I want to talk about one of the
long-standing applications for point-of-care ultrasound the assessment of soft tissue infection, and I want to tell you a little story. When I was in California working as a PEM (paediatric emergency medicine) fellow, I took care of a two-year-old girl who presented with recurrence of a buttock abscess. Now, MRSA was everywhere so getting abscesses over and over again wasn’t that unusual but what was troubling was that this one was always at the same site and this girl over the course of three
months had multiply IND’s, she had long courses of antibiotics, her
parents were at their wits end. So I took a look at with point of care ultrasound when she presented to me and instantly identified that there was a foreign body at the base of the abscess, and this foreign body had been acting as a nitus for ongoing infection. So we did an IND, we removed the foreign body turn out to be a bit of packing which we
presumed had come from the initial IND. So you can see the profound impact of point of care ultrasound. It’s important when you’re doing soft tissue
assessment of an abscess to kind of remember three things: You want to check with colors flow to make sure what you’re indeed dealing with is an abscess not a vascular structure.
You want to make sure that there’s a base and that you’re not
dealing with a fistula so make sure you define all the
boundaries of the abscess. And finally, make sure there’s no foreign body hiding in there. And if you follow those 3 rules you know, I think you’ll do a good job of
assessing abscess and clarifying what you’re going to do
when it comes to that soft tissue infections Remember to Like and Subscribe!