July 2018

First place

Dr. Josh Garber

 

Dr. Garber had a 69 yo female come in with hypotension and possible syncopal episode. Her VS apart from the hypotension were normal.  He performed a RUSH exam and found an IVC clot.  The CT chest/abdomen showed a renal cell carcinoma with clot propagating into renal vein and IVC, bilat large PE as well as right heart strain.  She had a slightly elevated BNP and lactate with a normal trop.  Patient was transferred to NYP for further care.  Check out the IVC images below.  A perfect example of how ultrasound changes management. 

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rUNNER UP:

Dr. Wing Tom

 

Dr. Tom had an elderly lady come in and was found to have a left femoral neck fracture.  A couple weeks before we had gone over a paper advocating for femoral nerve block use in the ED and he was able to put it to use on this patient, achieving pain control without using opiates.  He saved great images showing hydrodissection and creating a "donut" (bathing the whole nerve in anesthetic, causing it to pull away from the fascia).

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