Ultrasound QA Notes

 Can’t call it a gestational sac without there being a yolk sac on ultrasound
 For measurements of urinary retention, make sure to get measurements in both axis
(short and long) (from iliac to iliac, umbilicus to spine, and top to bottom on long view)
 Fat pad on heart view: only in one view (usually on PSLA at top), grainy appearance
 FL or BPD to get credit for OB ultrasound (get trans and sagittal view)
 If rib sign goes past diaphragm, then some type of pathology above diaphragm
 On LUQ fast view, fluid tends to collect above spleen first
 RUQ FAST view, fluid collects first at tip of liver, most dependent view is morrisons
pouch though
 Aortic study; seagull sign/whale sign
o NLM aorta: <3cm
o Ascending aorta: <4cm
o Iliacs: <1.5cm
 Gallbladder US
o 2 axis (long/short)
o Portal triad
o Measurements: CBD, GB wall
o Label whether if theres a murphy sonograph sign or not
 Thoracic lung US
o Lung sliding (at least 5 cm) and put in M mode
o 6 views (R1,R2,R3)

OB US Notes
st
 1 trimester: check to see if theres an IUP
 Is there an IUP?
o Discriminatory zone 1500
 Longitudinal view
o Transvaginal
 Marker dot towards the ceiling
o Curvelinear
 Marker dot towards pts head
 Transverse
o Curvilinear
 Marker towards pts right
o Transvaginal
 Marker towards pts right
 Ovaries: only need 1 transverse view
 Cardiac activity 6-8 wks
 Term to use for early gestational sac: Cyst like structure w/in uterus, no confirmed IUP
 If yolk sac, can label IUP
 Gestational age
o CRL,
o 2nd/3rd trimester BPD(outer skull to inner skull), FL
 Unstable child bearing female pt with + FAST, treat as ectopic until otherwise proven, no
need to wait for an hcg to call OB
 5 things to look for:
o Free fluid, IUP, adnexal mass, estimated gestational sac, FHR
 Threatened abortion
o Aka miscarriage
o 95% of folks with vaginal bleeding in 1st trimester with cardiac activity will carry
to term
 Negative predictive value of POC OB US confirming IUP: ~100%

Thoracic US
 PTX
o CXR:52% to detect PTX
o US: 88%
 Consolidation
o US:100%
o CXR: 38%
 R1: anterior chest
 R2: ant axillary line to post axillary line
 R3: posterior chest
 A and Z lines normal, B lines abnormal
 Dynamic bronchogram: PNA
 Static bronchogram: atelectasis or PNA
 Transition pt/lung point only confirmatory sign for PTX on lung US
 Lung pulse (barcode view with vertical lines) = no PTX
 No lung sliding, but B lines are present, means no PTX in that area
 Subpleural consolidation: viral PNA, early developing PNA, PE
