POCUS Flashcards
What are 6 reasons that AFAST and TFAST are useful in vet med?
- cheap
- can be performed point of care (cage side)
- easy to learn
- quick
- other diagnostics can be performed during (pulling blood samples, IV cath placement, etc.)
- radiation-sparing
What are the 3 applications of POCUS?
- Procedural (ex. thoracocentesis)
- Diagnostic (ex. pleural effusion)
- Screening (ex. free fluid check)
What position should patients be in for AFAST?
RIGHT Lateral recumbency
(left can be used but right decreases risk of hitting spleen)
Dorsal recumbency is NOT recommended.
What are the 4 areas you need to screen when doing AFAST?
- diaphragmatico-hepatic
- spleno-renal (left)
- cysto-colic
- hepato-renal (right)
What should you see in the diaphragmatico-hepatic view?
You should direct the probe TOWARDS the patients head.
diaphragm – bright white line
gallbladder – kissing the diaphragm
liver
Should normally see GLIDE sign indicating the lung is in contact with the chest wall
look into the thorax for effusion
What is the glide sign?
Lung is in contact with the chest wall
How can you use POCUS to do an indirect right-sided cardiac assessment?
Look at the dilation of the vessels in the DH view.
If the hepatic vein or caudal vena cava is dilated, it can indicate R heart issues?
What is an AFS score?
Abdominal fluid score
Score 1-4
Fluid positive at 1 of 4 sites = AFS 1
so on a so forth.
Initial and serial (q 4hr) AFS allows clinicians to semi-quatitatively assess ….
the severity of injury and the degree of ongoing hemorrhage/free fluid accumulation (increasing or decreasing)
what are the limitations of AFAST?
- requires clinical compentancy
- can give false positives (common at DH and SR sites)
- can give false negatives (intrapelvic fluid not visible)
- some patients (obese or with SQ emphysema) may be unable to be imaged.
Of the 4 AFAST sites, which 2 are most common to get false positives at?
DH
SR
what position should the patient be in for TFAST?
RIGHT lateral recumbency
(left or sternal also ok)
dorsal NOT recommended.
what position should you start your TFAST at?
- chest tube site (CTS) – highest outward point of the dogs thorax dorsal to the xiphoid with the probe held horizontally
- travel downward to the pericardial site (PCS) – probe placed caudal to the point of the elbow; look at the 5 cardiac views (emphasis on R-parasternal LV or mushroom view, and R-parasternal or base view)
- travel to DH site – probe placed subxiphoid/paracostally; look for effusion
T/F: a glide sign will be present in cases of pneumothorax
false – will be absent.
what are lung rockets on ultrasound?
3+ B-lines simultaneously visible between two ribs indicating interstitial disease.
