Brown Emergency Medicine Blog — BROWN EMERGENCY MEDICINE BLOG

Brown Sound: Ultrasound Diagnosis of Ectopic Pregnancy

A 36 year-old female presented with the acute onset of abdominal pain and sweating. She had taken multiple home pregnancy tests, all of which were positive, and then experienced a bout of severe dizziness. On physical exam, she was very pale, and had a flat, but tender abdomen. Soon after arrival, the patient became unresponsive, but was still breathing with rapid pulses. She was placed in reverse trendelenburg, and multiple attempts were made to get an automated blood pressure reading with no luck. Finally, a manual blood pressure of 70/58 was obtained. Fluid resuscitation was initiated and bedside ultrasound was performed…

This is Not the Appendix You're Looking For

A previously healthy 11 year-old male presents to the ED with three days of lower abdominal pain. The patient was evaluated at an urgent care center prior to arrival and was sent to the ED to “rule out appendicitis.” The patient reports intermittent “stabbing” pain that was initially suprapubic, but moved to the right lower quadrant today. The patient states the pain comes and goes without a clear trigger, but he has been able to eat normally and go to school. His mom became concerned today when they were about to eat dinner and the patient had an episode of severe pain that caused him to lie down. His mom gave him acetaminophen with some relief. He has not had fever, nausea, vomiting, or diarrhea. He has no sick contacts. He denies dysuria and penile discharge…

Radiology, GU, Pediatrics, UltrasoundJessie WernerNovember 29, 2019Emergency Radiology, UrologyComment

Idiopathic Intracranial Hypertension

A 22 year-old female with a medical history of migraines and obesity who presents to the Emergency Department with a headache. Her headache was gradual in onset, but has progressively worsened and has not been relieved with NSAIDs. She describes the headache as dull and pounding with photophobia and phonophobia. She also notes associated nausea but no vomiting, and no associated neurologic complaints. She does note that she thinks during a previous ED visit at an outside hospital she was told she may have “high pressure in her head” but she does not remember the details and is not on any medication for it…

Ultrasound, Neurology, OpthalmologyMichelle MylesOctober 18, 2019Ultrasound, #POCUS, #FOAMedComment

Take My Breath Away

A 31 year old female with no significant PMH presents to the Emergency Department with left-sided chest pain that started suddenly 3 hours ago while sitting in a lecture hall. She describes the pain as a constant stabbing sensation in her left anterior chest that radiates to her left neck. She endorses feeling short of breath and lightheaded. She has never had a sensation like this before. The patient denies smoking, fevers, chills, and trauma. Her vital signs are unremarkable, and her physical exam is notable for decreased breath sounds in the left upper lung field…

UltrasoundCaroline MeehanOctober 4, 2019Ultrasound, #POCUS, #FOAMedComment

A Bowel Inside a Bowel: Intussusception

A 14 month-old female with no significant PMH who presented to the Emergency Department with vomiting. Per mom, patient was well yesterday, but today has been refusing food, crying and vomiting. Patient has had no known sick contacts and her vaccinations are up to date. A review of systems was performed and was otherwise negative…

GI, Pediatrics, UltrasoundChloe SummerlandSeptember 20, 2019#FOAMed, #PEM, #POCUS, #IntussusceptionComment

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