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Biliary POCUS & Surgical Referral

Does Positive POCUS = Cholecystectomy?

By Michael Prats, MD on 02/04/19 06:00 AM

The gallbladder loves to be scanned - a fluid filled sac nestled against a wonderful acoustic window? Are you kidding me? In any case, here is what we know: ultrasound is good for diagnosing cholecystitis, point of care ultrasound in the emergency department is good for diagnosing cholecystitis, BUT many surgeons still prefer a comprehensive RUQ ultrasound prior to cuttin' anyone. This article takes a look to see if these positive findings in the ED lead to people requiring cholecystectomy. Also - does it actually save time? https://www.ncbi.nlm.nih.gov/pubmed/30109274


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Chest Pain and Shortness of Breath

Does POCUS Help?

By Michael Prats, MD on 01/21/19 06:00 AM

Chest pain is fun, right? Maybe add in some shortness of breath? It can be hard to sort through the potentially sick from the okay to go home. We know that point of care ultrasound (POCUS) can be helpful in making or excluding many cardiothoracic pathologies, but we don't even know if it really makes a difference! This article takes the first step by asking, "when you use POCUS, does it help lower the diagnostic uncertainty about that patient?" Secondly, it takes on an old rivalry by comparing POCUS to chest xray in these patients. https://www.ncbi.nlm.nih.gov/pubmed/30413369


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Carotid Flow Time for Fluid Responsiveness

The Solution for Fluid Responsiveness?

By Michael Prats, MD on 01/07/19 06:00 AM

Fluid responsiveness has been all the rage in emergency and critical care medicine. Trying to determine which patients will benefit from fluids or how much fluids is a daily struggle for providers. However, every new measurement or technique to quantify a patients possible responsiveness to fluids has been riddled with problems. Is carotid flow time, the holy grail that we have been waiting for? This study dives into the use of carotid flow time in an ICU patient population and attempts to answer if flow time can predict fluid responsiveness.


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