Josh Guttman
6,361 posts
Josh Guttman
@drjgutt
Emergency Physician and POCUS enthusiast. Founder of Peachtree POCUS Consulting @PeachtreePOCUS
Atlanta, GA
Joined June 2014
- Me: would you like a Covid vaccine? [expecting a harsh response] Patient: yes. Me: yes you want the Covid vaccine? Patient: yes. I then immediately run from the room all giddy while I enter the order.
- I hate aortic dissections 1/ A middle aged patient presents with a week of severe abdominal pain and constipation. Has not had a bowel movement in several days. No fever or history of similar pain. HR 110, BP 168/110 otherwise vs wnl. history of cholecystectomy and c-section.
- I declare that recurrent pneumothorax is now named oldmothorax
- 1/ Wild cardiac arrest with #POCUS playing a major role An elderly male was sent from the nursing home in cardiac arrest. Per the prehospital report that we got, the patient was in vfib and refractory to 5 defib attempts. The patient got amio as well as several doses of epi.
- Saw someone with a bow tie wheeling the ultrasound machine. Clearly he is going to do a formal ultrasound
- Triage note says this 55f is here for fibroid pain. It’s midnight on Saturday night. “I’ve had fibroids a long time”, she tells me. Indeed she had been to an urgent care and primary care for her pain. There is no imaging in our system. She says it’s been getting worse for 2 wks
- 1/14 The hallway SOBs Twas a busy evening in the ED. I was coming out of the ressusc bay and I see 3 patients with the CC of "shortness of breath" all placed in hallway beds. X-rays were ordered already but X-ray is backed up. A resident has already seen 2 of the patients.
- Replying to @drjguttI didn’t make a genius diagnosis. My POCUS certainly expedited her diagnosis. Lesson is, never assume. she said fibroid pain so everyone assumed fibroid pain. This could have been picked up earlier with a decent history and realizing that this didn’t fit. Fin
- 1/ The #POCUS was not what it seemed A strong 3rd year resident presented me this case. A 47f p/w with a complaint of 1 month of abdominal distention and bloating. She has a history of alcohol use disorder and fibroids but no other medical history. Her exam showed distention
- I made a diagnosis of pneumonia with my stethoscope today. Please don’t tell anyone, my reputation will be ruined.
