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Applications of Bedside Ultrasonography

Applications of Bedside Ultrasonography. Jay Pershad, MD, FAAP Le Bonheur Children’s Medical Center Pediatric Emergency & Sedation Specialists, PC. Urinary Bladder: Indications. Enhance Success Rate of Bladder Catheterization Suprapubic Aspiration Suspected Obstructive Uropathy.

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Applications of Bedside Ultrasonography

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  1. Applications of BedsideUltrasonography Jay Pershad, MD, FAAPLe Bonheur Children’s 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 > 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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