About Arun Nagdev, MD

ALiEM Guest Contributor
Director, Emergency Ultrasound
Department of Emergency Medicine
Highland General Hospital
UCSF Assistant Clinical Professor of Emergency Medicine

Use of Point-of-care Ultrasound in Tibial Plateau Fractures | Case Presentation

A 70-year-old female with no past medical history was hit by a motor vehicle while crossing the street. She experienced no head strike or loss of consciousness, however she was unable to ambulate at the scene, and upon arrival to the ED, complained of left knee pain. The emergency physician noted moderate swelling on exam with intact skin and distal pulses. She was tender to palpation over the proximal tibia. Portable 2-view radiographs were obtained and interpreted as “no acute fracture.” On repeat examination, however, the patient continued to have pain and was now unable to bear weight on the affected extremity. Is there a role for point-of-care ultrasound (POCUS) in this situation?

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Trick of the Trade: Patient positioning for ultrasound-guided ulnar nerve block

Ultrasound ForearmPatients with 5th metacarpal fractures (commonly termed “boxer’s fracture”) are frequently treated in the emergency department (ED) with closed reduction and splinting. Obtaining analgesia and a successful closed reduction can often be challenging without procedural sedation. Severe swelling can make a hematoma block difficult, often resulting in inadequate analgesia. An ultrasound-guided ulnar nerve block provides a simple method to facilitate pain relief and allow for improved fracture site manipulation.

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2018-10-28T21:25:09-07:00

Ocular Ultrasound: Retinal Detachment and Posterior Vitreous Detachment

eye-painIt’s 3 am in the middle of your busy night shift and you begin your evaluation of a 65 year-old woman with diabetes with several hours of unilateral flashes of light in her left eye. Her visual fields seem normal, but you are unable to see her fundus with your direct ophthalmoscope. Luckily, you remembered the teaching from your ultrasound rotation during residency.

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2016-11-13T09:43:25-08:00

Ultrasound-Guided Pericardiocentesis

pericardial tamponade ultrasound pericardiocentesis

All the years of ultrasound training in residency has paid off. You found the large pericardial effusion in the hypotensive patient who is still alive, but looks sick. You are a star! The only problem was that you never performed a pericardiocentesis in an awake patient. The cardiology fellow is at home sleeping and/or the closest receiving hospital is about 1 hour away. Now what?

Dr. Arun Nagdev reviews how to do an ultrasound guided pericardiocentesis as part of this new, ongoing series of advanced ultrasound tips for emergency physicians.

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2019-08-17T12:49:52-07:00