Looking forward to #POCUS webinar with @ASRA_Society with @jattarab @KalagaraHari @dr_melissabyrne and team! 
@dr_melissabyrne first up on cardiac US.
When Learning a new technique...
1. Set realistic goals for learning
2. Improve workflow efficiency
3. Scan based on pathology
Use the 4W approach
When to apply pocus
Where to place probe
What do images mean
What to do next
When Learning a new technique...
1. Set realistic goals for learning
2. Improve workflow efficiency
3. Scan based on pathology
Use the 4W approach
When to apply pocus
Where to place probe
What do images mean
What to do next
Some clever ways to use POCUS When performing a Regional anaesthesia procedure
Here are the 5 F’s...
A good step-wise way to implement a new skill
Next up Dr Blair DeHaan on lung Ultrasound
As regional anaesthetists- we will already be familiar with curvilinear and linear probes.
Lung US is the study of artefacts
As regional anaesthetists- we will already be familiar with curvilinear and linear probes.
Lung US is the study of artefacts
Normal artefacts
A-lines: reverberation artefacts
B-lines if 3 or less
A-lines: reverberation artefacts
B-lines if 3 or less
Lung Sliding and Lung Pulse are normal
This generates the Sea-Shore sign on M-mode
This generates the Sea-Shore sign on M-mode
Can also assess the Diaphragmatic recesses on left (spleen) and right (liver)
Abnormal artefacts
lung Rockets - B-lines in more than one area
Spine Sign - acoustic window where pleural effusion allows you to see vertebral bodies. (Absence of curtain sign)
lung Rockets - B-lines in more than one area
Spine Sign - acoustic window where pleural effusion allows you to see vertebral bodies. (Absence of curtain sign)
What about diagnosing a pneumothorax?
When should we consider Gastric Ultrasound?
What can you find out?..
How should we perform this?
Curvilinear probe
Supine and then Right lateral decubitus position
If empty...
Curvilinear probe
Supine and then Right lateral decubitus position
If empty...
Clear fluid ...
Fluid with air bubbles - starry night..
Solid food gives you this frosted glass pattern - early
Solid a little later...
So - how do you interpret the information?..
Another flow chart for interpretation
But how do you mention gastric Cross Sectional Area?
Use this nomogram.
CSA 6 and 10 are useful numbers to remember
CSA 6 and 10 are useful numbers to remember
What can you do with this information?...
Now James Green on FAST & Airway
FAST - Focused Assessment with Sonography in Trauma
Pos 1 heart - pericardial fluid/tamponade
Pos 2 & 3 diaphragm - looking for free fluid around liver/spleen and kidneys
Pos 4 - Pelvic - looking for free fluid
Pos 1 heart - pericardial fluid/tamponade
Pos 2 & 3 diaphragm - looking for free fluid around liver/spleen and kidneys
Pos 4 - Pelvic - looking for free fluid
Airway
Transverse scan- centre image on screen - mark midline
Transverse scan- centre image on screen - mark midline
Can scan over cricoid...
Oesophagus on left
I missed the image of the longitudinal scan, but here is one from @LITFLblog
litfl.com/airway-ultraso…
litfl.com/airway-ultraso…
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