Acalculous cholecystitis is thought to occur in patients with a severe systemic illness or during long periods of intravenous nutrition. We discuss a case of acalculous cholecystitis secondary to Ebstein-Barr virus detected by bedside ultrasound. We hope to alert clinicians who are actively using bedside of an important, yet not commonly discussed association. [West J Emerg Med. 2011;12(4): 481–483.]

Ultrasound-guided nerve blocks are quickly becoming integrated into emergency medicine practice for pain control and as an alternative to procedural sedation. Common, but potentially catastophic errors have not been reported outside of the anesthesiology literature. Evaluation of the brachial plexus with color Doppler should be standard for clinicians performing a supraclavicular brachial plexus block to determine ideal block location and prevention of inadvertant intravascular injection. [West J Emerg Med. 2014;15(6):-0]

Bedside ultrasound interrogation of the thorax can aide the clinician in determining the cause of the respiratory dysfunction. Often plain radiographs are not sufficient to differentiate pathology. We present a case in which bedside ultrasound defined the pathology without the need for further imaging. [West J Emerg Med. 2010; 11(4):322-323.]

This report highlights the importance of using bedside ultrasound in the emergency department to confirm guide-wire placement when performing central venous catheter placement prior to dilating and cannulating the vessel. [West J Emerg Med. 2011;12(1):100-101.]

A interesting case and image of a 50-year-old woman with a history of non-insulin diabetes mellitus (NIDDM) who presented to the emergency department with right hip pain for one week and the subsequent findings. [West J Emerg Med. 2012;13(6):494]

Introduction: The serratus anterior plane block (SAPB) has been shown to effectively treat pain following breast surgery, thoracotomies, and rib fractures. We present the first reported case of a bilateral ultrasound-guided SAPB in a multimodal analgesic regimen after an acute large, thoracic, deep partial-thickness burn.

Case Report: A 72-year-old male presented in severe pain two days after sustaining a deep partial- thickness burn to his anterior chest wall after his shirt caught on fire while cooking. The area of injury was on bilateral chest walls, and the patient was consented for bilateral SAPBs at the level of the third thoracic ribs (T3). With ultrasound guidance, a mixture of ropivacaine and lidocaine with epinephrine was injected into the fascial plane overlying bilateral serratus muscles at T3. The patient reported complete resolution of pain for approximately 15 hours and required minimal additional intravenous analgesia.

Conclusion: The ultrasound-guided SAPB may be an excellent addition to the multimodal analgesic regimen in superficial and partial-thickness burns of the anterior chest wall.

Ultrasound-guided nerve blocks are becoming more essential for the management of acute pain in the emergency department (ED). With increased block frequency comes unexpected complications that require prompt recognition and treatment. The superficial cervical plexus block (SCPB) has been recently described as a method for ED management of clavicle fracture pain. Horner’s syndrome (HS) is a rare and self-limiting complication of regional anesthesia in neck region such as brachial and cervical plexus blocks. Herein we describe the first reported case of a HS after an ultrasound-guided SCPB performed in the ED and discuss the complex anatomy of the neck that contributes to the occurrence of this complication. [West J Emerg Med. 2015;16(3):428–431.]

Left ventricular aneurysm (LVA) is a rare and dangerous disease process, for which rapid diagnosis can expedite further evaluation and treatment. Here we present the first case of LVA detected by focused cardiac ultrasound in a case of a patient with electrocardiographic findings consistent with a ST elevation myocardial infarction. [West J Emerg Med. 2012;13(4):326-328.]