scholarly journals Asteroid Hyalosis: A Mimic of Vitreous Hemorrhage on Point of Care Ultrasound

CJEM ◽  
2016 ◽  
Vol 19 (04) ◽  
pp. 317-320 ◽  
Author(s):  
Charles E.A. Stringer ◽  
Justin S. Ahn ◽  
Daniel J. Kim
Keyword(s):  
Point Of Care ◽  
Vitreous Hemorrhage ◽  
Posterior Chamber ◽  
Point Of Care Ultrasound ◽  
Washing Machine ◽  
Benign Condition ◽  
Ocular Ultrasound ◽  
Ultrasound Findings ◽  
Asteroid Hyalosis ◽  
History Of

Abstract Point of care ultrasound in the emergency department (ED) is increasingly being used to diagnose time-sensitive, vision-threatening conditions. We present a case of a 64-year-old female who presented to the ED with a three-day history of worsening left eye floaters. Point of care ocular ultrasound demonstrated a posterior chamber containing many echogenic opacities of varying size without acoustic shadowing. Movement of the eye resulted in significant after-movement of these opacities, giving the classic “washing machine” appearance seen with vitreous hemorrhage (VH). Based on these ultrasound findings, the patient was diagnosed with a VH and was referred to ophthalmology. The consulting ophthalmologist ultimately diagnosed the patient with asteroid hyalosis without VH. Asteroid hyalosis is a benign condition of the vitreous resulting in calcium phosphate and lipid deposits that can mimic more serious VH on point of care ultrasound. Knowledge of this mimic is helpful for communication with specialists and for awareness of the potential for misdiagnosis with ocular ultrasound.

scholarly journals Asteroid Hyalosis Seen on Ocular Point-of-Care Ultrasound

2019 ◽  
Vol 3 (3) ◽  
pp. 318-320
Author(s):  
Blake Arthurs ◽  
Randi Connor-Schuler ◽  
Wendelin Kreifels ◽  
Julian Suszanski ◽  
Sudhir Baliga ◽  
...  
Keyword(s):  
Ocular Trauma ◽  
Point Of Care ◽  
Vitreous Hemorrhage ◽  
Point Of Care Ultrasound ◽  
Benign Condition ◽  
Lens Dislocation ◽  
Ultrasound Evaluation ◽  
Ocular Ultrasound ◽  
Asteroid Hyalosis ◽  
Blunt Ocular Trauma

We present a case of a patient who underwent ultrasound evaluation for potential blunt ocular trauma. She was found to have multiple, freely mobile, scintillating hyperechoic opacities within the vitreous that was diagnosed as asteroid hyalosis, a rare but benign condition easily confused with vitreous hemorrhage, retinal detachment, lens dislocation, or foreign body on ocular ultrasound.

scholarly journals Point-of-care Ultrasound Detection of Cataract in a Patient with Vision Loss: A Case Report

2020 ◽  
Vol 4 (3) ◽  
pp. 355-357
Author(s):  
Kyle Dornhofer ◽  
Marawan Alkhattabi ◽  
Shadi Lahham
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Vision Loss ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Cataract Formation ◽  
Ocular Ultrasound ◽  
History Of

Background: Point-of-care ocular ultrasound in the emergency department (ED) is an effective tool for promptly evaluating for several vision-threatening etiologies and can be used to identify more slowly progressing etiologies as well, such as cataract formation within the lens. Case Report: A 62-year-old female presented to the ED with a two-day history of painless vision loss of the left eye as well as reduced vision for the prior 30 days. Conclusion: Point-of-care ultrasound was performed and showed calcification of the lens consistent with cataract.

scholarly journals A History of Fluid Management—From “One Size Fits All” to an Individualized Fluid Therapy in Burn Resuscitation

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 187
Author(s):  
Dorothee Boehm ◽  
Henrik Menke
Keyword(s):  
Fluid Therapy ◽  
Point Of Care ◽  
Fluid Management ◽  
Point Of Care Ultrasound ◽  
Burn Patients ◽  
Starting Point ◽  
History Of ◽  
Definition Of ◽  
Historical Developments ◽  
Burn Resuscitation

Fluid management is a cornerstone in the treatment of burns and, thus, many different formulas were tested for their ability to match the fluid requirements for an adequate resuscitation. Thereof, the Parkland-Baxter formula, first introduced in 1968, is still widely used since then. Though using nearly the same formula to start off, the definition of normovolemia and how to determine the volume status of burn patients has changed dramatically over years. In first instance, the invention of the transpulmonary thermodilution (TTD) enabled an early goal directed fluid therapy with acceptable invasiveness. Furthermore, the introduction of point of care ultrasound (POCUS) has triggered more individualized schemes of fluid therapy. This article explores the historical developments in the field of burn resuscitation, presenting different options to determine the fluid requirements without missing the red flags for hyper- or hypovolemia. Furthermore, the increasing rate of co-morbidities in burn patients calls for a more sophisticated fluid management adjusting the fluid therapy to the actual necessities very closely. Therefore, formulas might be used as a starting point, but further fluid therapy should be adjusted to the actual need of every single patient. Taking the developments in the field of individualized therapies in intensive care in general into account, fluid management in burn resuscitation will also be individualized in the near future.

