Right Ventricular Strain in Pulmonary Embolism

An 75 year old woman presented to the emergency department for evaluation of shortness of breath, generalized fatigue, and diarrhea. Initial nursing notes reported history of COPD with Sp02 of 89% on room air.  The patient had been discharged two...

Pericardial TB with tamponade

While working at a teaching hospital in Haiti, a patient in her 30s presented to the ED with altered mentation. Upon initial evaluation, the patient appeared to be very sick. The residents, who have embraced point of care ultrasound as a diagnostic tool, quickly noted...

Intrauterine Devices

A 23-year old female patient presented to the emergency department with a sensation that her intrauterine device (IUD) was out of place.  The patient had the device placed 2 weeks ago.  She was checking at home, thought she felt a piece of plastic, and presented to...

Post-Renal AKI

A 55-year-old male presented to the ED with a one-week history of fevers, nausea, vomiting, with mild supra-pubic discomfort in the absence of any other GI complaints. He endorses nocturia and incomplete bladder emptying for 10 years. He reports that at some point in...

HIV and Syncope

A 35-year old male with history of HIV presents to the ED after a witnessed syncopal event in clinic.  The patient walked up to front desk and collapsed.  There was no tonic-clonic activity and the patient quickly returned to baseline mental status.  He last...

Hand Infections

A 40 year-old male patient presents to an emergency department after suffering multiple dog bites, including one to the left thumb.  His wounds are irrigated, and he is suspected of having  a thumb extensor tendon injury on exam.  The lacerations are approximated with...

Spontaneous Pneumothorax

A young man presents to the ED with acute onset right chest pain and shortness of breath. Ultrasound exam is consistent with a pneumothorax, but he has a normal CXR. Which do you believe?

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