POCUS

By Eric Dornoff, MD; Kelly Rath DNP; Vasisht Srinivasan MD Case Details A 38-year-old woman, previously healthy, was admitted to the neuroscience intensive care unit following a thoracic fusion. On post-op day four, the patient suffered a syncopal event and was hypotensive, tachycardic, and hypoxemic. A rapid response was called, she was started on oxygen by nasal cannula, given intravenous fluid boluses, and admitted to the neurocritical unit for further monitoring and work-up. An EKG was obtained, which ...

Donald Langan, MD, PharmD, Alexandra Schroeder, PA-C Ischemic strokes in younger adults, those 18 to 50 years old, account for approximately 10% to 15% of all ischemic strokes. Risk factors for stroke between younger and older patients tend to be similar. Younger patients suffer from cardioembolic or embolic strokes of undetermined significance, while older adults, greater than 50 years, tend to have a higher frequency of ischemic stroke due to large vessel atherosclerosis or lacunar infarction. 1 Risk factors for cardioembolic stroke include atrial ...

Mikel Shea Ehntholt Neurocritical Care Fellow, Hospital of the University of Pennsylvania Department of Neurology A 73-year old woman presented to our institution with a three-week duration of headache and dizziness. She had a past known history of an aneurysmal subarachnoid hemorrhage, secondary to a posterior communicating aneurysm that was coiled five years prior, hypertension, and hyperlipidemia. Her symptoms prompted an outpatient evaluation and was recommended for repeat digital subtraction angiography (DSA). On the day of the DSA she ...

Mahammed Khansuheb, MD; Amay Parikh, MD Percutaneous tracheostomy (PcT) is a technique first described by Shelden in 1957. Over 100,000 adults in the United States receive tracheostomies each year.  More than 50% of these are for prolonged mechanical ventilation due to acute respiratory failure.[1] Traditionally, tracheostomy is favored prior to the fourteenth day of mechanical ventilation to minimize injury to the tissue surrounding the endotracheal tube and to initiate aggressive ventilator weaning. Ultrasound-guided PcT (US-PcT) is advantageous ...