The Role of Lung Ultrasound Before and During the COVID-19 Pandemic: A review article

2021 ◽  
Vol 17 ◽  
Author(s):  
Mustafa J. Musa ◽  
Mohamed Yousef ◽  
Mohammed Adam ◽  
Awadalla Wagealla ◽  
Lubna Boshara ◽  
...  
Keyword(s):  
Lung Ultrasound ◽  
Point Of Care ◽  
Power Doppler ◽  
Doppler Imaging ◽  
Point Of Care Ultrasound ◽  
Institute Of Medicine ◽  
Pubmed Central ◽  
Contrast Enhanced ◽  
Ultrasound Findings

: Lung ultrasound [LUS] has evolved considerably over the last years. The aim of the current review is to conduct a systematic review reported from a number of studies to show the usefulness of [LUS] and point of care ultrasound for diagnosing COVID-19. A systematic search of electronic data was conducted including the national library of medicine, and the national institute of medicine, PubMed Central [PMC] to identify the articles depended on [LUS] to monitor COVID-19. This review highlights the ultrasound findings reported in articles before the pandemic [11], clinical articles before COVID-19 [14], review studies during the pandemic [27], clinical cases during the pandemic [5] and other varying aims articles. The reviewed studies revealed that ultrasound findings can be used to help in the detection and staging of the disease. The common patterns observed included irregular and thickened A-lines, multiple B-lines ranging from focal to diffuse interstitial consolidation, and pleural effusion. Sub-plural consolidation is found to be associated with the progression of the disease and its complications. Pneumothorax was not recorded for COVID-19 patients. Further improvement in the diagnostic performance of [LUS] for COVID-19 patients can be achieved by using elastography, contrast-enhanced ultrasound, and power Doppler imaging.

scholarly journals Point-of-Care Ultrasound Findings and Clinical Outcomes in Patients with COVID-19

2020 ◽  
Vol 33 (11) ◽  
pp. 1416-1417 ◽  
Author(s):  
Rupa L. Iyengar-Kapuganti ◽  
Neil Patel ◽  
Malcolm Anastasius ◽  
Trent She ◽  
Bret P. Nelson ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Ultrasound Findings

scholarly journals Painless loss of vision: rapid diagnosis of a central retinal artery occlusion utilizing point-of-care ultrasound

2021 ◽  
Vol 2021 (6) ◽  
Author(s):  
Gregory M Taylor ◽  
Daniel Evans ◽  
Robert P Doggette ◽  
Ryan C Wallace ◽  
Andrew T Flack ◽  
...  
Keyword(s):  
Point Of Care ◽  
Posterior Vitreous Detachment ◽  
Central Retinal Artery Occlusion ◽  
Vitreous Hemorrhage ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Point Of Care Ultrasound ◽  
Loss Of Vision ◽  
Retinal Artery

ABSTRACT Point-of-care ultrasound (POCUS) has become an essential part of the evaluation of vision loss among emergency physicians in the emergency department (ED). It is frequently used to evaluate for vitreous hemorrhage, foreign bodies, retinal detachment, optic neuritis and posterior vitreous detachment; however, it can also be used to evaluate for a central retinal artery occlusion (CRAO). A POCUS can reveal a hyperechoic density in the optic nerve sheath just proximal to the retinal surface, and this is referred to as a retrobulbar ‘spot sign’ (RBSS). We present the case of an 88-year-old male that presented to our community ED with a painless loss of vision to his right eye. A POCUS revealed an RBSS of the central retinal artery and he was subsequently diagnosed with a CRAO. At his 1-month follow-up, he has regained light perception and 15% of his vision, however, remains with significant visual impairment.

scholarly journals Uveal Melanoma Identified as Ocular Mass on Point-of-care Ultrasound

