ULTRASOUND CHRONICLES: ALTERED MENTAL STATUS

“Here in our ultrasound images, we had been able to identify the root cause of his problem with no other test.”

by Dr. Lori Stoltz, GEC Ultrasound Director

Going through all of the cases of patients that I saw with the ECPs at Masaka during my last trip, one case stood out for having so many beautiful ultrasound images. The ECPs were called to help with a foley placement on the wards. The intern physician had tried and had been unable to place the foley and so had asked the ECPs to try. Deus was the ECP trainer in charge that day and he brought along the ultrasound machine. 

In front of us was an elderly gentleman, looking very ill, lying in bed, confused, moaning, on oxygen. The ECPs first took a look at his bladder with ultrasound and found an enormously dilated bladder. Next they looked at his kidneys…they were dilated with fluid on both sides. Whatever was obstructing his bladder, was obstructing the flow of urine all the way up to the kidneys. It became immediately apparent that this was the likely cause of his confusion. When urine cannot pass, the toxins and byproducts that urine is meant to expel build up. One of these, urea, causes confusion. Here in our ultrasound images, we had been able to identify the root cause of his problem with no other test. Deus noted that he was oxygen, so he looked at the patients lungs with ultrasound. The lungs were full of edema, or fluid. So, now we knew, that the kidney failure was enough to cause an overloading of fluid in his entire body causing even his lungs to be overcome with fluid.

They set about to the task of placing a foley. The catheter was expertly placed in urethra by one of the ECPs in training under the guidance and direction of Deus. A quick ultrasound exam showed the foley to be right where it should be in the bladder. Now the urine could drain from the bladder, then the kidneys and hopefully, the patient’s kidneys could continue to rid his body of the additional toxins and fluids that had built up. All around fantastic use of ultrasound. 

Ultrasound Machine Fundraiser for GEC – 100% Match
Thanks to a very generous gift from the Ellis family in honor of their parents, Dan and Barbara Ellis, we will be offering a 100% match on all ultrasound donations up to $10,000. Our goal in the next month is to raise $30,000 to fix one of our current ultrasound machines and to purchase two new ultrasound machines. Can you help save lives with a contribution towards these new ultrasound machines?