11. Case of the month: Right hip pain

Images Daniel Loui  Text Genevieve Carbonatto A 60 year old lady presents with recurrent syncopes associated with frequent falls. 2 weeks prior to presentation she had a fall on her right buttock  causing  right hip pain. Subsequently she developed a small heamatoma over her right buttock and a larger right thigh haematoma. She presents with  Read more about 11. Case of the month: Right hip pain[…]

9. Case of the month: PoCUS in pneumomediastinum

Images Chris Fox A 14 year old boy presents to ED with throat and neck pain after persistent vomiting. He states he vomited > 30 times over the previous 8 hours. On examination:  oxygen saturation 98% on RA, BP 128/89, HR 66/min. No obvious crepitaions to the neck. A chest Xray was ordered What can Read more about 9. Case of the month: PoCUS in pneumomediastinum[…]

3. Case of the month: Gallstones, dilated CBD

Case and images courtesy of Dr Micky Fiorentino (ultrasound under supervision of Dr James Dent) Triage at 1pm: 46F, representation with recurrent RUQ pain. Known gallstones. Representing with further pain, yellow skin colour and pale stool and dark urine. O/E Minimally tender RUQ, Murphy’s negative Jaundiced Initial blood tests: Hb 135 WCC 3.8 x 109 Read more about 3. Case of the month: Gallstones, dilated CBD[…]

2. Case of the month: FELS Right heart failure

Dr Chris Harrington (FACEM)  presents 2 cases for this month.  Both demonstrate the importance of ECHO in the context of the deteriorating patient with heart failure. A 48F is referred to the Emergency department by her cardiologist with exacerbation of right heart failure and rapid AF PHx aortic valve repair (for congenital aortic stenosis) severe Read more about 2. Case of the month: FELS Right heart failure[…]

10. Case of the month: Stanford type B dissection

Images Earl Butler, text Genevieve Carbonatto A 55 year old lady presents with acute numbness to her right leg and “dizziness” lasting a few hours. No back pain. No chest pain. There are no other neurological symptoms.  BP 175/85 HR 72/min, RR 16/min saturations 96% on room air. Because of the numbness in her leg Read more about 10. Case of the month: Stanford type B dissection[…]

Submassive Pulmonary Embolism – a critical care ECHO skill?

Images and Text Genevieve Carbonatto If we consider that there are different levels of expertise in the acquisition of knowledge of echocardiography for the Critical Care Physician, the recognition of acute cor pulmonale which we see with  submassive pulmonary embolus has been described as a Level II skill, level I being the minimal level of Read more about Submassive Pulmonary Embolism – a critical care ECHO skill?[…]

Ice cardiomyopathy, apical thrombus

Images Sarah Vaughan, text Genevieve Carbonatto A 38 year old man presents to the Emergency department with shortness of breath which he has had for 4 weeks. His symptoms have worsened  over the past 3 days. He can no longer go up 2 flights of steps to his apartment  and he has noticed his  ankles Read more about Ice cardiomyopathy, apical thrombus[…]

Takotsubo cardiomyopathy

Images and text Genevieve Carbonatto A 52 year old lady presents to the Emergency Department with chest pain. After an argument with her husband about his spending she developed acute severe central chest pain radiating down her right arm. She is mildly SOB. There is no past history of note, notably no cardiovascular risk factors. Read more about Takotsubo cardiomyopathy[…]

Biliary Obstruction: Double Barrel sign, Monkey Puzzle sign

Images and text Genevieve Carbonatto A 73 year old man presents to the emergency department jaundiced. He says he has not been feeling unwell but that over  the past 4 days  the white of his eyes have turned yellow as well as the skin of his face. His urine turned very yellow 4 days ago Read more about Biliary Obstruction: Double Barrel sign, Monkey Puzzle sign[…]