Clinical Procedures Using Ultrasound UC Irvine School of Medicine Nathan Molina Trevor Plescia Jack SIlva

Central Lines

Position the indicator toward YOUR left

Tenting Failure to overcome intravascular pressure “tenting”

Can lead to transection of vessel once the wall is finally punctured

Valsalva, Trendelenburg, or humming helps give an  abrupt  “jab”  to  overcome wall tension

Subclavian Technique

“Out  of  plane”  approach will be used

Start with the transducer inferior to the distal clavicle

Subclavian Technique Move the probe 2 cm medially

Be sure to compress the vessels to distinguish the vein from the artery

Subclavian vein should be inferior to the artery (anatomically)

Subclavian Compression

Lung

Peripheral Nerve Block “In-Plane”  approach

Median nerve

Aspiration and Injection

Pericardiocentesis

Cellulitis:  “Cobblestoning”

• Differentiating between an abscess and cellulitis • Don’t  stick a needle in it!

Deep Vein Thrombosis (DVT)

Examine the femoral and popliteal veins

Find veins in short axis and compress at multiple points along their course

Negative DVT (normal popliteal vein compression)

Positive DVT (popliteal vein fails to compress)

Atlas of Anatomy, Second Edition, By Gilroy, MacPherson, Ross, Schuenke, Schulte, Schumacher. Thieme Medical Publishers, 2012.

Introduction to Bedside Ultrasound, Volumes 1 & 2, Matthew Dawson and Mike Mallin, Emergency Ultrasound Solutions, 2013.

Select images from the UCISOM Ultrasound in Education Department

REFERENCES