Submitted by Ismaeil Maksoud Khazma, MD, CSHE
I am a pediatric resident. Last year I was an intern, and on a morning round, an infant admitted during the night was presented to the team as 4 months old twin, with a history of vomiting over the past one month, being managed as possible cow milk allergy after many visits to ED. The team was concerned as she seemed more lethargic that morning.
Differential was so wide, but her drowsiness was very concerning.
I have my own POCUS ultrasound probe, and I used to carry it with me. I scanned the patient’s brain through the fontanelle and was shocked to discover evidence of hydrocephalus with a mass. Was the patient herniating? Neurosurgery was consulted immediately, and the neurosurgery team was at the patient’s bedside in under 10 minutes. An urgent CT scan was ordered. Surgery was performed early next morning after the patient stabilized at PICU.
The sad part of this story is that the patient unfortunately died within 2 months.
Has POCUS impacted the care you provided to a patient? Has it altered the course of treatment or helped you to diagnose?
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