ULTRASOUND, ECHO AND FAST
ULTRASOUND FINDINGS FOR THE FOLLOWING
PromptAAA Leaking/ruptured
ResponseForcal dilation of aorta (Aneurysm)
Free intraperitoneal fluid
Peri-aortic fluid/retroperitoneal fluid/haematoma
Small or normal IVC
Free intraperitoneal fluid
Peri-aortic fluid/retroperitoneal fluid/haematoma
Small or normal IVC
PromptPericardial Tamponade
ResponsePericardial effusion
Diastolic collapse of RV (fairly specific)
RA collapse (sensitive but less specific)
IVC dilation with loss of respiratory variation
Respiratory variation of mitral inflow velocity (=sonographic pulsus paridoxus)
Diastolic collapse of RV (fairly specific)
RA collapse (sensitive but less specific)
IVC dilation with loss of respiratory variation
Respiratory variation of mitral inflow velocity (=sonographic pulsus paridoxus)
PromptPulmonary Embolus
ResponseRV dilation
Interventricular septal flattening
McConnels sign
Thrombus in R heart/pulmonary trunk
Hyperdynamic LV
Tricuspid regurgitation
D sign
DVT
Interventricular septal flattening
McConnels sign
Thrombus in R heart/pulmonary trunk
Hyperdynamic LV
Tricuspid regurgitation
D sign
DVT
PromptCardiogenic shock
ResponseLV dysfunction
Prominent B lines on lung ultrasound in all fields (Lung rockets)
Pleural effusions
Dilated IVC and/or IJV with absence of variability
Prominent B lines on lung ultrasound in all fields (Lung rockets)
Pleural effusions
Dilated IVC and/or IJV with absence of variability
PromptTension Pneumothorax
ResponseNo lung sliding
Dilated IVC and/or IJ vein
Presence of lung point/transition point
Absence of seashore sign
Presence of Barcode=stratosphere sign
Absence of normal comet tails/reverberation artifacts (Single comet tail excludes ptx at that point)
Absence of lung pulse
Dilated IVC and/or IJ vein
Presence of lung point/transition point
Absence of seashore sign
Presence of Barcode=stratosphere sign
Absence of normal comet tails/reverberation artifacts (Single comet tail excludes ptx at that point)
Absence of lung pulse
PromptMI
ResponseRegional wall motion abnormality
Acute MR/papillary muscle rupture
Acute MR/papillary muscle rupture
PromptTHORACIC Aortic Dissection
ResponsePericardial effusion
Cardiac tamponade
Intimal flap
Aortic root dilation
Aortic regurgitation
Dilated IVC/IJV
Regional wall motion abnormalities secondary to occlusion by intimal flap (typ. RCA)
Note: probably need a TOE to get most thoracic dissections.
Cardiac tamponade
Intimal flap
Aortic root dilation
Aortic regurgitation
Dilated IVC/IJV
Regional wall motion abnormalities secondary to occlusion by intimal flap (typ. RCA)
Note: probably need a TOE to get most thoracic dissections.
PromptHypovolaemia
ResponseSmall/collapsible IVC or IJV
Hyperdynamic LV
Small LVEDA <10 cm2 (LV end diastolic area)
Hyperdynamic LV
Small LVEDA <10 cm2 (LV end diastolic area)
PromptSepsis
ResponseHyperdynamic LV (early) or poor contractility (Late or severe)
Small or normal IVC
Potential source of sepsis
Small or normal IVC
Potential source of sepsis
- Lung consolidation
- Features of appendicitis/cholecystitis
PromptTrauma/Haemorrhage
ResponseSame as hypovolaemia
- Small/collapsible IVC or IJV
- Hyperdynamic LV
- Small LVEDA <10 cm2 (LV end diastolic area)
- Rib #
- Haemothorax
- Intraperitoneal fluid