Champagne Tap: Ultrasound "forEM"
Thursday, September 12, 2013
Ultrasound Competition WINNER for AUGUST
Dr. Laura Melville AND Dr. Mike McMahon
Youngish F hx thombophilia, DVT, PE s/p IVC placement presenting to the ID for suprapubic pain sudden, back pain for a week and arrived hypotensive, diaphoretic and tachycardic.
Vitals 70systolic, HR 120s. sat 99%.
In ED bedside echo showed massively dilated >1:1 RV:LV and PSS showed D sign. This essentially diagnosed PE.
Arrival to ED. pt got intubated, pressors, recieved tPA in ED. She was admitted to the ICU and found to have bilateral PE's with RLL infarction.
4 days later: Discharged. Placed on Xarelto. Pt extubated, off pressors, ECHO shows normal LV EF 62%,
RV pressure = 50
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