

Case 1 54 year old female presents with nausea and vomiting for the past 48 hours. She is asymptomatic in the Emergency Department. On your assessment, you note that the patient DID NOT have a sonographic murphy’s sign.