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Applications of Bedside Ultrasonography

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Le Bonheur Children's Medical Center. Pediatric Emergency & Sedation ... Curvilinear Abdominal Probe. Transverse Scanning Plane. 22G 1.5' needle for SPA ... – PowerPoint PPT presentation

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Title: Applications of Bedside Ultrasonography


1
Applications of BedsideUltrasonography
  • Jay Pershad, MD, FAAPLe Bonheur Childrens
    Medical CenterPediatric Emergency Sedation
    Specialists, PC

2
Urinary Bladder Indications
  • Enhance Success Rate of Bladder
  • Catheterization
  • Suprapubic Aspiration
  • Suspected Obstructive Uropathy

3
Bladder Technical Aspects
  • 2.5-5 MHz
  • Curvilinear Abdominal Probe
  • Transverse Scanning Plane
  • 22G 1.5 needle for SPA
  • US Assisted or US Guided

4
Soft Tissue Abscess
  • Indications
  • Abscess versus Cellulitis
  • Abscess versus Lymphadenitis

5
Abscess Technical Aspects
  • 5-10 MHz
  • Linear Array Probe
  • Liberal use of Gel
  • Compare Normal Side
  • Scan in gt 2 Orthogonal Planes
  • Acoustic Standoffs
  • THI Mode

6
Abscess Vs. Cellulitis
  • Hypoechoic cavity c relatively
  • hyperechoic rim
  • Posterior acoustic enhancement
  • Absence of Doppler flow

7
Abscess Vs. Lymphadenitis
  • Cortex hypo echoic Medulla hyper
  • echoic
  • Normal echo-density of surrounding
  • tissues
  • Smooth walled
  • Multiple
  • Doppler flow

8
Soft Tissue Foreign Body
  • Detection Indications
  • Radiolucent FB (e.g. Wood, Plastic)
  • Real Time Localization Removal

9
FB Detection Technical
  • Aspects
  • 6-12 MHz, Linear
  • Multiple Scanning Planes
  • SQ Tissue in Palms Soles Can Obscure or
  • Mimic FB
  • Hyperechoic focus with Shadowing
  • Acoustic Standoff
  • Operator Dependant

10
FB Detection Pitfalls
  • Negative Examination
  • False Positives in Palms Soles
  • Multiple FB (Wood Splinters)
  • Inaccessible Areas
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