MetroHealth Emergency Ultrasound
MetroHealth Emergency Ultrasound
This is the official account of the Case Western Reserve University & MetroHealth Medical Center Emergency Medicine Ultrasound Division. Videos are not medical advice or views/policy of these institutions.
MetroHealth is an academic medical center that has served the city of Cleveland and Cuyahoga County for over 175 years. We offer comprehensive point-of-care ultrasound education for medical students, residents, fellows and physician faculty.
Our mission is to promote the use of bedside ultrasound through program development, education and research. Throughout our educational programs we seeks to prepare future leaders in emergency ultrasound through the development of academic, clinical and administrative skills in emergency ultrasound.
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Thanks, this is awesome because I had this done before but never did get to see the charts or the results, only what my urologist told me…. It was a fluid build up and it went away thank goodness. I was having a slight pain in one and didn’t know why.
Gonzalez Daniel Hall Gary Thomas Charles
Any way to connect with Dr. Gibson?
Aa aaa aaà aaa 😂
Very useful video. Clear, actionable information. Thanks!
Correction at 30:36 - The sensitivity and specificity of McConnell's sign is inverted. It should be 19% sens and 100% spec.
I have had My-Thurners for quite a few years. The clot is in my abdomen.. I have extreme discoloration with the skin on my ankles to above my knees. They turn dark gray or black when my Legs are not elevated. I have three large circular wounds on my abdominal skin that can last for a year after treatment and they still return again and again. A lot of pain in my lower back from the clot. I went to a specialist in Boston he was just rude and dismissive to me after waiting 3 months for a appointment. His only comment was “I can put in a stent if you want, but I don’t recommend it”.
What about the large bowel? That could be obstructed. Do you check the large bowel to?
Great question. Yes, LBO can happen though significantly less common than SBO.
Thank you, do you give any medication ( for example midazolam) in emergency departmant before tee?
Our protocol requires patients to be intubated. So, they are already sedated for the intubation.
How is the caliper placed. Like how many cycles?
Caliper placed over the fetal heart. The number of cycles depends on the machine. Our machines are programmed to an every other beat cycle.
Amazing
This needs to be added as addressed as a vital sign. My sister died of sepsis, multiple organ failure.
Thank you for sharing your knowledge and experience
Thanks Dr
الله لا اله الا هو الحي القيوم
Great lecture! However, at 30:40 the sensitivity and specificity of McConnell Sign should be changed positions. Am J Cardiol. 2002 Sep 1;90(5):507-11. "Sensitivity and specificity were 81% and 45% for "RV-pressure overload" signs, 25% and 94% for 60/60 sign, and 19% and 100% for McConnell sign."
Thanks for picking that up. Correction made in the comments.
Well done...
Thanks
Hi
Had a nerve block prior to foot surgery. There was a painful shooting pain during the injection. Almost a 1 year later, I still have numbness and spasms in my foot. Hope it will resolve eventually.
Excellent
Thanks
Description in writing
Amazingg
Thanks
Good good
1) How do we know on a machine we've never used that u measure 1 or 2 cycles on M Mode? 2) at what week does CRL become phased out? I believe at week 12 from what I recall on most machines I've used. (General/vascular tech here that's done only vascular for the last 5 yrs)
Sometimes it tells you in the calculator. Otherwise you measure between peaks and see what number you get and see if it makes sense. If you measure every beat on a machine that does every beat, your rate will be 2x. Same and opposite if you measure every 2 beats on a machine that measures every beat.
Listening to replay in Kansas City.
Thanks Ron!
Hiii Can u make a video on transcranial ultrasound in adults?
