Slide 1: Which exam would be best performed with the linear high frequency ultrasound probe? (check all that apply). Measure cardiac ejection fraction. Mark epigastric vessels. Look for gallstones. Evaluate for DVT.

Slide 2: The correct answer includes mark epigastric vessels and evaluate for DVT.

Slide 3: Linear probes emit parallel sound waves, which are ideal for high resolution imaging, but they do not penetrate very deep in the tissues. Thus, linear probes are ideal for identifying superficial structures such as blood vessels, pleura, musculoskeletal, and soft tissues structures. Graphic showing linear probe characteristics. Increased frequency, decreased depth, increased resolution. Graphic showing curvilinear probe characters. Decreased frequency, increased depth, decreased resolution.

Slide 4: Evaluating for DVTs. Several studies have shown that with repeated practice, clinicians can be proficient in diagnosing and excluding lower extremity DVT comparable to vascular ultrasound and angiogram. Table. Title: Meta-analysis data showing combined test characteristics of emergency physician performed POCUS for lower extremity DVT. Sensitivity. 96.1%. Specificity. 96.8%. Positive LR. 30. Negative LR. 0.04.

Slide 5: Gif showing normal compressible vein. Gif showing non-compressible vein. Disclaimer. As with physical exam, physicians are responsible for knowing the limits of their point-of-care ultrasound skills. Decisions that greatly alter treatment course or diagnosis should be confirmed with standard of care imaging if reasonably accessible.

For more information, check out our ultrasound basics infographic.

References

  • Pomero F, Dentali F, Borretta V, Bonzini M, Melchio R, Douketis JD, Fenoglio LM. Accuracy of emergency physician-performed ultrasonography in the diagnosis of deep-vein thrombosis: a systematic review and meta-analysis. Thromb Haemost. 2013 Jan;109(1):137-45. PMID 23138420.

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