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October 21-22, 2018
Point of Care Ultrasound UCSF Continuing Medical Education RUQ, - - PowerPoint PPT Presentation
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
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3 Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier
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Areas to Identify
Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier
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Probe Selection
Curvilinear Phased Array
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Probe Position
- Knuckles on the bed
- Adjust probe angle for view between ribs and
take into account the angle of abdominal
- rgans
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Probe position
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Normal RUQ View
Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier
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RUQ/Perihepatic view
Normal Abnormal (subtle)
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RUQ/Perihepatic view
Normal Abnormal
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RUQ/Perihepatic view
Normal Abnormal
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RUQ/Perihepatic view
Normal Abnormal
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RUQ/Perihepatic view
Normal Abnormal
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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
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Gallbladder
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Wall Echo Shadow
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Gallbladder or something else?
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Normal LUQ
Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier
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LUQ/Perisplenic view
Abnormal Normal
Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier
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LUQ/Perisplenic view
Abnormal Normal
Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier
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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)
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Ultrasound for paracentesis
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Paracentesis: Probe + position
+
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Paracentesis: Orientation + US
Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier
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Paracentesis: Vessels
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Safe for Para?
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Safe for Para?
Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier
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Goals for Scanning Stations
- Can look for epigastric vessels on models
- Can follow needle insertion on table trainers
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