78 yo female presents with an ankle injury that was sustained after a fall from standing.
The patient has a history of severe pulmonary hypertension and CHF and is on 4L of nasal oxygen at all times. Orthopedics is requesting a sedation for reduction, but you are reluctant to perform this in the ED due to her significant comorbidities. What nerve block can be done to assist the reduction?
A 73 year old female presents with sudden onset of midsternal chest pain and shortness of breath. The pain is worse with deep respiration and does not radiate. The patient appears to be in severe pain and is diaphoretic. BP 82/45 P 74 O2 sat 95% RA.
This 56 year old smoker with a history of HIV and anal cancer presents with complaints of 1 month of gradual onset severe shortness of breath, much worse for the past week. Vitals: 82/46 130 98.6F 30 75%RA.
This patient presents with skin redness and warmth on his right lateral thigh for 3 days. On exam there is a 4 cm patch of erythema, with a moderate amount of induration. Should this be incised?
27 year old female brought in by ambulance after a high speed MVC. Vitals show a BP of 80 systolic and a heart rate of 140. There is evidence of significant chest trauma. Abdominal FAST is negative for free fluid. A subcostal view shows the following image:
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A 56 year old male is brought in by paramedics complaining of generalized abdominal pain and distension. He is 1 week status-post operative colonic resection and anastomosis. His vitals are a temperature of 38.5C, pulse of 115, blood pressure of 95/65, respiratory rate of 32, and saturations of 94% on room air. Bedside ultrasound shows the following:
The patient is a 32 year old male who has a history of IV drug use, presents as a transfer from an outside hospital (OSH) for sepsis. Was taken to the OSH with bouts of lethargy/AMS mixed with episodes of combativeness. Noted to be febrile, hypotensive. Given 5L NS and a dose of vancomycin PTA. On exam you hear a blowing diastolic murmur. What is the diagnosis and most appropriate management for this patient?
A 60 year old female presents with painful right neck swelling. She has a past medical history of alcoholic hepatic cirrhosis. Her vitals signs are within normal limits. On examination she has a mass in the right submandibular area. It is tender to palpation, but smooth with no fluctuance. The following images are obtained of the swollen mass.
This patient is a 61 year old female with a history of hypertension and diabetes who presents with 3 weeks of intermittent exertional left sided chest pain. The pain is dull, non-pleuritic, always comes on when walking around and resolves with rest. +shortness of breath. Vitals: 95/50 125 22 98.6 97% RA. What diagnosis is suggested by the following bedside echo, and what can be measured to clinch the diagnosis?
This patient is a 52 year old woman with a history of type 2 diabetes who presents with a 1 week history of bilateral flank pain associated with fevers and dysuria. 95/50 115 16 102.5F 100%RA
The post UOTW #72 appeared first on Ultrasound of the Week.
A 65 year old male presents to emergency department with a one week history of nausea and lethargy. He reports having consulted his GP early into his symptoms, for which he was given a course of antibiotics. He reports that his symptoms have not improved. The emergency physician sends blood work and the patient’s creatinine comes back at 18mg/dl with urea of 42mmol/L and K of 6.8. Patient is referred to Critical care for urgent dialysis. On further probing by the critical care team, patient reports history of occasional chills over the past one week and has also noticed that his urine output may have been lower than normal. The critical care physician places a probe on the patient’s abdomen and this is what he sees:
The post UOTW #73 appeared first on Ultrasound of the Week.
This is a 50 year old female who presents with sudden onset retrosternal chest pain that began just after she heard of her sister’s death. Pain has been continuous for 2 hours, it is a dull ache. Vitals stable. Initial and 2 hour ECGs/troponins are shown, along with a bedside echocardiogram.
The post UOTW #74 appeared first on Ultrasound of the Week.
This patient is a 31 year old female with a history of AIDS who presents with shortness of breath, cough and fever. Vitals: 120/80 95 19 102.5 91%RA.
The post UOTW #75 appeared first on Ultrasound of the Week.
A 45 year old male presents with shortness of breath following a right rotator cuff repair surgery. These scans were obtained at the mid axillary line at the level of T4.
The post UOTW #76 appeared first on Ultrasound of the Week.
A 56 year old male is brought in by paramedics complaining of generalized abdominal pain and distension. He is 1 week status-post operative colonic resection and anastomosis. His vitals are a temperature of 38.5C, pulse of 115, blood pressure of 95/65, respiratory rate of 32, and saturations of 94% on room air. Bedside ultrasound shows the following:
The post UOTW #68 appeared first on Ultrasound of the Week.
The patient is a 32 year old male who has a history of IV drug use, presents as a transfer from an outside hospital (OSH) for sepsis. Was taken to the OSH with bouts of lethargy/AMS mixed with episodes of combativeness. Noted to be febrile, hypotensive. Given 5L NS and a dose of vancomycin PTA. On exam you hear a blowing diastolic murmur. What is the diagnosis and most appropriate management for this patient?
The post UOTW #69 appeared first on Ultrasound of the Week.
A 60 year old female presents with painful right neck swelling. She has a past medical history of alcoholic hepatic cirrhosis. Her vitals signs are within normal limits. On examination she has a mass in the right submandibular area. It is tender to palpation, but smooth with no fluctuance. The following images are obtained of the swollen mass.
The post UOTW #70 appeared first on Ultrasound of the Week.
This patient is a 61 year old female with a history of hypertension and diabetes who presents with 3 weeks of intermittent exertional left sided chest pain. The pain is dull, non-pleuritic, always comes on when walking around and resolves with rest. +shortness of breath. Vitals: 95/50 125 22 98.6 97% RA. What diagnosis is suggested by the following bedside echo, and what can be measured to clinch the diagnosis?
The post UOTW #71 appeared first on Ultrasound of the Week.
This patient is a 52 year old woman with a history of type 2 diabetes who presents with a 1 week history of bilateral flank pain associated with fevers and dysuria. 95/50 115 16 102.5F 100%RA
The post UOTW #72 appeared first on Ultrasound of the Week.
