Point-of-Care Ultrasound is Having Its Moment

Prehospital Ultrasound Diagnosis of Massive Pulmonary Embolism by Non-Physicians: A Case Series

Massive pulmonary embolism (hemodynamically unstable, defined as systolic BP <90 mmHg) has significant morbidity and mortality. Point of care ultrasound (POCUS) has allowed clinicians to detect evidence of massive pulmonary embolism much earlier in the patient's clinical course, especially when patient instability precludes computerized tomography confirmation. POCUS detection of massive pulmonary embolism has traditionally been performed by physicians. This case series demonstrates four cases of massive pulmonary embolism diagnosed with POCUS performed by non-physician prehospital personnel.

Radiography Versus Sonography in the Detection of Acute Fractures: A Case Series

Plain radiography is often considered a first-line diagnostic tool and gold standard for bony fractures. This case series and brief literature review highlight the need for increased training in musculoskeletal sonography. A case is presented of a distal radial fracture that was not detected on radiography but diagnosed with sonography on the same day. Similarly, two fractures of the distal fibula were diagnosed using sonography after negative radiographs at follow-up appointments, led to misdiagnoses and mismanagement. A fourth case is presented to show an acute rib fracture diagnosed by sonography. These cases emphasize the importance of musculoskeletal sonography training in the diagnosis of acute fractures and its underutilization at the bedside. Collaboration between sonographers and physicians may increase utilization of musculoskeletal sonography which in turn may improve patient care and outcomes.