PV Card: Focused Deep Vein Thrombosis (DVT) Ultrasound

Deep vein thrombosis (DVT) is always a consideration when patients with asymmetric lower extremity swelling. Why is one leg. Two-point focused DVT ultrasonography of the femoral and popliteal veins can be incredibly useful in the Emergency Department when trying to narrow the differential diagnosis. Drs. Margaret Greenwood-Ericksen, Joshua Rempell, and Mike Stone provide a clear, image-based clinical reference tool on this ultrasound technique.

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2017-08-03T00:20:25-07:00

March 11th, 2015 | ALiEM Cards, Cardiovascular, Ultrasound

By: Scott Kobner

PV Card: Focused 1st Trimester Pregnancy Transvaginal Ultrasound

Early 1st trimester pregnancies can be challenging to risk stratify when patient present with bleeding or pain. The pregnancy may be still too early for transabdominal ultrasonography, which was covered in last week’s PV card. The same authors, Drs. Matt Lipton, Mike Mallon, and Mike Stone provide a great bedside clinical reference tool on performing the focused transvaginal ultrasound in pregnancy.

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2017-08-03T00:21:51-07:00

March 4th, 2015 | ALiEM Cards, Ob/Gyn, Ultrasound

By: Scott Kobner

Ultrasound for Verification of Endotracheal Tube Location

In patients undergoing emergent tracheal intubation, there is currently no universally accepted gold-standard test to confirm the location of the endotracheal tube (ETT).¹ End-tidal carbon dioxide (CO2) detection is the best of the tests that are routinely utilized to confirm ETT placement, however, it has been shown to have an error rate as high as 1/10 for proper determination of ETT location in emergency intubations.² As a result, multiple modalities are necessary to confirm ETT location, which can delay mechanical ventilation and other treatments. The lack of a single, reliable test to confirm ETT placement can potentially lead to confusion regarding the location of the tube. This confusion can result in both unrecognized esophageal intubations (“false positive”), as well as successful tracheal intubations that are subsequently removed (“false negative”), subjecting the patient to further unnecessary attempts at airway management. Both scenarios can lead to disastrous consequences.

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2016-11-18T10:10:26-07:00

March 2nd, 2015 | Critical Care/ Resus, Expert Peer Reviewed (Clinical), Ultrasound

By: Mark Favot, MD

PV Card: Focused 1st Trimester Pregnancy Transabdominal Ultrasound

Although history, physical, and lab tests are obtained for patients with first trimester vaginal bleeding and abdominal pain, none compare to the utility of bedside ultrasonography. Today’s PV card reviews the transabdominal approach to the focused pregnancy ultrasound and was written by Drs. Matt Lipton, Mike Mallon, and Mike Stone.

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2017-08-03T00:21:58-07:00

February 25th, 2015 | ALiEM Cards, Ob/Gyn, Ultrasound

By: Scott Kobner

Ultrasound For The Win: 46F with Right Abdominal and Flank Pain #US4TW

Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this peer-reviewed case series, we focus on a real clinical case where bedside ultrasound changed the management or aided in the diagnosis. In this case, a 46-year-old woman presents with acute right-sided abdominal and flank pain.

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2017-07-19T00:08:28-07:00

February 24th, 2015 | Expert Peer Reviewed (Clinical), Genitourinary, Ultrasound, Ultrasound for the Win

By: Jeffrey Shih, MD, RDMS

Trick of the Trade: Needle-vein alignment in ultrasound guided peripheral IV

Placing a peripheral IV under ultrasound guidance is often much more challenging than it outwardly appears, especially for novice users. One of the more difficult aspects is in making sure that the target vessel is perfectly in the middle of the screen and then guessing where that corresponds to the middle of the ultrasound probe.

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2016-10-26T17:04:32-07:00

February 23rd, 2015 | Tricks of the Trade, Ultrasound

By: Jeff Wiswell, MD

Ultrasound For The Win: 22M with Scrotal Pain #US4TW

Welcome to another ultrasound-based case, part of the “Ultrasound For The Win” (#US4TW) Case Series. In this peer-reviewed case series, we focus on real clinical cases where bedside ultrasound changed management or aided in diagnoses. In this case, a 22-year-old man presents with acute scrotal pain.
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2017-07-19T00:08:38-07:00

February 12th, 2015 | Expert Peer Reviewed (Clinical), Genitourinary, Ultrasound, Ultrasound for the Win

By: Jeffrey Shih, MD, RDMS