Welcome to the first CCM POCUS blog post of the new academic year!
Please view the post and reply with your thoughts/comments there!
These come from a patient who had a condition called for hypotension. These ultrasound images were obtained. Please reply with:
• What probe is being used?
• What views are shown in the clips
• What is your interpretation of the images?
Please post your thoughts/ comments/ answers and I will weigh in next week.
Here is another great case, using POCUS transthoracic echo in caring for a patient on VA ECMO.
Stem: Patient transferred from outside facility on VA ECMO for massive PE. Clips are labeled at 4.5 LPM, 2.5 LPM and 1 LPM flows.
• Based on these clips, how do you interpret these findings?
• What is the LV systolic function? What about the RV?
• Does this patient look ready to wean from VA ECMO support?
Here is another case!
Stem: Patient with PMHx of IVDA presented to ED for severe knee pain and fevers. Major concern was for septic arthritis and Ortho planned to take the patient to the OR for wash out.
What are your thoughts:
• What probe is being used?
• What views are obtained?
• What is your interpretation? What pertinent positive and negative findings do you note? (HINT: There are several findings noted throughout!)
Post you thoughts and comments! I’ll share more details next week!
Here is another, quick post. It is from a patient that had a PEA arrest with ROSC. Echo obtained upon patient arrival to ICU. What are your thoughts? How would you proceed, both for further workup (if any) and treatment?
Welcome to our 1st CCM POCUS blog post of the New Year!
40’s patient admitted with complaints of dyspnea for 3 months. The physician scanned bilateral IJ for placing a central line for vasopressor administration. Here are a collection of clips obtained.
I want to leave the discussion pretty open on this one. There are a lot of findings and some interesting takeaways/ teaching points.
This case comes to us from one of our Ped’s EM Ultrasound fellows! Here is the case:
Teenage female with a history of Crohn’s s/p colectomy presents with worsening symptoms for the past 4 days including increasing colostomy output, abdominal tenderness, and NBNB emesis. Vital signs are stable. On physical exam there is mild distention of the abdomen but no rebound tenderness or guarding. POCUS revealed the attached images.
We have a new post from our CCM POCUS Fellow, Mark Andreae, MD! We have a different type of teaching point for this case, so be sure to share your thoughts and see the results.
Here is the case stem:
50’s patient with history of ischemic cardiomyopathy POD3 s/p 4 vessel CABG. Condition C called for hypotension. BP 77/49, HR 89. Has felt constitutionally unwell throughout the day. He is pale and cool on exam. You place an arterial line - MAP 55-65 with large pulse pressure variation. You obtain these view on point of care ultrasound.
Here is a new case. For the purposes of HIPAA and patient/provider anonymity, I will not post any details. (Plus, I think the clips speak for themselves.) Cardiac POCUS shown in clips.
• What probe(s) is/are being used?
• What views were obtained?
• How do you interpret these images/findings?
Let me know your thoughts and I’ll post my own next week (9/29/20).
Here is a new case: 70’s female with history of COPD presented for severe dyspnea. Admitted to ICU on 2 pressors. EKG with q waves in V2-V3 (new) as well as elevated troponin and BNP. Lung Ultrasound demonstrated diffuse A lines (A profile) with pleural sliding throughout and no pleural effusions. Cardiac POCUS shown in clips.