Ultrasound detection of superior vena cava thrombus.

Superior vena cava (SVC) syndrome is most commonly the insidious result of decreased vascular flow through the SVC due to malignancy, spontaneous thrombus, infections, and iatrogenic etiologies. Clinical suspicion usually leads to computed tomography to confirm the diagnosis. However, when a patient in respiratory distress requires emergent airway management, travel outside the emergency department is not ideal.

Perceived effectiveness of teaching methods for point of care ultrasound.

Background: Point of care ultrasound (POCUS) is a rapidly expanding aspect of both the practice and education of emergency physicians. The most effective methods of teaching these valuable skills have not been explored.

Objective: This project aimed to identify those methods that provide the best educational value as determined by the learner.

False-negative FAST examination: associations with injury characteristics and patient outcomes.

Study Objective: Focused assessment with sonography in trauma (FAST) is widely used for evaluating patients with blunt abdominal trauma; however, it sometimes produces false-negative results. Presenting characteristics in the emergency department may help identify patients at risk for false-negative FAST result or help the physician predict injuries in patients with a negative FAST result who are unstable or deteriorate during observation. Alternatively, false-negative FAST may have no clinical significance.

Expressive aphasia and carotid dissection.

Ultrasound images of a patient presenting to the emergency department with expressive aphasia who was found to have carotid dissection. The first image is a standard two dimensional image that depicts the internal carotid with a visible flap within the lumen. The second image is a color Doppler image showing turbulent flow within the true lumen and visible flow within the false lumen.

Retrobulbar hematoma from warfarin toxicity and the limitations of bedside ocular sonography.

The following case describes a 26-year-old female who presented to the emergency department with a nontrauamtic retrobulbar hematoma associated with warfarin toxicity. The application and limitations of focused bedside ocular sonography for this condition are discussed.

Splenic injury sustained during body hardening drills and the utility of ultrasound in a prehospital combat medical environment.

This report describes a case of intra-abdominal hemorrhage from body hardening drills in a U.S. soldier during Operation Iraqi Freedom.

Cardiac pathological conditions in young soldiers: case series.

We briefly review the disease processes for four young healthy soldiers who presented to our emergency department with serious cardiac pathological conditions. We present two unusual cases of myocardial infarction, a coronary artery aneurysm, and a case of smallpox vaccine-induced myocarditis/pericarditis. Our intent is to encourage others in military medicine to maintain a high index of suspicion for cardiac conditions even in a relatively young healthy population.

Presentation and management of a stage Ia lung cancer patient with a paraneoplastic factor VIII inhibitor.

Acquired inhibitors to clotting factors most commonly involve factor VIII and are associated with autoimmune disease. Factor VIII inhibitors can cause severe spontaneous and iatrogenic bleeding that is difficult to manage. Factor VIII inhibitors are rarely associated with solid tumors and only three cases of adenocarcinoma of the lung have been reported.