February 26, 2021

A 31-year-old female presents with right ear pain and decreased hearing. Her symptoms started suddenly after trying to clean her ears with a Q-tip. She denies vertigo, nausea, vomiting, or other facial symptoms. On examination, you see a small perforation in the tympanic membrane (TM) with no discharge or other trauma.
What is your next step in evaluation and management?

It’s not what you think – POCUS is not going to be used to diagnose a GI bleed. However, perhaps it can be used to risk stratify this diverse group of patients. These authors had the idea to check IVC, echo, and LVOT VTI to see if it could help predict which patients are going to have adverse events from their bleed.