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Table 114.2

Practical Guide to Emergency Ultrasonography

Always optimize gain, depth and window sector size.
Cardiac scanThoracic scan

Probe:

  • Cardiac

Positioning:

  • Left lateral
  • Supine (subcostal view)

Views:

  • Parasternal long-axis
  • Parasternal short-axis
  • Apical four-chamber
  • Subcostal

Uses:

Loading conditions

Critical pathology in four areas of the heart:

  • The left ventricle
  • The right ventricle
  • Valve stenosis and regurgitation
  • Pericardial effusion

Probe:

  • Cardiac: for B-lines and pleural effusion
  • Curved: for all purposes
  • Linear: for pleura and detect pneumothorax

Positioning:

  • Seated forward with arms folded on pillow for pleural effusion
  • Any position for pulmonary oedema
  • Supine/near-to-supine for pneumothorax

Views:

  • Posterior approach for pleural effusion
  • Anti-dependent zones for pneumothorax (anterior saggital, second intercostal space, mid-clavicular line)
  • Dependent zones for cardiogenic pulmonary oedema

Uses:

  • Pleural effusions
  • Pulmonary oedema (cardiogenic, non-cardiogenic)
  • Consolidation
  • Pneumothorax

Abdominal scan

Probe:

  • Curved

Positioning:

  • Supine

Views:

  • Central abdominal
  • Left lower lateral
Uses:
  • Ascites and paracentesis

Bladder scan

Probe:

  • Curved

Positioning:

  • Supine with full bladder

Views:

  • Pelvis – sagittal – transverse

Uses:

  • Incomplete voiding
  • Reduced urine output vs catheter blockage