2021 ◽  
Vol 5 (3) ◽  
pp. 367-368
Author(s):  
Hannah Spungen ◽  
Daniel Weingrow
Keyword(s):  
Emergency Department ◽  
Retinal Detachment ◽  
Uveal Melanoma ◽  
Vision Loss ◽  
Point Of Care ◽  
Black Spot ◽  
Distant Metastases ◽  
Posterior Chamber ◽  
Point Of Care Ultrasound ◽  
Point Of Care Ultrasonography

Case Presentation: A 41-year-old man presented to the emergency department with five months of progressive monocular vision loss in his right eye, which he described as a gradually descending and enlarging black spot. He had no light perception in his right eye with elevated intraocular pressure and an afferent pupillary defect, while his left eye visual acuity and pupillary exam was normal. Point-of-care ultrasound demonstrated a hyperechoic, pedunculated mass in the posterior chamber of his right eye, consistent with a diagnosis of ocular melanoma. Ophthalmology scheduled the patient for an elective, right eye enucleation the following week, after which a diagnosis of uveal melanoma (UM) was confirmed on histopathology. Discussion: Uveal melanoma is an uncommon diagnosis that requires prompt intervention and surveillance due to the possibility of distant metastases arising in up to 50% of patients. Emergency department diagnosis of UM may be confounded by features of other intraocular pathology, such as increased ocular pressure or the finding of retinal detachment on fundoscopy. When emergency providers encounter glaucoma or retinal detachment on physical exam, point-of-care ultrasonography represents a key adjunct in the timely diagnosis and referral of this potentially vision- and life-threatening malignancy.

scholarly journals Point-of-care Ultrasound in the Diagnosis of Calciphylaxis

2020 ◽  
Vol 4 (3) ◽  
pp. 495-496
Author(s):  
Natasha Tobarran ◽  
Mark Collin
Keyword(s):  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Emergency Physicians ◽  
Computed Tomography Imaging ◽  
Case Presentation ◽  
Tomography Imaging ◽  
History Of ◽  
Calcium Deposits ◽  
Stage Renal Disease ◽  
End Stage

Case Presentation: A 63-year-old male with a past medical history of end stage renal disease presented to the emergency department with painful, lower-extremity necrotic ulcerations. Ultrasound and computed tomography imaging showed concerns for calcium deposits. Biopsy confirmed the diagnosis of calciphylaxis, a rare lethal disease. Discussion: Emergency physicians should keep this disease on their differential due to the high mortality rate.

scholarly journals A Case Report on Paget-Schroetter Syndrome Presenting as Acute Localized Rhabdomyolysis

2020 ◽  
Vol 4 (3) ◽  
pp. 358-361
Author(s):  
Jonathan Lee ◽  
Ami Kurzweil ◽  
Shadi Lahham
Keyword(s):  
Case Report ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Axillary Vein ◽  
Vein Thrombosis ◽  
Chiari Type 1 Malformation ◽  
Arm Swelling ◽  
History Of ◽  
Vein Stenosis ◽  
Deep Vein

Introduction: The life- or limb-threatening differential diagnosis for upper extremity swelling can include deep vein thrombosis (DVT), infectious processes, and compartment syndrome. Chronic anatomic abnormalities such as axillary vein stenosis are rarely a consideration in the emergency department. Case Report: We present a 26-year-old female with history of Chiari type 1 malformation who presented with acute left arm swelling. Initial workup, including point-of-care ultrasound, revealed the presence of significant soft tissue swelling without evidence of DVT. Conclusion: Further workup revealed an early, localized rhabdomyolysis secondary to axillary vein stenosis or venous thoracic outlet syndrome, also known as Paget-Schroetter syndrome.

Case Report: Early signs of tamponade may be detected by cardiac point-of-care ultrasound

POCUS Journal ◽  
2017 ◽  
Vol 2 (3) ◽  
pp. 24-25 ◽  
Author(s):  
Michael Cenkowski, MD ◽  
Amer M. Johri, MD ◽  
Raveen Pal, MD ◽  
Jennifer Hutchison, RDCS
Keyword(s):  
Blood Pressure ◽  
End Stage Renal Disease ◽  
Point Of Care ◽  
Vital Signs ◽  
Point Of Care Ultrasound ◽  
Past Medical History ◽  
Pleuritic Chest Pain ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

A 35-year-old male with a past medical history of end stage renal disease on hemodialysis and a chronic pericardial effusion secondary to dialysis presented to the Emergency Room (ER) with a 2-week history of a flu-like illness and pleuritic chest pain. He was compliant with dialysis three times per week. His blood pressure was 150/85 mmHg with a heart rate of 85 beats per minute and the remainder of his vital signs were stable. Pulsus paradoxus was not present.

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