…targeted duplex ultrasound (DUS), pre operative assessment, or evaluation of other atherosclerotic disease. Routine population screening is not recommended because the prevalence of severe asymptomatic…

…plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous…

…other underlying cause immediately. 9. Request ultrasound of the kidneys and urinary tract when a postrenal cause cannot confidently be excluded. 10. Contact nephrology early…

…septum bulges into the left ventricle (i.e. septal bulging ). Bedside echocardiography allows for immediate recognition of tamponade. Typically, acute tamponade arises from aortic dissection…

…Reverberations artifacts Ultrasound waves can be reflected multiple times between dense structures ( i.e structures with high echogenicity). For each reflection, a portion of the…

…ultrasound machine for analysis. The reflected sound waves will have the same speed as the emitted sound waves, but the amplitude, frequency and angle of…

…high frequency waves. The frequency of the ultrasound wave must generally be reduced in order to visualize objects located far away from the transducer. Hence…

…and ultrasound physics Unlike light waves, which can propagate through vacuum, sound waves can only propagate through a physical medium. This medium may consist of…

…frequency) . This is actually exploited to calculate the direction and speed of tissue and fluid movements. All structures in a medium can reflect ultrasound waves…

…ultrasound wave (cos θ). The Doppler equation is as follows: v = [c · (f r f e )] / [2 · f u · cos ϴ] The speed of…

…To create an image sector of 90° width and 15 cm depth, approximately 200 ultrasound lines are required and this takes about 40 milliseconds (ms…

…Doppler (CW Doppler), ultrasound waves are continuously emitted from the transducer and the reflections of these waves are analyzed continuously (Figure 1). This is possible…

Echocardiography Pulsed Wave Doppler The pulsed wave Doppler (PW Doppler) sends short pulses of ultrasound and analyzes reflected sound waves between the pulses. This is…

…renal failure or simply deterioration. The procedure itself is straightforward: ultrasound to find the fluid, an insertion site in the left lower quadrant lateral to…

…Procedure Choice of access The ultrasound, not tradition, determines the site. Scan subxiphoid, parasternally and apically, and choose the site where the rim of fluid…

…puncture site Relative Mechanical ventilation with a high PEEP (an increased risk of pneumothorax; ultrasound guidance is mandatory) Relative A very small or loculated effusion …

…events in observational studies. OCT OCT uses near infrared light rather than ultrasound. Its resolution is substantially higher than that of IVUS, approximately 5–20…

…Ryan Lafollette and Bill Hinckley run this amazing website which includes everything from ultrasound knobology and emergency procedures to practice guidelines for emergency medicine (and…

…tissue Fragments from vegetations (septic or aseptic vegetations) Fragments of calcifications Atherosclerotic debris Embolic potential Numerous conditions can give rise to emboli in the heart…

…The ultrasound system automatically calculates RWT (Relative Weight Thickness), provided that the patient's weight, height and sex are entered. RWT is a measure of…

…single ultrasound line, its temporal and axial resolution is very high, as compared with 2D echocardiography. M mode is useful for quantifying the mobility of…

…during the examination. Work related musculoskeletal disorders are a common cause of pain and sickness absence for ultrasound practitioners (Harrison et al). When performing emergency…

…Ultrasound imaging, including echocardiography, has become a standard tool for clinicians worldwide (Narula et al). This chapter discusses the principles of the standard echocardiographic examination…

…Figure 2). It is important to note that the apex of the heart is fixed to the diaphragm via pericardium and connective tissue. Therefore the…

…picture without a demarcated fluid collection. Ultrasound also shows the depth of the cavity and its distance to vessels. Contraindications and when to involve a…

…MHz, ultrasound gel, a blood pressure cuff of the correct size (the width should correspond to about 40 % of the circumference of the limb), a…

…However, intravascular ultrasound has shown that delayed opening of the bridged segment may extend into diastole, so the physiological effect is not limited to systole…

…Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) provide cross sectional information about plaque morphology and may clarify the mechanism of an acute coronary syndrome…

…Stress increases myocardial oxygen requirements, principally through increased heart rate and contractility. In the presence of a flow limiting coronary stenosis, supply cannot increase adequately…

…using pulsed wave Doppler and measurement of the diameter. Cardiac output (CO) Cardiac output is the product of stroke volume (SV) and heart rate (HR)…

…orientation of the index marker and the scanning plane through the heart. Figure 2. PLAX, Parasternal Long Axis View. Position of the transducer : The ultrasound…

…With regards to echocardiography and ultrasound imaging in general, v is the maximum velocity measured using Doppler. Moreover, the first part of the formula (0…

…are routinely missed. The third thing to know by heart is that an arterial line must never be confused with a venous access. Indications Continuous…

…ultrasound of the liver and biliary tract . Go through the medication and any herbal preparations carefully — drug induced liver injury is the commonest cause of…

…a large bore cannula in a suitable vein). Standby access in a patient at risk of rapid deterioration. Intraosseous access: Cardiac arrest where venous access…

…embolism: Criterion Points : : Clinical signs of deep vein thrombosis 3 Pulmonary embolism is the most likely diagnosis 3 Heart rate 100/min 1.5 Immobilisation ≥…

…by radiography. Assessment should include consideration of associated vascular disease. In patients with AAA, duplex ultrasound screening for femoropopliteal aneurysms should be considered. Opportunistic screening…

…NSTEMI than in those presenting with STEMI. Approximately one third of patients with MINOCA may present with STEMI. Pathophysiology and causes MINOCA encompasses several distinct…

Echocardiography Color Doppler Velocities recorded in a sample volume of the pulsed wave Doppler can be presented with a color. A color scale from blue…

…to be detected and analyzed by the ultrasound machine. Figure 2. Reflections from an erythrocyte. Flowing erythrocytes will alter the frequency of reflected sound waves…

…most common agent. These streptococci most often originate from the oral cavity and affect heart valves that have some kind of damage, change or degeneration…

…consists of a parietal layer and a visceral layer. The parietal layer is 2 mm thick, rich in connective tissue and envelops the entire heart…

…of recording these flow variations with high precision. To calculate flow across a valve, the Doppler line is placed in the valve orifice. The ultrasound…