Anaesthesiology - Critical Care Medicine - POCUS Flashcards
Define different echogenicities produced by US probe
- Isoechoic
- Hyperechoic – e.g. stones
- Hypoechoic – e.g. lymph node
- Anechoic – e.g. fluid
Define colours on colour flow doppler
Blue away, Red towards (BART)
4 positions of cardiac imaging by POCUS
Define the structures seen on PLA on cardiac POCUS
S
Define the structures seen on PSA on cardiac POCUS
Define the structures seen on apical 4 chambers view on cardiac POCUSS
Define the structures seen on subxiphoid view on cardiac POCUS
Define Cavel Index and clinical use
Cavel index measures respiratory variation in diameter of the inferior vena cava to predict fluid responsiveness in spontaneous breathing emergency department patients with signs of shock.
Index correlates IVC size on POCUS with CVP
Assesses volume status and guides fluid management: low caval index in a patient with signs of shock is associated with fluid unresponsiveness; high caval index is inconclusive
What is the normal size of the right ventricle at the apical 4 chamber view?
right ventricle is less than 2/3 of the size of the left ventricle
Where is pericardial effusion in relation to the descending aorta in the parasternal long axis?
Anterior to the descending aorta
List applications of cardiac POCUS
Assess cardiac function
Valvular assessment: Valve morphology (number of leaflets, movement, rheumatic heart valves, calcifications, vegetation)
Fluid status
Pericardial effusion +/- tamponade
Acute right heart strain (e.g. acute pulmonary embolism)
Aortic dissection
Methods to assess left heart function on POCUS
LeLt ventricular ejection fraction
- Assess in Parasternal long axis view
- estimate bu “eyeballing LV movement” or degree of “LV squeeze”
- Measure distance of anterior mitral valve leaflet to septum (MV slapping septum = >50% LVEF; MV not touching septum = 30-50%; MV not moving = <30% LVEF)
Assess severity of mitral regurgitation on POCUS
Observe doppler colour and size of mitral regurgitation jet:
Jet <20% of LA area = mild MR
Jet 20-40% of LA area = moderate MR
Jet >40% = severe MR
Identify pathology
Calcified aortic valve (bright area), with severely impaired valve opening
Identify pathology
Aortic regurgitation
Jet return to LA during systole