Monthly Archives: April 2010

Case of the Month: April 2010

Thanks to Tatiana for an expertly presented ultrasound case of the month.  She was kind enough to put together this summary.

43y.o. F with pmh of asthma, HTN, recently treated for PNA p/w worsening dyspnea, pleuritic chest  pain,  cough and fever. Found to be tachypnic and tachycardic in the ED. CXR suggesting perihilar PNA. While awaiting chest CTA to r/o PE you perform bedside echo and obtain the following image:

Is there anything abnormal? How does this change your management?

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SAEM Endorses the 2008 ACEP Ultrasound Guidelines

ACEP and SAEM are now united in their support of the revision of ultrasound guidelines published by ACEP in 2008.  See Dr. Moak’s comments below:

I am pleased to announce that the SAEM Board of Directors has endorsed the 2008 ACEP Ultrasound Guidelines.  The vote was unanimous.  This endorsement represents a very strong commitment to our aims as a community of emergency sonographers, and is congruent with our mission as educators and researchers in the field.  I’d like to highlight the hard work of Dr. Vivek Tayal, the primary editor of the guidelines, and the many others who contributed.  We are also grateful to Dr. Jeff Kline for his advocacy for this initiative among the membership of the SAEM BOD.

Best regards,
Chair, SAEM Ultrasound Interest Group

Top 50 CME Blogs

Finally- a little recognition! We were named one of the top 50 continuing medical education blogs by Nurse E.D.U.
Although there is no mention that they were listed in any particular order, we will consider ourselves in the top 20 of that list since that’s where we fell.
Today, Nurse E.D.U.
Tomorrrow, The Huffington Post!

Research scholars

The ultrasound division is proud to welcome two research scholars: Dr. Hong Chuen Toh and Dr. Shiang-Hu Ang.

Drs. Shiang-Hu Ang (Ash) and Hong Chuen Toh

Dr Hong Chuen Toh is an Associate Consultant from the Department of Emergency Medicine, Alexandra Hospital, Singapore. He obtained his bachelor degree in medicine and surgery M.B.B.S (Singapore) in 2000 and post graduate degree in Accident and Emergency Medicine MRCSEd (A&E) in 2007. He’s a member of the Royal College of Surgeons of Edinburgh, and his main sub-clinical interest is in emergency ultrasound. He has organized many WINFOCUS courses at his home hospital.
Dr. Shiang-Hu Ang (also known as Ash) is from Singapore’s Changi General Hospital Department of Emergency Medicine. He has been tasked to set up an emergency ultrasound service for his department. His interests include emergency ultrasound as well as emergency critical care, and his research interests lie in the ever expanding field of emergency soft-tissue ultrasound. He also manages the website of the Society for Emergency Medicine in Singapore- please check it out!

Lung point

Thoracic ultrasound is one of the hottest topics in emergency and critical care sononography. Assessment for pneumothorax is accurate and relatively easy to learn.

One important sign when assessing for pneumothorax is the lung point. This is the point where normal pleural interface contacts the boundary of the pneumothorax. It is the most specific sign for pneumothorax using ultrasound.

Using B-mode ultrasound, the lung point will appear as the boundary between normal lung sliding and still lung.

Lung point:

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AIUM 2010- Day 3

Another beautiful sunny day. Although some people left for early flights back home, there was still some life left in the conference on Saturday.

Notable events included:

Sinai’s own Henrietta Rosenberg, MD, hosting a meet-the-professor session on sonography of the infant hip

EM/Critical Care track session on the ultrasound evaluation of dyspnea, featuring Anthony Dean, Paul Sierzenski, Vicki Noble, David Bahner, and Jim Tsung.

Scientific session on Emergency Sonography research in the afternoon

Just Images- cardiac ultrasound in the ED and ICU, including contributions by Chris Moore, Alexander Levitov, Jim Tsung, and Erika Kube.

San Diego 2010 Final Thoughts:


The Transcranial Doppler session was great. The best part of the AIUM conferences for me is learning something new and getting outside of my comfort zone. The faculty for the TCD course made the technique look easy. Although you can’t hope to master a new clinical skill in an afternoon, I was inspired to learn more about this technique and how it could impact care in the ED.

Zsolt Garami, director of the TCD Center at Methodist Hospital in Houston, demonstrated the perfect blend of knowledge, technique, wit, and sarcasm to make for a fantastic experience!


The Just Images sessions were really useful. Lots of great cases, and an excellent video of a pupillary reflex from Chris Moore.


The coolest thing I saw was in one of the OB sessions- a 4D/3D plus real-time movie of an ultrasound guided needle sampling of fetal blood cells from an umbilical cord floating in the amniotic sac.  That was pretty cool- and the future for ultrasound guided procedures.