Life is a lot like ultrasound. Nothing is black and white.

Ultrasound is increasingly being used throughout the hospital, particularly in the ED and in critical care settings. Tracking effusions, looking for acute blood on the FAST exam, looking at IVC diameter to judge resuscitation requirements, etc. are all things you can learn how to do. Additionally we use ultrasound to help place catheters and to perform biopsies.

You may be asked to use ultrasound as an intern to do any one of these things. We will review some essential cases in today’s ultrasound practical later today. Later on in the rotation ask one of us if you want to try your hand at doing some ultrasound scanning yourself.

Keep in mind that ultrasound is a sound-based modality, relying on emitted high frequency waves being reflected on things to outline anatomy – some things reflect sound better than others. Sound travels through water very easily (nothing is reflected back to the probe, making water look black). However sound does not travel easily through bones or calcified gallstones, and those structures reflect almost all of the sound waves and thus look bright.

To start, review this excellent website for an overview of ultrasound. This tutorial focuses on how you can use ultrasound (or order an ultrasound) to evaluate various acute presentations.

Skip the" technique" section because it is frankly boring.

Lets focus on the clinically relevant situations and start with “RUQ Pain” (the menu is on the left).

https://www.med-ed.virginia.edu/courses/rad/edus/ruq1.html#

Finally, briefly review these cases before your session with your resident. You might find some of the cases again from the website! If you have no idea what is going on, don't worry -- nothing is black and white. We will explain it all to you.