- Cardiac Ultrasound
- Lung Ultrasound
- Ocular Ultrasound
- Soft Tissue Ultrasound
- Trauma Ultrasound (E-Fast)
Cardiac Ultrasound
- Indications
- Chest pain/Palpitations
- Significant EKG changes
- Shortness of breath
- Hypotension
- New heart murmurs
- Cardiac arrest
- Dizziness
- Common Findings/Interpretation
- Regional wall motion abnormality
- Suggests ischemic heart disease
- Poor squeeze
- Decompensated HF
- Hyperdynamic Squeeze
- Sepsis, Pneumonia
- McConnell’s Sign
- Acute PE
- D Sign
- Acute PE
- RA Collapse/RV Collapse
- Cardiac tamponade
- Pericardial effusion
- Best found with parasternal long-axis and subcostal four-chamber view
- Regional wall motion abnormality
*Deep Dive: Scanning School – Cardiac (Taming the SRU)
Lung Ultrasound
- Indications
- Shortness of breath
- Hypoxia
- Pleuritic chest pain
- Chest trauma
- Common findings/interpretation
- A-lines
- Normal lung
- B-Lines
- Sensitive for pulmonary edema
- Absence of lung sliding; finding of “lung point”
- Suggests pneumothorax
- Shred sign
- Sign of lung consolidation (pneumonia)
- A-lines
*Deep Dive: BLUE Protocol (International Emergency Medicine Education Project)
Ocular Ultrasound
- Indications
- Vision loss
- Symptoms of increased ICP
- Trauma
- Common Findings/Interpretation
- Disruption of globe architecture or anterior chamber collapse
- Globe rupture
- Hypoechoic fluid posterior to globe
- Retrobulbar hematoma
- “Twinkle” or hyperechoic object
- Foreign body
- Posteriorly displaced lens
- Lens detachment
- Separation of hyperechoic linear structure from posterior choroid
- Retinal detachment
- Disruption of globe architecture or anterior chamber collapse
*Deep Dive: Ocular Ultrasound (CORE EM)
Soft Tissue Ultrasound
- Indications
- Suspected foreign bodies
- Suspected soft tissue infection
- Common Findings/Interpretation
- Cobblestoning
- Suggests cellulitis
- Hyperechoic ring, hypoechoic circular area, squish sign
- Suggests abscess
- Acoustic shadowing (ring down appearance)
- Wood/splinter foreign body
- Reverberation
- Metal foreign body
- Cobblestoning
*Deep Dive: Ultrasound G.E.L – Ultrasound in Skin and Soft Tissue Infection (emDocs)
Trauma Ultrasound (E-FAST)
- Indications
- Blunt or penetrating trauma
- Common Findings/Interpretation
- Absent lung sliding
- Suggests pneumothorax
- Anechoic area in pericardial space
- Suggests pericardial tamponade
- Anechoic area between liver and kidney
- Suggests hemorrhage in morrison’s pouch
- Anechoic area between diaphragm and spleen
- Suggests hemorrhage
- Anechoic area between spleen and kidney
- Suggests hemorrhage
- Anechoic area between superior and posterior to walls of bladder
- Suggests hemorrhage
- Absent lung sliding
*Deep Dive: How To Do E-FAST Examination (Merck Manual)
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