Two yrs ago. I was standing on the back deck .A board broke ,I had no time to react .Fast forward I had a follow up with the orthopedic to see if I was going to be released for work .My job is very physical .The P.A walks in and says .I don't see why you wouldn't be able to return to work .I had a fluid pocket on my thigh .She never looked , dismissed my concerns and they don't treat hematomas . The very next night ,my leg had busted open .I didn't even realize it was ruptured until my flipflop was wet ..Long story !! Saturday Eve it ruptured Tues afternoon I was in the ER very sick !! Worst pain ever .Spent 19 days in the hospital .gases trapped , debridement twice !! And I have a non healed wound . Devastating injury .Lots of times patients are misdiagnose.just a disheartening injury
Hi doc, I hope you'll notice, Do musculoskeletal ultrasound will show muscle tissue damage? Thank you
It can depending on the injury. It will often appear as a disruption of the normal fibular architecture of the muscle. Often combined with change in echogenicity, thickening and fluid.
Hi doc, I hope you'll notice do MSK ultrasound will show muscle injury? Thank you doc
I think given the findings of prophy-vap trial, ed physician can quickly scan the acute brain insult patient who had an rsi and if there is full stomach, confidently give emperical antibiotics to prevent downstream VAP. What are your thoughts?
Great question, but probably a highly nuanced answer. The prophy-vap study is an interesting idea but a reasonably small study. While there may be some signal here, we probably need more studies for it to be accepted as mainstream. As for gastric POCUS first to determine if we should give antibiotics - if the prophy-vap outcomes hold up, further studying which patients benefit most (+/- POCUS) would be an interesting area of study.
This is fasciianating
Hi doc, I hope you'll notice, may I ask what's the difference between MSK Ultrasound ang General Ultrasound? Thank you
The thing being evaluated. Both rely on basic ultrasound principles. But MSK ultrasound focuses on muscle/tendon/bone.
hello doc, very thank you for this lecture!!! May I wish that you make a video of POCUS of peripheral arterial occlusion disease at the future? thank you!
This is the best video I have seen so far. The way he explained the fibrous encapsulation helped me a lot. I was hit by a car 14 years ago. I developed a large morel lesion. After the original event I had to have fluid removed. Years later there is no longer fluid, but the large mass is still there. The ultrasound suggested fluid accumulation, but nothing came back during aspiration. The doctor told me there was nothing they could do because there was no fliud to remove. They didnt explain why the mass is still there. Thanks for the video.
great tutorial 💯
Appreciate it
Beautiful video Sir.👍
Thank you
really grateful and excited to see this topic! thank you
You're so welcome!
Hi doc, is it possible that hematoma will take for a year to resolve? Thank you
Hi doc, may I ask? why doctors recommend aspiration for hematoma and why some says not recommended to do aspiration? Thank you
Your wisdom, even beyond ultrasound, is appreciated!
Also want to know if we can angle correct CW dopppler sampling in eccentric TR jets to get a close to true TR velocity
Same as previous response. Machine dependent.
Excellent discussion and teaching. Congratulations. My questions: Can we do angle correction in pulsed doppler to assess mitral E velocity?. I notice that the LV imflow is sometimes at an angle and such correction will give the true E velocity
Great question. It would be machine dependent. If the machine doesn’t allow then you need to adjust your window to optimize the Doppler angle.
Thanks that was very comprehensive. Any suggestions about applying traction for loose skin. Sometimes i run into issues puncturing the vein on older patients.
Thank you. Loose skin is less important with ultrasound. Once you get under the skin, follow the ultrasound to guide the needle to the vein. Rolling veins can be a problem. When you get the needle tip over the vein where you can see some tenting of the vein wall, give the needle a sharp pop and you can usually get the needle tip in the vein.
Please make a video on diastasis recti
Really appreciated your lecture on soft tissue
Glad it was helpful!
Excellent
Thank you so much 😀
Great info! Ty!
Dr, Matthew, excelent analisis on IVC U.S. observation, it´s not just good images and messurements, the usefullnes is to understand the dynamics in order to take some action (or not) on a patient. based on theese observation . thanks and go on with this work
Thank you.
Thanks man!
hello doctor, can I ask from which article do you find the result that stone < 5mm might don't have posterior acoustic shadow, thank you!