The case.
An obese 86 year old female is bought to ED by private car with a 5-6 day history of progressive dyspnoea and fevers. She is promptly rushed into the resus bay in extremis with cyanosis & poor respiratory effort. [Read more…]
probe prevents probe…
Recently, a colleague of mine was wanting to perform a diagnostic tap on a patient with cough, fever and a CXR suggesting a left sided pleural effusion….
I was asked to perform a bedside USS to mark out the safest place to perform the pleural aspirate.
I percussed the chest to the dullest point and then slapped the ultrasound on (left posterior chest wall, longitudinal plane, just below tip of scapula).
This is what I saw…
Needless to say the needle was re-sheathed and the procedure aborted. I am convinced that if we were going by x-ray and clinical examination alone we would have created more problems for this guy.
What made a difference….
- Turner JP, Dankoff J. Thoracic ultrasound. Emerg Med Clin North Am. 2012 May;30(2):451-73.
- Ultrasound Podcast Episode 31 (Pneumothorax & Pleural Effusion) & Episode 32 (Pneumonia & ARDS)
- Sonocloud