Point of Care Ultrasound UCSF Continuing Medical Education RUQ, - PowerPoint PPT Presentation

Point of Care Ultrasound UCSF Continuing Medical Education RUQ, LUQ, Paracentesis Brandon Boesch, DO October 21-22, 2018

Disclosure I have no relevant financial relationships with any companies related to the content of this course.

3 Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier

Areas to Identify Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier 4

Probe Selection Phased Array Curvilinear 5

Probe Position - Knuckles on the bed - Adjust probe angle for view between ribs and take into account the angle of abdominal organs 6

Probe position 7

Normal RUQ View Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier 8

RUQ/Perihepatic view Abnormal Normal (subtle) 9

RUQ/Perihepatic view Normal Abnormal 10

RUQ/Perihepatic view Normal Abnormal 11

RUQ/Perihepatic view Normal Abnormal 12

RUQ/Perihepatic view Normal Abnormal 13

Gallbladder Can be a very challenging exam False positives are very common in hospitalized patients Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier 14

Gallbladder 15

Wall Echo Shadow 16

Gallbladder or something else? 17

Normal LUQ Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier 18

LUQ/Perisplenic view Normal Abnormal Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier 19

LUQ/Perisplenic view Normal Abnormal Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier 20

Goals for Scanning Stations - Identify all the structures in RUQ and LUQ - Look for the large vessels and spine deep on the image - Don’t spend too much time searching for the gallbladder (especially since the models have eaten lunch) 21

Ultrasound for paracentesis 22

Paracentesis: Probe + position + 23

Paracentesis: Orientation + US Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. 24 Philadelphia: Elsevier

Paracentesis: Vessels 25

Safe for Para? 26

Safe for Para? Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier 27

Goals for Scanning Stations - Can look for epigastric vessels on models - Can follow needle insertion on table trainers 28