Can we fight against Pulmonary Embolism using the LR’s arrows?

Clinical Scenario

A 80 y/o woman presented to the ED for dyspnoea.

She underwent a knee replacement 2 weeks ago, RR is 24, O2 saturation is 88%. HR is 90, the knee is edematous.

You are going to hunt a pulmonary embolism (PE)

While you phone the radiologist for a thorax CT scan you have an idea:

Can a compression ultrasonography (CUS) helps to avoid a CT?

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Can Ultrasound rule out a pneumothorax?

Clinical Scenario

You are allerted for a level 3 trauma from the mountain, a cyclist has fallen going down hill.

You prepar the shock room with everything you may need, dress up, and wait.

A 25 y/o cyclist arrives completely immobilized, you immidiately start to  perform ABCDE as you learned in your recent ATLS course (you feel confident).

First stop is a possible problem in “B” (breathing): he has an ecchimosis on the right emithorax, not crepitation, maybe there is a less vescicular murmur on the same side, but you are not sure (the shock room is very crowded an noisy!), he is slightely tachypnoic (RR is 24), O2 saturation is 96%. …you go on….in “E” (Exposure) you find an exposed, bleeding, thigh bone fracture that surly is going to need surgery, at the moment you stop the bleeding, stabilize, allert orthopedic…ect…

FAST is normal. You ask for X-Ray : anteroposterior (AP) chest x-ray, pelvis and thigh bone. Confirmed exposed fracture, no signs of pneumothorax, surgery room is ready…

You recently have reeded the previous post and you don't feel confident about a negative thorax x ray, so you decide to “extend” your FAST and on the right emithorax you find a "lung point"...

are you going to let this patient be intubated?

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Is CRP correlated to CT result in the evaluation of abdominal pain?

A 74 yo/man complained of diffuse abdominal pain. The pain was intermittent and accompained by vomiting. He has no history of abdominal pain or abdominal surgery.

On examinations the patient presented non icteric, afebrile, not tachicardic. 

The abdomen was mildly distensed with midline tenderness. 

The US evidenced a normal aorta diameter. 

Abdominal x ray showed non specific bowel gas pattern. 

CRP value was 7 mg/L.

The radiologist says it is a little value to perform an abdominal CT, we see tomorrow…..

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Diagnosis of pneumonia. Is it the time for a combined imaging strategy?

A 80 yo man is brought from an assisted-living facility because of fever, productive cough, tachycardia and dyspnoea. 

He has a history of dementia and hypertension.

He is cachectic, you hear ronchi on the left side. 

How should you approach this patient?

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