Background: The latest guidelines on parapneumonic effusion (PPE) management1 recommend immediate evaluation of PPE with ultrasound. Recognizing that bedside procedure services (BPSs) staffed with procedural hospitalists (proceduralists) are becoming the first point of ultrasound contact for many patients admitted with PPE our study sought to demonstrate that proceduralists can reliably agree with radiologists (viewed as […]

Background: Despite widespread use of peripherally inserted central catheters (PICCs), about 1 in 20 patients who receive these devices will develop PICC‐related deep vein thrombosis (DVT). Preventing this complication is an important goal for hospitalists. Although prophylactic anticoagulation with heparin for the duration of catheter placement (both in and out of the hospital) has been […]

Background: Deep Vein Thrombosis (DVT) is a pathology characterized by the formation of a blood clot inside the venous system. It comprises either distal vein thrombosis, but also proximal vein thrombosis (i.e. Femoral, Popliteal and Iliacal veins), which leads to a significant increase in complications of the disease, such as pulmonary thromboembolism (PE) and even […]

Case Presentation: Lemierre's syndrome is a rare form of thrombophlebitis, usually associated with tonsillitis and peritonsillar abscess, which can harbor anaerobic bacteria (most commonly Fusobacterium necrophorum). Deep to the abscess, the bacteria can grow and pass into an adjacent internal jugular vein, causing septicemia and septic emboli. A 19‐year‐old female presented to the ED with […]

Background: Point-of-care ultrasound (POCUS) is increasingly being used across medical specialties, improving diagnostic accuracy in numerous medical presentations and levels of acuity. Training in these skills is currently offered through major societies, but graduate medical POCUS training in internal medicine and family medicine is not common in US residencies. Therefore, we designed a two-week inpatient […]

Case Presentation: A 41‐year‐old man with insulin‐dependent diabetes and hepatitis C cirrhosis with multiple variceal bandings presented with progressive right‐sided weakness had been seen at an outside hospital 6 months prior to admission, where ring‐enhancing lesions in the left frontal lobe were noted on CT and MRI. CSF and serum analyses for toxoplasmosis and a […]

Case Presentation: A 53‐year‐old woman presented with vomiting, severe headache, and neck stiffness. She had no recent sick contacts, travel or tick bites. She was without identifiable HIV risk factors or family history of immunodeficiency disorders. Physical examination was notable for fever and meningismus. She had no rashes or neurological deficits. CBC and CMP were […]

Background: We have markedly expanded Point-of-Care Ultrasound (PoCUS) education within our Internal Medicine residency program through multifaceted instructional interventions. But despite an increasing number of trainees familiar with PoCUS, there remains insufficient real-time clinical use and supervision due to a lack of formal PoCUS training and experience among attending faculty. Traditional PoCUS faculty development programs […]

Case Presentation: A 28‐year‐old previously healthy Hispanic man presented for evaluation of bleeding gums and rash. Four days prior he noted mild fatigue, cough, headache, and subjective fever consistent with an upper respiratory tract infection. On presentation, vital signs were stable, and physical exam revealed petechial hemorrhages on the soft palate with bleeding gums (wet […]

Background: POCUS is increasingly being used across medical specialties, and adds value to diagnostic accuracy for numerous pathologies and levels of acuity. Emergency Medicine providers were early adapters, providing examples of how POCUS increases patient satisfaction and diagnostic clarity (1, 2). Internal Medicine and Family Medicine have been slower to adopt this technology; however, general […]