Lung ultrasound is quick, easy, and very helpful in a patient with undifferentiated shortness of breath. There are, however, a few subtleties that I often see learners not grasp. Let’s clear it up.
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Make your DVT studies worth the risk
I’ve done this topic before, but I left some meat on that bone. Let’s get into the weeds.
Continue readingBladder Ultrasound: part 3
In part 3 of our discussion about the uses of bladder ultrasound in the emergency department, we consider the case of a 70 year-old man with urinary retention in whom we were unable to place a urinary catheter.
Continue readingBladder Ultrasound: part 2
Part two in our three part series on bladder ultrasound. We will look at two cases.
Continue readingRegional Wall Motion Abnormality
A 45 year-old man presents by EMS after a VF arrest. On arrival at the ED he has a pulse. An ECG shows an anterior STEMI. The cath lab is activated and the cardiologist is en route. While waiting for the cavalry to arrive, you ultrasound his heart and strike gold.
Continue readingA Tale of Two Clots
A thrombus in the heart is really the holy grail of point-of-care ultrasound. Here are two great examples.
Continue readingUltrasound Guided Needle Placement
I spent some time this week with the interns shoring up their technique for using ultrasound in vascular access. Specifically, I’m referring to an out-of-plane approach – which I recommend in most cases as it lets you see the needle in relation to any large arteries or nerves that may be around.
I think if I had one point to reinforce, it would be the fact that this a dynamic process for BOTH HANDS.
Continue readingHow to not screw up your DVT studies
There are some mistakes that learners commonly make as they are getting the hang of lower extremity DVT ultrasound. Here are some that I see them make when imaging the femoral vein:
- Mistaking the greater saphenous vein for the femoral vein
- Having the probe too distally and not seeing the point where the saphenous joins the common femoral vein
- Finding an image of the femoral vein and thinking it is the common femoral vein
- Not recognizing that they did not actually see the deep femoral vein
- Checking boxes in the “Views Obtained” section of their Qpath worksheet of images they did not actually obtain. Sometimes this is clerical; other times this represents a knowledge gap.
Median Nerve Block
One of the interns did this fantastic block. There are lots of examples of good technique here.
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Searcy EM 