We're building out our new comprehensive Bedside Ultrasound Manual. Check it out here. New chapters added regularly! The post January Update appeared first on UCSD Ultrasound ..read more

In the first video of our TE X instructional series, Zac Fica, MD, MS, walks us through the basic features and functionality of our new Mindray machine. The post Rapid Fire Ultrasound: Introduction to the Mindray TE X appeared first on UCSD Ultrasound ..read more

A 73-year-old male with a past medical history including atrial fibrillation and hypertension presented to the ED for admission for planned resection of a parotid mass with ENT. He first noted pain to his right cheek several months prior. Over this period, a mass was noted. The mass continued to grow over time, raising concern for malignancy, and the decision was made to pursue resection of the mass. On presentation, he endorsed significant pain to the right parotid area, but denied any fever, chills, chest pain, SOB, nausea, vomiting, abdominal pain, or dysuria. On physical exam, gross obse ..read more

  A 77-year old man presented to the emergency department with a complaint of appetite loss over the past 15 days. He reported ongoing symptoms for the past 5 months. However, over the previous 15 days, his appetite had been so poor that he only drank 1-2 nutrition drinks per day. He reported a 10-15 lbs weight loss paired with fatigue and weakness. He denied nausea, vomiting, abdominal pain, fevers, and chills. The patient reported normal bowel movements. He denied any significant medical history and had no records in our EMR. He reported an unremarkable colonoscopy 7-8 years ago. &nbs ..read more

A 77-year-old patient presented to a rural Emergency Department with a chief complaint of shortness of breath a day prior to presentation. Patient also reported that he fell several weeks ago and hurt his ribs. He was subsequently admitted to the hospital and was ultimately treated for pyelonephritis. He endorsed being more sedentary than usual for the next several weeks. On the day of presentation he was lying in bed when he began to suddenly feel short of breath. He denied feeling any chest pain, lightheadedness, dizziness, nausea, vomiting, diarrhea, diaphoresis, jaw or arm pain. His shor ..read more

A 53-year-old homeless alcoholic female presented to the emergency department with a chief complaint of localized left lower quadrant abdominal pain secondary to a possible gunshot wound. She was unclear but stated she thinks some boys in a gang fired at her two days prior with a possible BB gun. Pertinent medical history included psychiatric history, morbid obesity (BMI>40), chronic alcohol abuse, sepsis and hypoxemic respiratory failure. The patient was clinically intoxicated upon arrival and therefore history was of limited accuracy.    Upon arrival, patient appeared sta ..read more

A 37-year-old female presented to the emergency room with severe, radiating bilateral flank pain lasting one week. Pain was constant and pressure-like. Patient had a past medical history significant for constipation, ovarian cysts, diverticulitis, and a colonic polypectomy. She denied fever, vomiting, and denied melena and hematochezia. Patient had no dysuria, frequency or hematuria. She denied vaginal discharge or odor. Patient was seen and treated by her primary care provider with ciprofloxacin and metronidazole for presumed diverticulitis. When pain failed to improve two days later, patie ..read more

A 35 year old male with a history of IV drug use and HIV on ART presents to the emergency department with pain and redness of his left upper extremity for a few days. He denies systemic symptoms or prior history of abscess. Vitals: Temp 98.5, HR 93,  BP 122/75, RR20 Physical Exam: Notable for a large, well circumscribed area of induration, erythema, warmth, and  tenderness on the left upper arm. Distal to the lesion, there is intact cap refill and 2+ radial pulse. A bedside ultrasound was performed. What do you see?   Answer and Learning Points Answer: Image 1 is a t ..read more

Background Bedside ultrasound can be used to diagnose full and partial tendon disruptions and can be especially useful in patients who are unable to provide history or otherwise participate in their own care (1). Numerous studies have previously reported the sensitivity and specificity for diagnosing full and partial tendon disruptions to be close to 100% (2-3). However, there is little information in the literature regarding accuracy of bedside musculoskeletal ultrasound in diagnosing these tendon ruptures specifically in the emergency department and whether it expedites patient care. This pr ..read more

Background Ultrasound has been shown to be superior to supine chest x-ray in the diagnosis of pneumothorax, with one recent systematic review demonstrating 91% sensitivity using ultrasound compared to 50% using chest x-ray.1 CT scan remains the gold standard in diagnosis but is often not feasible in unstable trauma patients. Ultrasound is recommended by ATLS guidelines for use in trauma patients as part of the eFAST protocol. There are three main described ultrasound findings in pneumothorax: lung sliding, B-lines, and the lung point. While B-mode (2D mode) is commonly described, many resource ..read more