Welcome back to Tox in the Land!
After a short recess it’s time to get back at it. Since we are knee deep into interview season, there is no better time to put a spot light on our former chief resident and medical education fellow, Matthew Mullins, MD. He is here to guide you through the classic topic of iron toxicity and its management. Don’t worry, we will be back quickly to feature some of our medical student rotators as well!
Lauren Porter DO, Ryan Marino MD, Bryan Ross MD and Marielle Brenner, MD
This case is by Dr. Ryan Starkman (now PGY2) and is a great example of a large circumferential pericardial effusion with sonographic tamponade physiology diagnosed with POCUS. This expedited interventional cardiology involvement before the patient decompensated, and 750cc of fluid was successfully drained in the cath lab.
This case is by Dr. Jacob Perino and is a great example of an incidental finding of an iliac aneurysm found when performing a bladder ultrasound on a patient presenting with a malfunctioning Foley catheter. Read on to learn more about iliac aneurysms and bladder ultrasound in the setting of a Foley.
This month’s case is by Dr. Yanina Guevara who shares a case of painless monocular vision changes in a patient who was found to have a retinal detachment (and vitreous hemorrhage), first diagnosed with point-of-care ultrasound! This is accompanied by an overview of how to perform an ultrasound ocular exam and highlights some of the pathologies that can be visualized. Read on to learn more!
Dr. Nick DiMeo provides an overview of traumatic arthrotomy and outlines a diagnostic approach for this high risk pathology.
Dr. Bejan Kanga (PGY3) highlights the prevalence and morbidity of DVTs and PEs, provides a framework for determining appropriateness for outpatient management, and discusses treatment options.
Our latest Intern Ultrasound of the Month is by Dr. Abby Wissman and features a cool case of a complex cystic renal mass found incidentally. She reviews the basics of renal POCUS and dives into a great discussion about various renal pathology that we may see on ultrasound.
To follow up our most recent case of McConnell’s sign in the setting of an acute pulmonary embolism, Dr. Isma Dhanani goes more in-depth on the right heart and covers additional signs of right heart dysfunction - acute and chronic - that can be quickly identified with POCUS.
Our latest Intern Ultrasound of the Month is brought to you by Dr. Gabe Alagna. He presents a case in which POCUS performed on a patient in cardiac arrest found an enlarged right heart with McConnell’s sign, raising concern for PE, which quickly changed management. Read on to learn more!
Now that we’re in the midst of winter, there’s a good chance you’ll have a patient presenting with hypothermia. Our latest blog post by Lucas Rappert, a 4th year medical student from Kansas City University College of Osteopathic Medicine who recently completed our Resus elective, provides an excellent review of the pathophysiology and management of hypothermia in the ED. Read on to learn more!
Our latest Intern Ultrasound of the Month is by Dr. Annie Thai. She shares a case of a symptomatic abdominal aortic aneurysm and provides a great review of how to perform and optimize your aorta ultrasound exam. We hope you enjoy!
Holidays are a time for fun with the family, holiday traditions and snacks. Here is a blog from our PGY 1, Dr. Gabe Alagna, explaining why enjoying whipped cream from the can may not be the best option.
Our latest resus blog is an excellent review of REBOA by CWRU MS4 Matthew McCabe! Hope you enjoy!
Our next Intern Ultrasound of the Month is by Dr. Dave Wiliams and features a classic case of cellulitis in which POCUS helped support the clinical diagnosis and rule out an abscess. Read on for a great review of cellulitis and how to evaluate for soft tissue infections using POCUS.
Our latest blog is by MS4 Erica Fleming-Hall and explores the indications and evidence for Resuscitative Thoracotomy. Read on to learn more!
Our next Intern Ultrasound of the Month is by Dr. Matthew Hom and features a great case of vitreous hemorrhage diagnosed with POCUS. Read on to learn more about this and how to differentiate from ophthalmologic emergencies such as retinal detachment.
Our latest Resus blog post is by former CWRU MS4 Chris Schlechter which features a great discussion of resuscitative TEE and the evidence supporting its utility!
Our next Intern Ultrasound of the Month is by (now PGY2) Dr. Brian Fort and features a great case of post-viral pneumonia with associated pleural effusions diagnosed with POCUS when the patient was too unstable for CT. The patient’s course was further complicated by bacterial superinfection resulting in Lemierre syndrome.
Our latest Resus blog post is by former MS4 at CWRU Alexandria Gerber (now EM intern at UPMC) and features a great discussion about thromboelastography (TEG) and its utility in assessing real-time coagulation status and guiding management in resuscitations!
Summer has made our hearts sing! But that means it’s time to review some action potentials. This month’s blog is brought to you by now MD/PhD Dr. Sweet, a budding cardiologist in the making who rotated with us this past spring while still a student. Enjoy and call the Poison Center!
As of this year, providers with a DEA license can now prescribe buprenorphine as a treatment for opioid use disorder. Check out this great graphic by Dr. Shauna Combs for further clarification!
Our latest Intern Ultrasound of the Month by Dr. Shruti Africawala features a great case of left ventricular hypertrophy and hypertrophic cardiomyopathy, along with a review of evaluating LV function with POCUS.
Not all hydronephrosis is a kidney stone! Our latest Intern Ultrasound of the Month by Dr. Brooke Ott features a great case of a patient presenting with flank pain whose renal POCUS found hydronephrosis in addition to complex mass in her pelvis. This led to the discovery of tubo-ovarian abscess as the culprit. Learn more in this blog post!
As the weather warms up, the tides change and that means it’s time for some shellfish! This blog is brought to you by Student Doctor Sun, an upcoming resident who will take you through some amnestic shellfish poisoning. Enjoy and remember to call your poison center!
Flashes & floaters & POCUS, oh my! Our latest Intern Ultrasound of the Month is by Dr. Ranjana (RJ) Ravikumar and features a great case of a large retinal detachment diagnosed with POCUS! Check it out !
Our latest blog post is by R3 Dr. Dan Saadeh and features a great review of hypercalcemia and how to manage it in the ED! This served as the framework for his recently published Clinical Practice Guideline in our department!
Spring is here! This means foraging will be back in style! Our R3 Dr. Haley Wartman brings a quick review of common mushroom exposures and their management. Remember 6 hour rule, supportive treatment and calling your poison center!
Our next Intern Ultrasound of the Month is by Dr. Kelsie Rhyne and features a great case discussion about the diagnostic and procedural utility of POCUS for evaluating and managing a painful, swollen knee (and other joints).
