Vascular Ultrasound - Aorta & Lower Extremity Veins
/It's a frosty Easter morning and the ED is "q!&%t," all except for the 2 patient's turned over to you by the night ranger. You greet the first patient, a 75 yo M complaining of flank pain - probably a kidney stone you think to yourself as you walk in to the room. Walking into the room, you see the patient rolling around on the stretcher (as one would expect from those with a stone jammed in the UVJ), but something about his presentation strikes you as odd - a bit of diaphoresis, clammy pale skin. It could just be pain, but the specter of a ruptured abdominal aortic aneurysm still looms large in your differential diagnosis. You quickly exit the room, grab the ultrasound machine and head back in to take a look at his aorta...
Abdominal Aortic Ultrasound
After finding the 1st patient's ruptured AAA, you take a breath and see what has brought patient 2 to the ED. Walking into the room, introducing yourself to the patient, you find Sam, a pleasant 35 yo F who came into the ED with swelling of her right leg. Examining her you find a diffusely swollen right leg without any skin changes to suggest cellulitis and positive calf tenderness. Concerned for the possibility of DVT, you could risk stratify her by Well's DVT score, maybe send a d-dimer, maybe empirically anti-coagulate and have her follow up tomorrow when the vascular techs are in house. Or, you could take a look yourself...
