Brown Emergency Medicine Blog — BROWN EMERGENCY MEDICINE BLOG

A 26 year-old with no significant past medical history presents with two days of abdominal pain and vaginal bleeding. She describes the pain as a 4/10, “crampy” and diffuse, located in the lower abdomen. She is not experiencing any nausea, vomiting, diarrhea, constipation, dysuria, or increase in urinary frequency or urgency. Her last menstrual period was approximately 7-8 weeks ago and she has a history of regular periods. She has no history of STIs, prior surgeries or pregnancies, and is uncertain whether she desires pregnancy currently…

Clinical Image, OB/Gyn, UltrasoundSarena HayerMarch 19, 2021Ectopic Pregnancy, UltrasoundComment

Utility of POCUS in Evaluating for Pulmonary Embolism

A 58-year-old woman with a past medical history significant for hypertension and hyperlipidemia presents to the Emergency Department with 3 days of dyspnea. She also endorses non exertional pleuritic chest pain, chills, and malaise that started on the morning of her presentation. Vital signs were notable for tachycardia of 110 beats per minute and an oxygen saturation of 93% on room air, but were otherwise normal. Physical exam revealed clear lung fields bilaterally and was otherwise unremarkable…

Cardiology, UltrasoundBenjamin HaganMarch 12, 2021Cardiology, Pulmonary EmbolismComment

POCUS And Its Utility in the Rapid Diagnosis of Acute Cholecystitis

A 48-year-old female with a past medical history of hypertension and hyperlipidemia and no past surgical history presented to the ED with constant, sharp, and burning epigastric pain. The pain started two weeks ago and was initially intermittent, centered in the epigastric region. Over the past day or so, the pain worsened and began traveling to the right side of her chest and around to the back. The pain was daily, usually after meals, and made worse by fatty foods. The patient felt slightly better after taking antacids. She reported the pain was 8/10 at worst, typically lasting several hours at this intensity, and receded to 3/10 at its best. She had some nausea but no vomiting. She denied changes in stool consistency/frequency or dark or bloody stools. She denied chest pain, sweating, or palpitations. She reported a subjective fever last night and into this morning, but no chills or change in weight. She had been compliant with her home medications.

Ultrasound, RadiologyToby NicholsonJanuary 15, 2021Cholecystitis, Bedside UltrasoundComment

Brown Sound: (Almost) Scared to Death by Takotsubo Cardiomyopathy

A 75 year-old female with a past medical history of hypertension, hyperlipidemia, SVT, chronic kidney disease, diabetes, lung cancer status post partial right lung resection, and remote history of breast cancer status post resection presented with chest pain. She awoke in the middle of the night after hearing a loud crash and found her husband lying on the ground unresponsive. She thought he was dead and felt an overwhelming sensation of fear, followed immediately by the onset of substernal chest pain radiating to the back associated with some shortness of breath. She denied fever, diaphoresis, nausea, vomiting, or palpitations. She denied any history of angina. Upon arrival to the emergency department she was given nitroglycerin with a subsequent improvement in her chest pain…

Cardiology, UltrasoundDanielle KerriganJanuary 5, 2021ultrasound, echocardiography, Takotsubo, cardiomyopathyComment

Bround Sound: Ultrasound to Assess Extraocular Movements and Pupillary Light Reflex

The assessment of extraocular movement (EOM) and pupillary light reflex can be used to evaluate for ocular injury post-trauma. However, many patients with ocular trauma can present with significant orbital edema or pain that limits assessment due to the physician being unable to retract the eyelids. Ocular ultrasound provides a unique way to assess the eyes in the event of a trauma without causing significant pain or harm to the patient. This blog post provides techniques on how to perform ocular ultrasound to assess EOM and pupillary light reflex…

Opthalmology, UltrasoundMeagan KozhimalaDecember 22, 2020ultrasound, ocular, traumaComment

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