Ultrasound

Assessing intravascular volume on an obese patient

by Teresa Wu, MD & Brady Pregerson, MD on May 6, 2009

“Doctor, I can’t get the blood pressure cuff around her arm.” You aren’t surprised by your trauma nurse’s comment as you stare at the 450-pound woman lying on a backboard in front of you. EMS miraculously cut her out of her tiny two-door sedan with the jaws of life and dropped her off in your ED, with a 22 gauge IV in her right hand and her left leg extended in traction.

Imaging Artifacts: An ED Ultrasound Overview

by Teresa Wu, MD & Brady Pregerson, MD on April 6, 2009

This month we’re going to answer some basic ultrasound questions and go over imaging artifacts. The main benefits of learning how to perform bedside ultrasounds include efficiency and the ability to obtain repeat scans. Efficiency, for obvious reasons, is a critical consideration in the management of the unstable patient.

Ultrasound-Guided Thoracentesis

by Teresa Wu, MD & Brady Pregerson, MD on February 28, 2009

It’s just been one of those nights. It just took you three attempts to get the CSF on a patient that should have been the easiest LP in the world. Your guidewire headed north instead of south during a subclavian vein cannulation for central venous access. And now your charge nurse is telling you that your 85-year-old patient in the resuscitation bay is becoming more short of breath and his O2 sats are dropping. Read more

Left Lower Quadrant Pain with a Twist

by Laurence M. Edelman, MD; Beatrice Hoffmann, MD, PhD, RDMS Frederick Levy, MD, JD; Brady Pregerson, MD on January 31, 2009

A 67-year-old man with a history of heavy ethanol and crack cocaine abuse presented to the emergency department with one day of severe generalized abdominal pain.
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Be More Efficient at Work

by Jonathan Sherbino, MD on December 31, 2007

Patients with a low risk Wells’s score and a negative moderately-sensitive D-dimer assay (e.g. whole blood agglutination – SimpliRed) have less than a 1% chance of deep vein thrombosis (DVT). Patients with a moderate risk Wells’s score and a negative highly-sensitive D-dimer assay (e.g. ELISA) have a 1% chance of DVT.

"My Face Feels Squishy..."

by Brian Wessman, MD PGY3 on December 31, 2007

The patient (CR) is a 16-year-old Caucasian male with a past medical history significant for asthma (no prior intubations or hospitalizations). CR’s mother called her pediatrician’s office on a Friday morning complaining that her son had mild facial swelling in bilateral cheeks and neck.