POCUS

Question 1

What are some examples of procedural applications of POCUS?

Answer 1

(Thoracocentesis, abdominocentesis, pericardiocentesis, central and peripheral vascular access, regional anesthesia, and incision/drainage of abscesses)

Question 2

What are some examples of diagnostic applications of POCUS?

Answer 2

(Pericardial effusion, pleural effusion, abdominal fluid, pneumothorax (difficult but not impossible), severe left atrial enlargement)

Question 3

What is the optimal position for an AFAST?

Answer 3

(Right lateral recumbency but do not force a traumatized patient into that position to get an AFAST; benefits are it allows for ECG placement, TFAST, echo, and there is a decreased risk of hitting the spleen if you are performing an abdominocentesis)

Question 4

What are the four AFAST windows?

Answer 4

(Diaphragmatic-hepatic (DH), spleno-renal (SR), cysto-colic (CC), and hepato-renal (HR))

Question 5

Which direction is the US probe directed when in the DH window?

Answer 5

(Towards the patients head → gallbladder can be imaged by keeping the probe toward the head and scanning slightly downward toward the table the animal is laying on)

Question 6

Why should you always look into the thorax when in the DH window?

Answer 6

(Can look for pleural and pericardial effusion using this window)

Question 7

What abnormality is indicated by a dilated hepatic vein and caudal vena cava?

Answer 7

(Seeing that during your AFAST indirectly tells you something is wrong with the right side of the heart)

Question 8

If there is fluid observed in 3 of the AFAST sites, what is the fluid score?

Answer 8

(3)

Question 9

Why is it important to make sure your patient is in the same position every time you fast scan them?

Answer 9

(Bc fluid shifts, they might only have an AFS 1 but an hour later if you do it in another position, fluid could shift and change their score when there hasn’t been an actual increase in the amount of fluid present)

Question 10

What other positions can be used for a TFAST if the patient does not agree with right lateral recumbency?

Answer 10

(Left lateral or sternal/standing, essentially AFAST and TFAST can be done in any position that isn’t dorsal recumbency)

Question 11

Where is the TFAST chest tube site (CTS)?

Answer 11

(Highest outward point of the dog’s thorax to the xiphoid (usually 7-8th intercostal space))

Question 12

In what position is the US probe held when looking at the chest tube site?

Answer 12

(Horizontally (parallel to the patients spine))

Question 13

There are 5 cardiac views that can be obtained during a TFAST but there are two in particular that are important to get, which are they?

Answer 13

(The LV/mushroom view and the heart base view; other views are mitral valve/fish mouth view and then two 4 chamber views)

Question 14

Which TFAST view do you use with M-mode on to calculate fractional shortening?

Answer 14

(The mushroom view which can be obtained with right parasternal short axis positioning)

Question 15

Which TFAST view do you use to determine the LA:AO?

Answer 15

(The heart base view which can be obtained with right parasternal short axis positioning, LA:AO should be < 1.5)