Category Archives: Learning Bedside Ultrasound

Getting to the Point of Ultrasound Assisted Lumbar Punctures

The Case

There are a few cases I could talk about… Ultrasound guided LPs have turned out to be a surprisingly useful skill. Lucky for you, I’ve restrained myself.

The first time I heard about ultrasound guided LPs was during a spectacular yearlong ultrasound elective in medical school. I was sitting in the doctor’s pod with THE ultrasound attending of ultrasound attendings. He casually asked “Have you ever heard of ultrasound guided LPs?” Never. “Do you want to see one?” Obviously. He explained how ultrasound guided LPs follow the principle of “Measure twice. Cut once.” He spent a minute (and I mean literally just one minute) visualizing the spinal landmarks and marking them on a somewhat altered, seriously chunky patient. He proceeded to get the LP in one stick! I remember thinking he was a wizard in that moment, a wizard who uses ultrasound to elevate patient care to another level; and that I want to be the badass attending that gets LPs on obese, altered patients in one stick. I had to learn this skill…

One year and a few ultrasound guided LPs later, I found myself on an internal medicine rotation. By then I had earned myself a reputation as “the ultrasound chick”. My first senior resident was also especially interested in bedside ultrasound. On our first day without prompting he said “bedside ultrasound is the future of medicine.” I literally did a small happy dance and told him we were going to have a great month. And we did! Internal medicine had never seen so much ultrasound before our partnership. It was wonderful! Fast forward a couple months. The above senior resident catches me in the hall and asks my team if he can borrow me. “I’ve got a patient for you!” It’s an obese, ICU patient with suspected meningitis, who has failed multiple LP attempts. “Can you do an ultrasound guided LP for me?” We were at a small community hospital without interventional radiology. Fluoroscopy isn’t an option (and moving her seems like a bad plan anyway). We roll in the ultrasound, identify the spinous interspace, mark it, and start the LP. I get the CSF and we do happy dance in the hall… Another patient wins thanks to bedside ultrasound!

Continue reading Getting to the Point of Ultrasound Assisted Lumbar Punctures

New SonoMojo Resource: Soft Tissue Ultrasound Cheat Sheet

The latest SonoMojo ultrasound cheat sheet has arrived! The Soft Tissue Ultrasound Cheat Sheet is a brief review of soft tissue ultrasound and it’s applications. Use it to quickly review the essentials before performing a scan or as an overview of soft tissue ultrasound before diving into the Soft Tissue Ultrasound Module.

In case you haven’t heard of “Ultrasound Cheat Sheets”…  they’re all the basic info you need to review before performing (or teaching) a specific ultrasound scan. They are 1-2 pages long and consist of an brief check list of information on the application, image acquisition, and interpretation of a scan.

So be sure check out SonoMojo’s latest addition to the Ultrasound Cheat Sheets Collection,  soft tissue ultrasound!

SonoMojo Featured on Critical Care Practioner Podcast

Hey sono enthusiasts! Exciting news! SonoMojo was recently featured on Critical Care Practioner Podcast! “Episode 37: How to Make Ultrasound Easier” features myself and the SonoMojo site in an episode discussing how to make learning ultrasound easier through #FOAMed resources and strategies for learning ultrasound. I’m so thrilled about the whole experience and getting to work with fellow FOAMer Jonathan Downham. Jonathan is a class act and he’s put together a great episode! Be sure to check it out!

Life in the eFAST Lane: Extended Focused Assessment with Sonography for Trauma (Part 2)

That’s right! The Life in The eFAST Lane series is back! Last time we reviewed eFAST basics and half of the eFAST technique. Hopefully you’ve been practicing the heart, RUQ, and LUQ scans like my friend below. So without further adieu…. I give you eFAST Part Deux!

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Figure 1 – An eFAST Rockstar in Action
Figure 1 – An eFAST Rockstar in Action
How to Do I Perform an eFAST? (Continued from Part 1)

Pelvis

Probe position

  • Probe marker towards patient’s head (longitudinal view) or towards patient’s right (transverse view).
  • Place the probe just above the pubic symphysis and look for the bladder in men and both the bladder and uterus in women.
    • If it’s not awkward, it’s not right and you’re not low enough.
  • Once you’ve completed the longitudinal view, turn your probe 90° for the transverse view.  Both views should be evaluated to avoid false positives.
Figure 2 – Longitudinal Probe Position (from sonocloud.org)
Figure 2 – Longitudinal Probe Position (from sonocloud.org)

Continue reading Life in the eFAST Lane: Extended Focused Assessment with Sonography for Trauma (Part 2)

Life in the eFAST Lane: Extended Focused Assessment with Sonography for Trauma (Part 1)

This is the first of a three part series reviewing the eFAST scan in detail. The goal of this series is to aid new ultrasound users to perform their first eFAST scan correctly and improve existing sonographer’s understanding of the eFAST.

The Case

There are just too many eFAST cases to choose from. Which one to tell you…? Should I talk about my first eFAST patient, the supposed-to-be-simple-but-really-wasn’t, coumadin guy who laid out his motorcycle? What about the lady from the rollover down a twenty foot embankment? Or the teenager from a horseback riding accident? Should I tell you about the night I hung out in resuscitation and did an eFAST on every patient that came through? A December night in medical school I like to think of as Ultrasound Christmas. A night when a trauma alert rolled in and before I knew what was happening, the resident put the ultrasound probe in my hand and said “Go for it!” Needless to say it was AWESOME! Like do-a-secret-happy-dance-in-the-hallway-afterwards kind of awesome. I definitely loved my ultrasound elective, especially once I became competent at eFASTs. So what’s an eFAST you ask? It’s simple really. It’s a systematic ultrasound scan to check for pneumothorax and free fluid (usually blood) in the abdomen and chest. It’s quick, easy, and incredibly useful. You don’t have to be a genius for this stuff. My first year med students can do this and so can you! If you’re going to spend time in the Emergency Department or with critically ill patients, you should learn the eFAST. End of story. So now that you’re convinced… just how do you do an eFAST?

What’s eFAST All About?

The eFAST is a fast (pun intended) and easy way to check for blood in the chest and abdomen. Continue reading Life in the eFAST Lane: Extended Focused Assessment with Sonography for Trauma (Part 1)

New SonoMojo Resource: DVT Ultrasound Cheat Sheet

A new SonoMojo Ultrasound Cheat Sheet is here! The DVT cheat sheet is a brief review of DVT bedside ultrasound. You can use it for a quick review of the essentials before performing a scan or an overview of the key points before diving into learning DVT ultrasound.

In case you don’t know what an Ultrasound Cheat Sheet is…. they’re all the basic info you need to review before performing (or teaching) a specific ultrasound scan. They are 1-2 pages long and consist of an brief check list of information on the application, image acquisition, and interpretation of a scan.

So be sure check out the newest installment of Ultrasound Cheat Sheets, DVT ultrasound, on the Ultrasound Cheat Sheets page!

New SonoMojo Resource: eFAST Ultrasound Cheat Sheet

There’s a new SonoMojo Ultrasound Cheat Sheet! The eFAST Ultrasound Cheat Sheet is here! In case you don’t know what an ultrasound cheat sheet is…

Ultrasound cheat sheets are all the basic info you need to review before performing (or teaching) a specific ultrasound scan. They are 1-2 pages long and consisting of an brief check list of information on the application, image acquisition, and interpretation of a scan.

Be sure to check out the latest ultrasound cheat sheet, the eFAST, on the Ultrasound Cheat Sheets page!