Minimum images for common scans

FAST

  • Morrison’s Pouch
    • The most sensitive image is the inferior tip of the liver and the inferior pole of the kidney
  • Bladder in short and long axis
  • Splenorenal space
  • Subxiphoid or parasternal long axis view of the heart

EFAST

  • Same as the FAST
  • Also with lung sliding on each side – upper / anterior segments
    • Looking for lung sliding:
      • Either zoom in close to the pleura with a curved probe or
      • Use the linear probe
        • (needs depth to look for b Lines and effusions)

Cardiac

  • Parasternal Long Axis
  • Parasternal Short Axis
  • Apical 4 chamber
  • Subxiphoid
  • IVC

*not all views will be ideal on most patients – get as good as you can

Lung

  • Abdominal probe if looking for B lines
    • Minimum one segment on each side
  • Linear probe if looking for lung sliding
    • Minimum one segment on each side
  • It’s okay to start and the top and slide down over several rib spaces in one video clip

Kidney

  • Short and Long axis view of both kidneys
  • Short axis view of the bladder

DVT

  • Clip showing compressability of the femoral vein just above, at, and below the branch point of the saphenous
  • Clip showing compressability of the the femoral vein just above and at the level of the trifucation in the popliteal fossa
    • Need to make sure the femoral vein is compressible from the branch point of the saphenous through the adductor canal, but don’t necessarily need to save every clip of this.

Aorta

  • 3 short axis views (proximal, mid, and at the bifurcation)
  • 1 long axis view

Gallbladder

  • Minimum: short and long axis view of the gall bladder
  • Ideally: common bile duct and the neck of the gall bladder

* be aware that your exam is very limited if you only see the body of the gall bladder.  If you don’t focus on the neck and see the CBD – consider the exam very cursory

Central Line

  • At minimum, a short axis image of the wire in the vein
  • Ideally, a long axis view of the wire in the vein as well

Regional Anesthesia

  • Minimum: a “before” image of the nerve to be blocked
  • Ideally, an image with the needle in the picture near the nerve to be blocked

First Trimester

  • Minimum: short and long axis view of the uterus with the yolk sac or fetal pole visible in both images/clips
  • Do not use pulsed wave doppler to check FHR in the first trimester, use M-mode
  • If a video clip is obtained that shows a grossly normal heart flicker, documenting the number is not mandatory
  • Ideally: if using the endocavitary probe, get 2 views of the uterus and fan through both adnexa in short axis (marker to 9 o’clock)