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Open Access Publications from the University of California

Scholarly Works (3 results)

  • Article
  • Peer Reviewed
Clinical Practice and Cases in Emergency Medicine, Volume 3, Issue 3 (2019)
A healthy 18-year-old male presented to the emergency department with chest pain, palpitations, and dyspnea. His exam was unremarkable; however, point-of-care ultrasound (POCUS) revealed right ventricular strain with a D-sign and enlarged right ventricle. He subsequently reported a history of factor V Leiden. His D-dimer was markedly elevated, and a computed tomography angiogram of the chest demonstrated submassive pulmonary embolism (PE). He was taken to the catheterization lab for directed thrombolysis and was discharged in good condition two days later. Factor V Leiden is the most common genetic cause of venous thromboembolism. POCUS can facilitate rapid diagnosis and risk stratification of patients with acute PE.
  • 2 supplemental videos
Cover page: Dyspnea in an Otherwise Healthy 18-year-old: The Importance of Point-of-care UltrasonographyCreative Commons 'BY' version 4.0 license
  • Article
  • Peer Reviewed
UC San Francisco Previously Published Works (2020)
A patient presented to the emergency department with altered mental status and lower extremity weakness in the setting of nitrous oxide inhalant abuse and Coronavirus Disease-2019 (COVID-19) infection. He subsequently developed hypotension and severe hypoxia, found to have a saddle pulmonary embolus (PE) with right heart strain requiring alteplase (tPA).
    Cover page: Nitrous oxide inhalant abuse and massive pulmonary embolism in COVID-19
    • Article
    • Peer Reviewed
    Clinical Practice and Cases in Emergency Medicine, Volume 4, Issue 3 (2020)

    Introduction: First detected in December 2019, the severe acute respiratory syndrome coronavirus 2 pandemic upended the global community in a few short months. Diagnostic testing is currently limited in availability, accuracy, and efficiency. Imaging modalities such as chest radiograph (CXR), computed tomography, and lung ultrasound each demonstrate characteristic findings of coronavirus disease 2019 (COVID-19). Lung ultrasound offers benefits over other imaging modalities including portability, cost, reduced exposure of healthcare workers as well as decreased contamination of equipment such as computed tomography scanners.

    Case Series: Here we present a case series describing consistent lung ultrasound findings in patients with confirmed COVID-19 despite variable clinical presentations and CXR findings. We discuss a triage algorithm for clinical applicability and utility of lung point-of-care ultrasound in the setting of COVID-19 and advocate for judicious and targeted use of this tool.

    Conclusion: Lung point-of-care ultrasound can provide valuable data supporting diagnostic and triage decisions surrounding suspected cases of COVID-19. Prospective studies validating our proposed triage algorithm are warranted.

    • 2 supplemental videos
    Cover page: Using Lung Point-of-care Ultrasound in Suspected COVID-19: Case Series and Proposed Triage AlgorithmCreative Commons 'BY' version 4.0 license
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