Chapter 182 - Sonography in the Emergency Room

Question 1

The abdominal fluid scoring (AFS) system was developed to better characterize bleeding dogs.
Compare higher-scoring dogs with lower-scoring dogs in terms of hemoabdomen.

Answer 1

Higher-scoring dogs with AFS 3,4 will predictably become anemic and ∼20–25% of bluntly traumatized dogs with AFS 3,4 will become anemic enough to require blood transfusion(s) and, uncommonly, surgical exploratory surgery.
In contrast, higher-scoring AFS 3,4 dogs bleeding post-interventionally or from penetrating trauma or ruptured tumors generally require resuscitation and exploratory surgery to stop the bleeding.

Therefore, if an AFS 1,2 dog or cat is anemic or becomes anemic, then pre-existing anemia was present or bleeding is occurring at another site (another space or cavity, gastrointestinal tract, reproductive tract, fracture site(s), or externally), respectively (or there is hemodilution due to large volumes of intravenous fluids)

Exceptions would include coagulopathic dogs, including those with anaphylaxis

Question 2

What is Bull’s eye sign?

Answer 2

Sign indicative of pericardial effusion at the right tFAST PCS view (directing the probe toward the sternum) through the observation of the heart’s apex rounded by free fluid contained within the pericardial sac

Question 3

In hypovolemic shock,

1. contractility of the heart?
2. how the CVC looks like?
3. how the lungs look like?

Answer 3

1. Hypercontractile heart
2. Flat CVC
3. Dry Lung

Question 4

What is the wedge sign?

Answer 4

The wedge sign is a subset of the shred sign and strongly suggests the presence of pulmonary thromboembolism (vascular infarction).