Imaging ECC patient Flashcards
What factors must be considered when selecting an imaging modality for an ECC (Emergency and Critical Care) patient?
Patient Safety (positioning, cardiovascular, respiratory, neurological compromise)
Species and situation
Speed of obtaining results
Diagnostic utility
Availability of equipment
What are the advantages and limitations of CT in ECC patients?
Advantages:
- High sensitivity & specificity for free fluid, gas & organomegaly
- Rapid imaging (<1 min for full-body scan)
Limitations:
- Slow patient prep (sedation or GA required)
- Long processing & reporting time
- Limited availability in veterinary practice
What are the advantages and limitations of MRI in ECC patients?
Advantages:
- Gold standard for brain & spinal cord imaging
- Excellent for equine distal limb lameness (bone, tendon, ligament, joint capsule)
Limitations:
- Slow imaging process
- Limited utility in emergencies
What are the advantages and limitations of radiography in ECC patients?
Advantages:
- Good for free gas detection (e.g., pneumothorax)
- Useful for obstructive GIT/urinary disease & orthopaedic injuries
- Widely available, cost-effective
- easy to perform
Disadvantages:
- Requires restraint/sedation (risky for unstable patients)
- Limited assessment of soft tissue structures
- Moderate sensitivity for free fluid detection
What are the advantages and limitations of endoscopy in ECC patients?
Advantages:
- Excellent for upper respiratory distress in equine
- Can be used for curative intervention
Limitations:
- Less useful in small animals (requires anaesthesia in unstable patients)
What are the advantages and limitations of ultrasound in ECC patients?
Advantages:
- Safe for unstable patients (minimal restraint)
- Non-invasive, rapid, easy to interpret
- Good for free fluid detection, cardiac assessment, surface lung assessment, abdominal organ assessment and soft tissue structures
- Used for interventions (e.g., ultrasound-guided centesis, arterial blood sampling)
Limitations:
- Limited for deep thoracic structures
- Cannot assess airways effectively
What is the best imaging technique in emergency patients?
Ultrasound (safe & rapid)
What is POCUS
Point of Care UltraSound
(originally developed for ER doctors to diagnose severe abdominal trauma rapidly)
What is a FAST scan
Focused assessment using sonography for trauma
(aimed at looking for free abdominal fluid)
How has POCUS expanded beyond the initial FAST scan?
It now includes assessment of thoracic fluid, pleural space disease, lung parenchymal disease (VetBLUE) & basic echocardiography
What is Global FAST (GFAST) and why is it important?
comprehensive approach combining VetBLUE, TFAST & AFAST to assess both thoracic & abdominal cavities
What is VetLUE?
Veterinary bedside lung ultrasound exam
Allows assessment of lung parenchyma & pleural space
4 point scan on both sides of chest (red X’s)
What is PLUS?
Pleural lung ultrasound
Addition to VetBLUE
sweep ‘S’ across lung fields (blue lines)
9 points in total on both sides of chest
What is TFAST?
Thoracic focused assessment using sonography for trauma, tracking & triage
Allows for assessment of pericardial effusion, cardiac chambers & contractility
5 point scan
- CTS & DH view will have already been covered if doing a global FAST
- becomes a 2 point scan
- PCS to look at heart on both sides
(don’t need to know names, just know what you’re looking for)
What is AFAST?
Abdominal focused assessment using sonography for trauma, tracking & triage
Allows for assessment of free fluid in abdomen, incl. producing abdominal fluid score
Allows for assessment of caudal vena cava & gall bladder
Also looking at spleen, kidneys, liver & bladder
4 point scan (patient in right lateral recumbency)
- HRU can be problematic because often only see guts due to gravity
(don’t need to know names, just know what you’re looking for)
What is FLASH
Fast localised abdominal sonography of horses
Allows for assessment of abdominal & thoracic free fluid & assessment of small intestinal loops
7 point scan
Has worksheet to help you look for the right things
Dilated turgid small intestinal loops 80% sensitive & 96% specific for SI obstruction so you know it’s surgical case
