The outbreak of a novel coronavirus disease (COVID-19) has been of concern to health care workers (HCW's) in the emergency department (ED) due to potential exposure and transmission. This case report describes a man who was referred to the ED for abdominal and testicular pain who was subsequently found to test positive for COVID-19. Due to the lack of respiratory symptoms, proper protective equipment (PPE) was not donned, and it led to several patients and health care workers being exposed. Given recent new descriptions of patients who present atypically, full PPE for all patients may be considered as community spread increases.
Background: Lung point-of-care ultrasound (POCUS) is a critical tool for evaluating patients with dyspnea in the emergency department (ED), including patients with suspected coronavirus disease (COVID)-19. However, given the threat of nosocomial disease spread, the use of ultrasound is no longer risk free. Objective: Here, we review the lung POCUS findings in patients with COVID-19. In doing so we present a scanning protocol for lung POCUS in COVID-19 that maximizes clinical utility and provider safety. Discussion: In COVID-19 lung, POCUS findings are predominantly located in the posterior and lateral lung zones bilaterally. A six-zone scanning protocol that prioritizes obtaining images in these locations optimizes provider positioning, and minimizes time spent scanning, which can reduce risk to health care workers performing POCUS. Conclusions: Lung POCUS can offer valuable clinical data when evaluating patients with COVID-19. Scanning protocols such as that presented here, which target clinical utility and decreased nosocomial disease spread, must be prioritized.
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