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Chest Pain in the Emergency Department

Really Focused or Hocus POCUS?

By Michael Prats, MD on 06/18/18 06:00 AM

This seems like a good idea. Chest pain is common. Ultrasound can see many causes of chest pain. Sooooo lets use ultrasound in patients with chest pain to help with decision making. Well, wipe the smile from your face validity because it is not that simple. This article takes an interesting approach in performing a rather complex "focused" echo in the emergency department and uses it to determine the patient's disposition. The main goal was to see how accurate this method could be. Let's see how this pans out.


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POCUS for Appendicitis in Moderate to High Pre-test Probability

Can you be more specific?

By Michael Prats, MD on 06/04/18 06:00 AM

Point of care ultrasound for appendicitis has a long and checkered past. It is well-established as first line in the pediatric population, but less accepted in adults. Some studies show that is great, other studies show that it is about as useful as an air conditioner in Antarctica. This article hits on the idea that perhaps we should risk stratify our patients and focus on ruling in the disease in those that are more likely to have it. Sound intriguing? Check it out.


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Emergency Physician Accuracy in Identifying and Grading Hydronephrosis

Can POCUS make the grade?

By Michael Prats, MD on 05/21/18 06:00 AM

As more and more emergency physicians are using point-of-care ultrasound to assess for hydronephrosis in the setting of renal colic, it becomes important to determine how accurate they are for the diagnosis. This study takes previously recorded clips and compares the EP interpretation to a radiologists interpretation. The idea is to see if EPs can determine the presence or absence of hydro, as well as the grade of it, compared to a radiologist looking at the same images. Both are then compared to CTs done in the same patients for a second standard of comparison. This brings to light interesting findings as well as questions regarding the best standard of comparison in this practice.


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Have you been living under a rock? If not - then you know that POCUS doesn't help hypotensive patients. Well...maybe don't believe all the hype. We will cover this in a podcast later, but for now you should read it yourself!