POCUS Study Guide

What is a POCUS?

Bedside US performed by clinician to provide immediate info for diagnosis and management; widely used in EM/ critical care/ IM/ and other specialties

What is ultrasound physics?

understanding sound waves, frequency, and interaction of ultrasound with tissues

What is image acquisition?

proper probe selection, positioning, and movement (sliding, tilting, rotating)

How will weak reflectors appear?

As black on the screen, Anechoic (causes posterior enhancement)
-soundwaves passes through them, very few echoes return to probe
ex: blood, cysts, seromas, effusions, ascites, free fluid

How do strong reflectors appear?

Appear as White, Hyperechoic (causes posterior shadowing)
-most soundwaves bounce off the structure and reflect back to the probe
ex: bone, gallstones, kidney stones, diaphragm, pleura, air

What is the purpose of cardiac focused assessment with sonography for trauma (FAST)?

Rapid assessment for free fluid in the pericardium, pleural spaces and peritoneum

What are views in focus assessment with sonography for trauma?

Subxiphoid, parasternal long axis, apical four chamber, subcostal views

What is the purpose of echocardiography?

Assess cardiac function, chamber size, presence of pericardial effusion

What are the views for echocardiography?

Parasternal long axis, parasternal short axis, apical four chamber, subcostal

What is the purpose of a lung ultrasound?

Evaluate for pneumothorax, pleural effusion, pulmonary edema, consolidation

What findings are seen on a lung US for a patient with pneumothorax?

Absence of lung sliding, presence of “lung point”

What findings are seen on a lung US for a patient with pleural effusion?

Anechoic or hypoechoic fluid collection

What findings are seen on a lung US for a patient with pulmonary edema?

B lines (comet tail artifacts)

What findings are seen on a lung US for a patient with Consolidation?

Hepatization of lung tissue, air bronchograms

What finding would indicate an anuerysm?

Aortic diameter >3cm

What findings could you see in the gallbladder?

Gallstones, thickened gallbladder wall, pericholecystic fluid
*evaluate for cholecystitis and cholelithiasis

What findings could you see in the kidneys?

Dilated renal pelvis and calyces, echogenic stones with shadowing
*assess for hydronephrosis and renal stones

What findings could you see in a patient with DVT?

Lack of compressibility, presence of thrombus
*compression US of common femoral, superficial femoral, popliteal veins

What findings would you see in a joint effusion?

Anechoic or hypoechoic fluid collection
*detect fluid in joints

what findings could you see in fractures?

Cortical disruption, step-off
*identify bone discontinuity

What ocular findings could you see?

Retinal detachment (hyperechoic membrane), optic nerve sheath diameter > 5mm

What technique should you use for nerve blocks?

Identify target nerve, visualize needle path
*guide needle placement for regional anesthesia