To image something which moves, you must remain still. To image something which is still, you must move. If you think on this long enough, the point is self-evident and requires no explanation. Or, just see some examples below. We are prett…
Thoracic sonography is one of the most rapidly growing areas of emergency and critical care ultrasound. One very important emerging indication is to assess for lung consolidation. The characteristic appearance of consolidated lung is very s…
We already know it is helpful to use ultrasound to guide placement of central venous catheters. How can we use ultrasound to help confirm proper placement of an internal jugular catheter? There are several methods which have been describe…
We mostly focus on ultrasound here, but a large part of what we do is information exchange, adult education, and the like. We give a lot of presentations, and many of our faculty are interested in the art of speaking, the aesthetics of pres…
Hopefully you are using ultrasound to guide your insertion of central venous catheters. Once they are in, you still have to suture them at some point. Straight suture needles are often used to secure arterial and venous catheters to the ski…
Welcome new interns across the land! You will be receiving lots and lots of advice from many sources, so I’d like to pour some ultrasound scanning tips into the information deluge. Most of these tips were posted here at SinaiEM.us a f…
The subxiphoid four chamber view is commonly used in cardiac assessments and the FAST exam and for many is the initial “go-to” view of the heart. Difficulty obtaining this window can frustrate novice and seasoned operators, and…
One common source of confusion or false positives in the FAST exam is the assessment of the left upper quadrant. We’ve already covered some tips on improving your view of the spleen. This post will illustrate how the stomach can mimic…
Finding the right angle is critical to optimal imaging. In fact ‘right angle’ or perpendicular imaging is the best way to get a clear image. At 90 degrees, many more sound beams reflect back to the transducer than at more shallo…
We’ve all seen ultrasound augment the physical examination and even allow for assessments we could not otherwise accomplish at the bedside. One great example is the use of ultrasound to check the pupillary light reflex. If you are won…
Hippocrates, Galen, and a host of classical physicians wrote extensively on the spleen and its maladies. As I’m sure you recall, the spleen is tasked with the metabolism of black bile. Failure of the spleen to clear this fluid leads t…
Probe Manipulation – Rotation from Sinai EM Ultrasound on Vimeo. How do you obtain that nice long image of the peripheral blood vessel for a longitudinal approach? It is easy to say ‘rotate the probe 90 degrees from the transver…
The first and most important step in paracentesis is confirming there is ascites to begin with! Physical examination findings can be misleading, and inserting a needle blindly into the abdomen can cause complications unnecessarily. Note the…
One of the most common pitfalls in gallbladder sonography is confusion with the structure which abuts it in the right upper quadrant – the duodenum. This loop of bowel can easily be mistaken for the gallbladder especially if it contai…
