Intro to POCUS

Question 1

What are the uses of POCUS?

Answer 1

• CVC placement
• Chest drain placement
• BLUE to diagnose cardiogenic pulmonary oedema, COPD/asthma, Pulmonary embolism, Pneumothorax, Pneumonia
• AAA diagnosis
• Renal Colic
• Cardiac arrest
• RUSH protocol (Rapid Ultrasound in Shock and Hypotension) to assess types of shock (hypovolaemic, distributive, obstructive, cardiogenic).

Question 2

What are the probe locations for VetBlue?

Answer 2

• caudo-dorsal view
• forwards and down - couple of rib spaces peri-hilar view
  ◦ Ventral middle chest - middle lung view
  ◦ Cranial lung view

Question 3

what is seen by the red and blue line?

Answer 3

red - facial plane
blue - pleural interface

Question 4

what is seen here? what does it mean?

Answer 4

B lines - represent fluid in the lungs
Score the number of B lines to monitor progress

Question 5

What heart view is this - what are you assessing?

Answer 5

Mushroom to LA:Ao and normal ejection fraction - 40-50%

Question 6

What view is this and what are you assessing?

Answer 6

Long axis - four chamber
Ratio should be 1:1 (Left atrium to Right atrium)
RA will be smaller if LA is enlarged
LV expexted to be 3x as big as RV
If RV enlarged - pulmonary hypertension (give viagra)

Question 7

what drug is given to increase cardiac contactility?

Answer 7

pimobendan

Question 8

what is seen here on this thoracic scan?

Answer 8

pericardial effusion

Question 9

What are the 4 veiws of the AFAST?

Answer 9

• DH - xyphisternum
• Splenorenal view (left kidney
• Bladder - cystocolic
• Umbilicus - aim down towards floor - looking for fluid (hepato renal umbilical site)

Question 10

This is an enlarged caudal vena cava, what else is seen here?

Answer 10

Hepatic arborisation - pressure from the right side of the heart, backing up into the liver

Question 11

What is seen here on this scan of the liver ? what does it mean? what are the 4 reasons?

Answer 11

Gall bladder halo sign
Oedema of the GB wall
* because of hydrostatic pressure - right sided heart failure or cardiac tamponade
* reduced oncotic pressure - protein losing diseases
* leaky vessels (sepsis or SIRS)
* Anaphylaxis

Question 12

This is a thoracic scan, what is seen and what is your top differential?

Answer 12

Consolidated lung - looks like liver
Has so much fluid there is no more air - pneumonia (alveoli affected and filled with pus)