Category Archives: SonoExtras

Pre-hospital (paramedic) US: Re-appreciating the Golden Hour…

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HAPPY EMS WEEK!!!! We so appreciate all that you do! Along those lines…… and along with many others all over the world in years past, at Stanford there has been a 2-part study being done supervised by Drs. Sarah Williams and Jessica Pierog (PEEPS study) and at UCI supervised by Dr. Chris Fox and others (PAUSE protocol) on the prehospital use/acquisition/ interpretation of emergencies visible by bedside US.  It is evident (an understatement, actually) that US needs to go into our ambulances. Continue reading →

An Excerpt from LITFL today: a Cheap way to Make an US Simulator!

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An excerpt from Life in the Fast Lane (LITFL): VERY cool US simulator that you can make cheaply!!! Just need hardware….The guys from Saskatchewan, Paul Kulyk and Paul Olszynski (http://www.edus2.com/) have developed a trainer for using in simulation which they explain very well in their project summary: “The Emergency Department Ultrasound Simulator (edus2TM) is a portable bedside ultrasound device that allows for the seamless integration of Emergency Department Ultrasound (EDUS) into high fidelity simulation scenarios (HFS). Trainees using the edus2 gain the opportunity to determine whether to use bedside ultrasound (indications), how to properly hold and place the probe (image generation) and finally how to assess scans (image interpretation) as displayed on the edus2 screen all within the context of an HFS scenario.”

SonoFiler: profiling Dr. Chris Fox

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The inaugural Sonofiler – profiling a leader in bedside US, is, of course, going to be about the guy who first taught me everything there is to know about US during my residency at UC Irvine, Dr. Chris Fox – or as I used to call him “Foxy Methoxy” – not exactly how he got that nickname but I bet it had something to do with a psych patient in ED Rm 20. I sent Chris a few questions, and the answers are not only sooo Chris (and not surprising with his amazingly sarcastic and funny wit), but also quite profound, and a true testament as to why he is one of the leaders in bedside US. Continue reading →

SonoCase: TA Pelvic US: What’s up with that Uterus?!

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Crazy case I saw recently… 38 yo female who came to the ED for vaginal bleeding that was unrelenting for 6 months, not changed with repeated PO hormonal treatment by PCP, and “I just want an answer.” Stable vitals, no sx of anemia, she was not tender on exam and pelvic was unremarkable except for some blood. In my efforts to simply appease her as I wasnt going to do much more, I did a Transabdominal Pelvic US (sagittal view shown below). Once I saw this, I started to pay more attention (of course, it should have been the other way around, but thats just my skeptical self). I asked her about weight loss (she had 15 pounds loss in 6 months (already a pretty petite girl) and no significant family history, but I realized when speaking to her for more time that she kept having an intermittent dry cough every now and again. I asked her about it, and she thought it was allergies “and I just dont think i got over that cold from a month ago.” Pretty sad case -CXR showed mets…..”platinum” scan done, admitted to Medicine, biopsy/onc/chemo underway… shows the importance of TA Pelvis for not just the 1st trimester pregnancy VB/abd pain evaluations. Continue reading →

US for epidurals!

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Very Cool illustration page of US for epidurals for my anesthesiology friends by Dr. Chris Mitchell as described by the Broome Docs blog!

Happy Mother’s Day: a dancing baby for all US lovers!

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For all the moms out there on Mother’s day! And for all who know me well, you know the baby will be dancin’ to Party Rock! If an expectant mom comes in with pelvic pain or vaginal bleeding, check for fetal dancing: Continue reading →

SonoStuff: new and upcoming US equipment

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Sonosite’s iPAD style US machine – coming soon! http://mobilehealthoutlook.com/?p=846GE’s hand-held Vscan is upgraded! better, fasterhttp://medgadget.com/2012/05/ge-upgrades-its-portable-vscan-ultrasound.html

Zonare’s faster software and improved image resolution:http://www.zonare.co.uk/products/

Phillips new Clearvue for improved Echocardiography:http://www.healthcare.philips.com/us_en/products/ultrasound/systems/clearvue550/

SonoStudy: Top Research in Bedside US – the short of breath patient

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Very cool review article on the evaluation of the short of breath patient by bedside US…. the RADIUS study – strong name, if I do say so myself…

http://www.scribd.com/doc/93314237/The-Rapid-Assessment-of-Dyspnea-With-Ultrasound-RADiUS

SonoApp: Ocular US – “Blinded by the light!” – Pupillary Constriction

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THIS is truly my fav when it come to US applications. If you ever show this to any group of students or other learners, the entre room responds with , “Oooooooh, Awwwww.” You can see pupillary constriction by angling the probe upward to get a coronal view of the eye and shining a light on the eye – or the opposite eye. Or, you can decrease your depth and have the linear probe directly on the eyelid in transverse view while the patient looks upward. You will see the linear muscle layers which will constrict when a light is shined in the opposite eye (as seen below) … Pretty cool stuff, I tell ya….

Orbital US: EXTRA-ocular movements

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“The Eye is the window to the soul”…. or something like that…. but I actually think that ultrasound comes pretty darn close to being that window – or at least being the key to the door. Orbital US is super cool. People talk about the orbital pathology that you can assess all the time, but what is also amazing is being able to assess normal anatomy and physiology of the eye – like extra-ocular movements (by using the linear high frequency probe and a tegaderm with gel over the orbit, have the patient move their eye left and right – along the plane of the probe – then rotate the probe 90 degrees and have them move their eye up and down).