Can J Emerg Med
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Acute heart failure and chronic obstructive pulmonary disease (COPD) are sometimes difficult to differentiate in the emergency department (ED). We sought to determine the clinical impact of point-of-care ultrasonography (POCUS) in ED patients with suspected acute heart failure or COPD. ⋯ In this study, use of lung POCUS resulted in no difference in ED length of stay and time to disposition decision, but was associated with faster administration of disease-specific treatments for elderly patients with suspected acute heart failure or COPD.
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A 67-year-old male presents to the emergency department (ED) with a 10-minute history of right upper extremity and right facial weakness, which came on suddenly. His symptoms spontaneously remitted. He has never experienced symptoms like this before. ⋯ Reflexes, coordination, and gait are all within normal limits. Cardiac and respiratory examination are also unremarkable. His electrocardiogram shows normal sinus rhythm.
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A 12-year-old male injured his ankle while playing hockey (Figure 1). His dad reports that he was checked into the boards. ⋯ His distal neurovascular exam is normal. There is bony tenderness over the lateral malleolus in accordance with the Ottawa Ankle Rules.