POCUS Flashcards
Aorta: AAA Def’n Pocus
> 3 cm diameter
Aorta vs IVC
Aorta:
- Round
- Left of vertebra
- Incompressible
- Thick walled
- No change with sniff/valsalva
Aorta: Scan Technique
Start at Xyphoid
Cannot miss > 1 cm of Aorta
Curvilinear probe 2.5-3.5 MHz
Maximize depth at the vertebral body
Aorta Clinical Judgement
Cannot say ruptured vs not.
Must use clinical judgement based on presentation
Cardiac: Questions that can be answered for level
1) PCE
2) LVEF by EPSS and FS
3) Cardiac Activity
Cardiac PCE Sizes
< 1 cm small
1-2 cm moderate
> 2 cm large
Must view the 7 sign - the RV wall meets the septum
Cardiac: SubXy strategies for gas obscuring view
1) Pt deep inspiration
2) Move to pt right to use liver as window
Cardiac PSL Basics: Technique
Cardiac probe - 3.5-5 MHz
Sternal border
4-5th intercostal space
Probe to pt R shoulder
Cardiac PCE: False positives of effusion
Epicardial fat
Perihepatic fat
Left sided pleural effusion
Posterior valves
Cardiac PCE: False negatives
Clotted hemopericardium
Fibrinous pericarditis
Loculated effusions
Effusions in mediastinum
eFAST Anatomy Landmarks
RUQ: Posterior axillary line - T8-T10.
- View of Morrison’s pouch
LUQ: Same, just left,
- View is the spleno-renal interface and spleno-diaphragmatic interface.
Suprapubic: Females views the pouch of Douglas.
Subxyphoid
Chest 2-3rd intercostal mid axillary.
Absence of lung sliding mimics
Bullae / Emphysema
Fibrosis
Emphysema
R mainstem intubation
eFAST test characteristics
Sens: 80-90%
Spec: 90-100%
Gallbladder diagnostic criteria - Cholecystitis
Sonographic Murphy’s
Stones present
Wall thickening > 3 mm
Pericholecystic fluid
Distension: > 4cm
Is the CBD dilated > 8 mm abnormal
- ** < 6 normal.
Ddx thickened gallbladder
Postprandial
Older age
Adenomyomatosis
Cholangiocarcinoma
HIV
Hypoalbuminemia
Ascites
Renal Failure
CHF
