Check out our latest Resus blog post! Megan Callaghan, MS4, breaks down Sympathetic Crashing Acute Pulmonary Edema (SCAPE) — from clinical presentation to management.

This case is by Dr. Nicole Minnerath and illustrates the detection of new hydronephrosis in a patient with bilateral nephrostomy tubes and ureteral stents. Read on to explore the role of renal and bladder POCUS in evaluating obstructive uropathy.

In this post, Dr. Tiana Sarsour highlights a case of recurrent abscesses and fever where POCUS confirmed a drainable collection, followed by a great review of abscess management and the role of ultrasound for skin and soft tissue infections.

This case is by Dr. Hannah Hendrix (now PGY2) and features a great example of the retrobulbar spot sign — a unique finding associated with embolic central retinal artery occlusion (CRAO). Read on for a quick review of ocular ultrasound and a closer look at this highly specific sonographic feature.

This post by Dr. Thomas Evans walks through the essentials of ultrasound-guided pericardiocentesis — when to do it, how to do it, and what pitfalls to avoid. We highlight the subxiphoid, parasternal, and apical approaches with practical POCUS tips for real-time needle visualization, plus a review of complications and how to keep the procedure as safe as possible.

To ring in our new year we wanted to spotlight another one of our former medical student rotators, Aubrey Strickland, who highlights the importance of using MAT in pregnancy. Remember narcan for everyone and to always call the poison center!

To get our medical student series started we want to introduce Student Doctor Janine Corley. She was inspired by our summer months in Cleveland and wanted to give a solid warning about eating shellfish. Enjoy this edition of Tox in the Land about Paralytic Shellfish Poisoning.

Lauren Porter DO, Ryan Marino MD, Bryan Ross MD, Marielle Brenner MD

Our latest blog post, by Sailakshmi Kumar, a fourth-year medical student at CWRU, explores ECMO in pregnancy with a focus on indications, physiological changes, and best practices for maternal and fetal care.

Welcome back to Tox in the Land!

After a short recess it’s time to get back at it. Since we are knee deep into interview season, there is no better time to put a spot light on our former chief resident and medical education fellow, Matthew Mullins, MD. He is here to guide you through the classic topic of iron toxicity and its management. Don’t worry, we will be back quickly to feature some of our medical student rotators as well!

Lauren Porter DO, Ryan Marino MD, Bryan Ross MD and Marielle Brenner, MD

This case is by Dr. Ryan Starkman (now PGY2) and is a great example of a large circumferential pericardial effusion with sonographic tamponade physiology diagnosed with POCUS. This expedited interventional cardiology involvement before the patient decompensated, and 750cc of fluid was successfully drained in the cath lab.

This case is by Dr. Jacob Perino and is a great example of an incidental finding of an iliac aneurysm found when performing a bladder ultrasound on a patient presenting with a malfunctioning Foley catheter. Read on to learn more about iliac aneurysms and bladder ultrasound in the setting of a Foley.

This month’s case is by Dr. Yanina Guevara who shares a case of painless monocular vision changes in a patient who was found to have a retinal detachment (and vitreous hemorrhage), first diagnosed with point-of-care ultrasound! This is accompanied by an overview of how to perform an ultrasound ocular exam and highlights some of the pathologies that can be visualized. Read on to learn more!

Dr. Nick DiMeo provides an overview of traumatic arthrotomy and outlines a diagnostic approach for this high risk pathology.

Dr. Bejan Kanga (PGY3) highlights the prevalence and morbidity of DVTs and PEs, provides a framework for determining appropriateness for outpatient management, and discusses treatment options.

Our latest Intern Ultrasound of the Month is by Dr. Abby Wissman and features a cool case of a complex cystic renal mass found incidentally. She reviews the basics of renal POCUS and dives into a great discussion about various renal pathology that we may see on ultrasound.

To follow up our most recent case of McConnell’s sign in the setting of an acute pulmonary embolism, Dr. Isma Dhanani goes more in-depth on the right heart and covers additional signs of right heart dysfunction - acute and chronic - that can be quickly identified with POCUS.

Our latest Intern Ultrasound of the Month is brought to you by Dr. Gabe Alagna. He presents a case in which POCUS performed on a patient in cardiac arrest found an enlarged right heart with McConnell’s sign, raising concern for PE, which quickly changed management. Read on to learn more!

Now that we’re in the midst of winter, there’s a good chance you’ll have a patient presenting with hypothermia. Our latest blog post by Lucas Rappert, a 4th year medical student from Kansas City University College of Osteopathic Medicine who recently completed our Resus elective, provides an excellent review of the pathophysiology and management of hypothermia in the ED. Read on to learn more!

Our latest Intern Ultrasound of the Month is by Dr. Annie Thai. She shares a case of a symptomatic abdominal aortic aneurysm and provides a great review of how to perform and optimize your aorta ultrasound exam. We hope you enjoy!

Holidays are a time for fun with the family, holiday traditions and snacks. Here is a blog from our PGY 1, Dr. Gabe Alagna, explaining why enjoying whipped cream from the can may not be the best option.

Our latest resus blog is an excellent review of REBOA by CWRU MS4 Matthew McCabe! Hope you enjoy!

Our next Intern Ultrasound of the Month is by Dr. Dave Wiliams and features a classic case of cellulitis in which POCUS helped support the clinical diagnosis and rule out an abscess. Read on for a great review of cellulitis and how to evaluate for soft tissue infections using POCUS.

Our latest blog is by MS4 Erica Fleming-Hall and explores the indications and evidence for Resuscitative Thoracotomy. Read on to learn more!

Our next Intern Ultrasound of the Month is by Dr. Matthew Hom and features a great case of vitreous hemorrhage diagnosed with POCUS. Read on to learn more about this and how to differentiate from ophthalmologic emergencies such as retinal detachment.

Our latest Resus blog post is by former CWRU MS4 Chris Schlechter which features a great discussion of resuscitative TEE and the evidence supporting its utility!

Our next Intern Ultrasound of the Month is by (now PGY2) Dr. Brian Fort and features a great case of post-viral pneumonia with associated pleural effusions diagnosed with POCUS when the patient was too unstable for CT. The patient’s course was further complicated by bacterial superinfection resulting in Lemierre syndrome.

Our latest Resus blog post is by former MS4 at CWRU Alexandria Gerber (now EM intern at UPMC) and features a great discussion about thromboelastography (TEG) and its utility in assessing real-time coagulation status and guiding management in resuscitations!

Summer has made our hearts sing! But that means it’s time to review some action potentials. This month’s blog is brought to you by now MD/PhD Dr. Sweet, a budding cardiologist in the making who rotated with us this past spring while still a student. Enjoy and call the Poison Center!