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drshukla14 Profile picture
@DrShukla14
Mar 27, 2020 • 3 tweets • 2 min read • Read on X
#POCUS in #COVID19 - there is some controversy about its use- due to infection control issues. IMHO - in EM - the role is even bigger in undifferentiated dyspnea in this pandemic. How do you know if its COVID19 or even pneumonia in the beginning!
The EM question is: Can #POCUS add value to physical exam in Acute Dyspnea performed with full #PPENow - in resource limited setting? I think the question answers itself.
My favorite resource on Lung #POCUS for this by the fantastic @theSonoCave sonocave vimeo.com/400061273

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More from @DrShukla14

drshukla14 Profile picture
Sep 15, 2023
1/n Acute right hip pain on the background of subacute migratory polyarthritis, probably reactive. #POCUS helped diagnosis of right hip effusion, consistent with synovitis. Normal left hip joint image for comparison, showing no effusion.

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2/n Joint aspirated. Low clinical suspicion of septic arthritis, thus simultaneously injected with triamcinolone+lidocaine (rheumatology colleagues supported the decision).
3/3 IMHO hip aspiration, though not commonly done by EM, is an easy skill for ##EMPOCUS provider who already does US guided vascular access. Reduced ED LoS to 4 h in this case (very supportive rheumatology followup). Moreover patient was very satisfied with symptom relief.
Read 4 tweets
drshukla14 Profile picture
May 26, 2023
1/n: Thread of interesting ED #POCUS case. F/70+, known epigastric hernia (relapsed post repair years ago). Repeated vomiting since 1 week. Labs and plain x-rays - ImageImage
2/n Distended stomach noted on #POCUS -
3/n Clinically the hernia appeared to be reducible. However, #POCUS demonstrated obstruction of gastric outflow due to incarcerated portion of gastric antrum.
Read 6 tweets
drshukla14 Profile picture
Mar 11, 2023
1/n #POCUS Acute right scrotal pain. Performed awaiting scrotal exploration. "Saddle view" from inferior poles to assess gross difference between echotexture
2/n The normal (Left) testis - shows normal internal septal architecture with pulsatile blood flow on color power doppler, with normal overlying skin thickness.
3/n Right testis is swollen, disturbed architecture with heterogenous echoes due to edema and absent flow on CPD
Read 7 tweets
drshukla14 Profile picture
Nov 19, 2022
#POCUS case 1/n - Chest pain since 2 hours. Is it posterior STEMI ?
2/n #POCUS Apical Long Axis (A3C)
3/n Admitted to cardiology and PCI to LCX done.
Read 5 tweets
drshukla14 Profile picture
Apr 21, 2022
1/4 #POCUS EM case: M/50, anginal pain since 2 hours. ECG: lateral STEMI. Decision for fibrinolytic therapy (non-PCI site)
2/4 #POCUS appearance of lateral hypokinesia on Short Axis LV:
3/4 #POCUS appearance of lateral wall hypokinesia on Apical 4 Chamber -
Read 5 tweets
drshukla14 Profile picture
Apr 9, 2022
1/n #POCUS case - F/28. Left wrist pain since 2 weeks, severe since 48 h -> ED visit. Unable to grip due to painful thumb movements. Tender over lateral radial styloid area, Finkelstein test +. Dx: De Quervain tendinopathy.
2/n Comparison with normal - * marks fluid pockets around thickened tendons APL and EPB.
3/3 Gratifying relief after injection (levobupivacaine+triamcinolone), discharged with primary care followup.
Read 4 tweets

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