Ultrasound

A Toddler with Abdominal Pain and Emesis

Saema Said, BS^* and Kevin Koenig, MD^*

DOI: https://doi.org/10.21980/J8XW2P Issue 2:2 No ratings yet.

In the long axis video, the appendix appears as an enlarged, non-compressible, blind-ending tubular structure (white arrow) with distinct appendiceal wall layers and lack of peristalsis. In the short axis video, the appendix appears as a target sign (yellow arrow) between the abdominal and psoas muscles. The maximal outer diameter (MOD) measures 11.8mm and the appendix wall measures 0.17mm. There is trace adjacent free fluid and echogenic periappendiceal fat. Transverse axis video and image (red arrow) demonstrate that the appendix is not compressible. These findings are consistent with acute appendicitis.

Advanced Ultrasound Workshops for Emergency Medicine Residents

Michelle Lall, MD, MHS^*, Sierra Beck, MD^* and Jehangir Meer, MD, FACEP, RDMS, RDCS^*

DOI: https://doi.org/10.21980/J8W88F Issue 2:1 No ratings yet.

This curriculum seeks to renew interest in ultrasound by presenting two advanced workshops on nontraditional content. Sessions covered ways ultrasound could augment or replace aspects of the physical exam, and covered ultrasound guided nerve blocks

Ultrasound Curricula

Bedside Echocardiography for Rapid Diagnosis of Malignant Cardiac Tamponade

Alaina Brinley, MD, PhD*, Maili Alvarado, MD* and J Christian Fox, MD*

DOI: https://doi.org/10.21980/J82S38Issue 2:1 No ratings yet.

The video shows a subxiphoid view of the heart with evidence of a large pericardial effusion with tamponade – note the anechoic stripe in the pericardial sac (see red arrow). This video demonstrates paradoxical right ventricular collapse during diastole and right atrial collapse during systole which is indicative of tamponade.1,2 Figure 1 is from the same patient and shows sonographic pulsus paradoxus. This is an apical 4 chamber view of the heart with the sampling gate of the pulsed wave doppler placed over the mitral valve. The Vpeak max and Vpeak min are indicated. If there is more than a 25% difference with inspiration between these 2 values, this is highly suggestive of tamponade.1 In this case, there is a 32.4% difference between the Vpeak max 69.55 cm/s and Vpeak min 46.99 cm/s.

Cardiology/Vascular Hematology/Oncology Ultrasound Visual EM

Cholelithiasis: WES Sign

Hamid Ehsani-Nia, MS^* and Shannon Toohey, MD, MAEd^{^}

DOI: https://doi.org/10.21980/J8X300Issue 2:1 No ratings yet.

Abdominal ultrasound showed the classic presentation of the Wall-Echo-Shadow (WES) sign. The superficial aspect of the gallbladder wall is represented by a hyperechogenic curve. Below this, bile fluid is represented by hypoechogenicity. Underneath the bile fluid is the echo of the dense border created by the collection of gallstones, represented by a hyperechogenic curve. Due to the high density of the gallstones, nothing deeper can be visualized (including other gallstones or the far end of the gallbladder); this is the shadow.

Abdominal/Gastroenterology Ultrasound Visual EM

A Formalized Three-Year Emergency Medicine Residency Ultrasound Education Curriculum

Andrew King, MD^*, Alyssa Tyransky^*, Alexa Coffman^*, Sarah Greenberger, MD^*, Ashish Panchal, MD, PhD, RDMS^*, David P. Bahner, MD, RDMS^*, Sorabh Khandelwal, MD^* and Creagh Boulger, MD, RDMS^*

DOI: https://doi.org/10.21980/J8RG6HIssue 1:2 No ratings yet.

Learners will 1) know the indications for each the 11 ACEP point-of-care ultrasound (POCUS) applications; 2) perform each of the 11 ACEP POCUS applications; 3) integrate POCUS into medical decision-making.

Ultrasound Curricula

Atrial Myxoma

Alisa Wray, MD^*

DOI: https://doi.org/10.21980/J87P45Issue 1:1 No ratings yet.

Bedside ultrasound revealed the presence of a left atrial mass that appeared to be tethered to the mitral valve. The mass was best viewed on ultrasound in the apical four-chamber window with the phased array probe placed over the patients’ point of maximal impact (PMI), with the patient in left lateral decubitus position.

Ultrasound Cardiology/Vascular Visual EM