Cardio- Ultrasound

Question 1

What is the difference between POCUS echo and FORMAL echo?

Answer 1

POCUS ECHO

Immediate answers bedside

▸ Extra time with patient

▸ Visual explanation

FORMAL ECHO

▸ Limited availability

▸ More thorough exam

▸ Patient may have to be transported

Question 2

Appropriate probe selection for cardiac exam and why?

Answer 2

Phased array

▸ Smaller foot print

▸ Picks up motion well

▸ Low frequency, good at depth

Question 3

What is the best position for the cardiac ultrasound?

Answer 3

supine or left lateral

Question 4

Which way does the probe marker move in cardiac mode?

Answer 4

left (it is right in most other cases)

Question 5

Where should you place the parasternal long axis?

Answer 5

3rd or 4th intercostal space (left)

▸ Probe marker toward right shoulder

▸ Best view for estimating EF

Question 6

What is involved in the parasternal short axis?

Answer 6

▸ Turn probe 90˚ clockwise

▸ Probe marker toward LEFT shoulder

Question 7

Which view, parasternal long or short axis?

Answer 7

Parasternal long (probe toward right shoulder)

Question 8

Which view, parasternal long or short axis?

Answer 8

short axis (probe to the left shoulder)

Question 9

What is the pathology?

Answer 9

pericardial effusion (fluid anterior to descending aorta)

Question 10

What is the most important risk factor to causing tamponade?

Answer 10

rate of accumulation of fluid

Question 11

Which side is pericardial effusion and which has progressed to tamponade?

Answer 11

Left is pericardial infusion as right ventricle is more round (not collapsing) while the image on the right, the right ventricle is more flat (tamponade)

Question 12

How can you estimate the ejeciton fraction with POCUS ultasound?

Answer 12

the flappiness of mitral valve (the valve should hit the ventricular septum)

Question 13

Why place a central line (infusions to SVC/IVC)?

Answer 13

medications (those that can damage peripheral veins) or get it in fast and at the same time

Question 14

What are 3 common sites of central lines?

Answer 14

1. internal jugular
2. Subclavian vein
3. Femoral vein

Question 15

What are some complications of a central line?

Answer 15

▸ Infection ▸ Arterial puncture ▸ Pneumothorax

Question 16

What technique will be used to place a central line?

Answer 16

Seldinger technique

Question 17

Where is the artery and vein?

Answer 17

artery smaller and on the right

Question 18

With an ultrasound guided needle placement, which ultrasound view is this?

Answer 18

out of plane or short axis

the other would be called in plane or long axis

Question 19

What are the guidelines for ultrasound guided needle placement?

Answer 19

▸ Follow needle tip with probe ▸ Needle in dominant hand

Question 20

Which is long axis and short axis?

Answer 20

top is long axis or in plane(more difficult)

bottom is short axis or out of plane