SonoCase: 54yr old abdominal pain, fever, vomiting – common US app by Dr. Hisset @emnews #FOAMed

The May 2013 issue of EM News highlights one of the basic, yet most difficult, ultrasound applications to perform. It is one of the most common abdominal applications given how common the disease process shows itself in the emergency department. Nice work to Dr. Hisset, a first year resident! from Louisiana, on writing this review.

The case: “A 54-year-old woman presents to the emergency department with four days of fever, abdominal pain, nausea, and vomiting. She reports that all of this started after eating pork at a casino buffet. She is not jaundiced on exam, but has severe pain to palpation of the entire abdomen, worst in the right upper quadrant with a positive Murphy’s sign. Her blood pressure is 96/52 mm Hg, pulse is 110 bpm, and her temperature is 100.4°F. Fluid resuscitation is started, and a bedside ultrasound is performed.”

Screen Shot 2013-05-09 at 9.33.44 AMTo find out what they found and a description of the application in a concise format, go here.

SonoCase: 70 yr old fever, hypotensive after root canal, diarrhea & abd pain…”RUSH” +1

This case is one of those cases that make me so proud of the residents I work with…. Drs. Brianne Steele and Cesar Avila identified the need for a RUSH exam, but didn’t stop there – they noticed something during their RUSH and proceeded with another evaluation – obtaining the surprising diagnosis below, saving him time in the emergency department and canceling his CT scan that didn’t need to be done, which I then conclude controls his healthcare charge. period.

70 year old male with a history of (ready for it…) Continue reading

SonoCase: good one by a good friend – 28yr old abdominal pain on EPMonthly!

Teresa Wu, Associate Residency Director, and Director of Ultrasound and Simulation Programs and Fellowships, for the Maricopa Emergency Medicine Program (otherwise known as “T Wu” – as shouting that loud over and over again gets even the innocent bystanders at the bar chiming in )- has joined her colleague, Brady Pregerson (who manages a free on-line EM Ultrasound Image Library and is the editor of the Emergency Medicine Pocketbook series) once again for a fantastic case highlighted in the recent issue of EP Monthly. Its about a 28 year old female walking in to the waiting room and telling the nurse she has abdominal pain Continue reading