POCUS

• 5 Min Sono

• Ultrasound of the Week

Cleaning

• All machines must be cleaned with antiseptic wipes (gray tub). This includes the screen, the handles and the probes. Probes must be put back in the appropriate holders.

• At the end of each shift, the senior resident in Pod C/D needs to make sure the equipment is cleaned and properly stored.

• The storage boxes attached to each machine should only have clean hand towels and unused gel packets. Nothing else.

• There are to be no needles, no open gel packets or other accoutrements in the baskets.

• Trauma/EFAST machines must be cleaned by the junior resident as they are the ones doing the exam.

• If you see a consultant or a non-ED personnel use the machine, please ask courteously that they clean the machine after use.

Where equipment should be stored:

• Mindray #1: stored in Pod D to be used for Pod D/R

• Mindray #2: stored in Pod B/C

• Sonosite #1: stored in Trauma Bay

• Sonosite #2: stored in the ambulance bay by the WOWs

• If a machine is not being used it needs to be plugged in.

• Machines are NOT to leave the ER (ie, cannot go to the ICU) unless accompanied by an attending and the attending must ensure proper return of equipment. If someone requests to take the machine out of the department, please ask for his/her ID that can be held until the machine is properly returned.

What to do with damaged equipment:

• Equipment that does not work or is damaged, an email should be sent to me mistryja@armc.sbcounty.gov for evaluation and subsequent repair

Sharps/contaminated equipment:

• There should be NO sharps in any ultrasound basket.

• Sharps are to be used on a case by case basis to avoid accidental needle injury.

Who can access equipment and who needs supervision

• All residents and staff PAs can use the ultrasound machines regardless of training level.

• All students and PA fellows need supervision and permission from a resident or attending.

• Starting January, we will have a dedicated ultrasound rotation for medical students who can only use the machines once completing their hands-on orientation. We may assign one specific machine for educational purposes.

• Students on the ultrasound rotation should receive a hands-on tutorial by Dr. Mistry.

• Views

  • RUQ

  • LUQ

  • Subxyphoid or parasternal

  • Pelvic

  • Ant Chest L&R

• Video

• Views: Min 3 views

  • PSL

  • PSS

  • AP4

  • Subxyphoid

• Video

• Views:

  • GB short axis

  • GB long axis

  • measurement of GB wall

  • measurement of CBD

• Video

• Views:

  • Uterus transverse and longitudinal

  • IUP

  • FHR

• Views

  • 2-3 views of bowel, appendix, pyloric stenosis, etc

• Video 1

• Video 2

• Views

  • Multiple views longitudinally and transverse, through bifurcation

  • Measurement of aorta

• Video 1

• Video 2

• Views

  • Coronal and transverse view of both kidneys

  • Transverse view of bladder

• Video 1

• Video 2

• Views

  • Anterior and lateral view of lungs fields (L&R)

  • Posterior optional

• Video

• Views

  • multiple views showing compressibility of femoral and popliteal veins

• Video

• Views

  • Image of needle or wire in vessel

• Views

  • Clip of ascites

  • image of site of catheter placement

• Views

  • Clip of eye - normal gain for retinal pathology, high gain for vitreous pathology

  • Kinetic exam

• Video