Ultrasound
Ruptured Hemorrhagic Ovarian Cyst Mimicking Ruptured Ectopic Pregnancy in a Post-Transplant Patient: A Case Report
DOI: https://doi.org/10.5070/M5.52390A formal transvaginal ultrasound was ordered in the setting of the positive beta-hCG levels, which demonstrated a moderate volume of debris-containing free pelvic fluid layering in the posterior cul-de-sac (yellow highlighting), without sonographic evidence of an intrauterine gestational sac or yolk sac. Additionally, the left ovary contained a 2.8 cm cystic structure consistent with a hemorrhagic ovarian cyst (blue highlighting).
Case Report: Sonographic Detection of Chorionic Hemangiomas in Sturge-Weber Syndrome
DOI: https://doi.org/10.5070/M5.52314Ocular point-of-care ultrasound (POCUS) was performed using a linear 12-3 MHz probe on a Sonosite PX system. Examination of the symptomatic right eye revealed a complete retinal detachment. The detached retina appeared thickened, consistent with chronic detachment. Deep to the retina, the choroid was markedly thick with the widest portion observed in the posterior wall of the globe near the optic nerve. Sonographically, the choroid was isoechoic to the retina in the near field, hyperechoic to the retina in the far field (secondary to posterior acoustic enhancement) and homogenous. In the colorized image of the right eye, the red color denotes the choroid, labeled C, and the green color denotes the retina, labeled R. The left eye was also examined, shown in the last case image, and was grossly normal. No color doppler imaging was utilized for either eye. Optic nerve sheath diameter (ONSD) was 0.54 cm bilaterally.
A Novel Low-Cost Phantom for Ultrasound-Guided Fascia Iliaca Nerve Blocks
DOI: https://doi.org/10.5070/M5.52321By the end of the training session using the FI phantom and bedside ultrasound, learners should be able to: 1) discuss indications, contraindications, and complications of FI blocks; 2) identify anatomy relevant to performing an FI block on ultrasound; and 3) independently perform an FI block or demonstrate proper needle position for FI block on ultrasound of the phantom.
A Woman’s Infertility Journey Complicated by Severe Ovarian Hyperstimulation Syndrome – A Case Report
DOI: https://doi.org/10.5070/M5.52309Computed tomography (CT) of the abdomen and pelvis demonstrated pleural effusions in the lung bases (blue stars), ascites (blue stars), and enlarged ovaries with multiple cysts/follicles (white arrows). A formal pelvic US also demonstrated large volume ascites (white diamonds) and bilateral ovarian enlargement with numerous cysts. A CT angiogram (CTA) of the chest demonstrated small bilateral pleural effusions and no obvious pulmonary embolism.
Ultrasound Case: Syncope in PE
DOI: https://doi.org/10.21980/J8.52365By the end of the session, learners will be able to: 1) obtain and interpret the parasternal short-axis view of the heart to assess right ventricular size and function, 2) identify ultrasound findings suggestive of pulmonary embolism (PE) on cardiac short-axis view, including right ventricular dilation and septal bowing, 3) demonstrate appropriate probe selection and positioning to obtain optimal images of the heart and inferior vena cava (IVC), 4) evaluate the IVC using a subxiphoid or longitudinal view to assess distension and lack of respiratory collapse as supportive findings for elevated right heart pressures, 5) identify the anatomy of the neck vasculature, differentiate between the internal jugular vein and carotid artery, and select the appropriate puncture site, 6) describe ultrasound-guided central venous catheterization via the right internal jugular vein, using a sterile technique and real-time guidance
In Too Deep: A Point-of-Care Ultrasound (POCUS) Escape Room
DOI: https://doi.org/10.21980/J8.52100By the end of this session, the participant will be able to: 1) evaluate and identify the nature of metallic foreign bodies using POCUS; 2) identify common emergency department fractures on X-Ray and identify relevant sonoanatomy for ultrasound-guided regional anesthesia applications relevant to those fractures; and 3) identify normal lower extremity venous POCUS sonoanatomy and demonstrate understanding of proximal versus distal anatomical location within the lower extremity venous system.
Ultrasound Guided Peripheral Nerve Block Workshop: How to Take Your Residents from Zero to Hero
DOI: https://doi.org/10.21980/J8.52156After completing this small group workshop, the resident should be able to: 1) recognize the indications for the serratus anterior plane block, the posterior tibial block and the ulnar, median, and radial nerve blocks and the anatomical locations that would benefit from these blocks, 2) identify proper probe selection and placement, in addition to patient positioning, in order to perform these blocks, as well as anesthetic choice and dosing, 3) demonstrate knowledge of anatomical landmarks and areas to avoid evidenced by probe placement and positioning, 4) describe the steps to perform these nerve blocks, and 5) demonstrate knowledge of contraindications to these blocks as well as potential complications of these procedures and how to mitigate them.
Innovative Ultrasound-Guided Erector Spinae Plane Nerve Block Model for Training Emergency Medicine Physicians
DOI: https://doi.org/10.21980/J8PW7DThis innovation model is designed to facilitate hands-on training of the ultrasound-guided ESP nerve block using a practical, realistic, and cost-effective ballistics gel model. By the end of this training session, learners should be able to: 1) identify relevant sonoanatomy on the created simulation model; 2) demonstrate proper in-plane technique; and 3) successfully replicate the procedure on a different target on the created training model.