Moving beyond FAST and free fluid: Rapid practical Point of Care Ultrasound any practitioner can apply in everyday practice.
Ever wonder why a cat is dyspneic (asthma vs. pleural effusion vs. heart disease) and you cannot obtain thoracic radiographs for fear of decompensation of your patient? Ever debate if you can safely give a patient IV fluids or when you should stop giving IV fluid boluses? Or why an animal presents for “ain’t doing right” with no specific clinical signs? Veterinary point of care ultrasound (POCUS) can help you manage these patients! POCUS techniques are easy to learn, require minimal training, and can be completed in under 5 minutes. They are practical ultrasound skills that ANY practitioner can apply in everyday practice. However, to maximize success the clinician must ask the right question (often binary), at the right time, in the right patient; don’t randomly place the probe on the patient without having a specific question or set of questions you are trying to answer based on the patient’s, history, clinical findings, and ancillary tests. It is also important to realize that POCUS is used differently for trauma, triage, tracking, treatment, and total screening, and protocols vary for abdominal, pleural, pulmonary, vascular, and cardiac conditions; choose the correct POCUS test to perform in the correct clinical setting. When applied correctly, POCUS has high sensitivity and specificity for the detection of abdominal effusion and other abdominal applications (GI motility, bladder volume estimation, gallbladder halo, pneumoperitoneum, renal pelvic dilation), and several thoracic, vascular, and cardiac pathologies (pneumothorax, pleural effusion, alveolar interstitial disease, left and right-sided heart failure, pericardial effusion, intravascular volume estimation and response to fluid therapy).
Through comprehensive and interactive lectures delivered by two of the founders and leading experts in the field of veterinary POCUS (lots of banter between the two lecturers!), participants will have the opportunity to learn and practice the skills of POCUS. Lectures are heavily case-based and designed to provide a solid understanding of normal findings as well as pathology, which will be followed by a hands-on laboratory on live animals. Time permitting, vascular access techniques using ultrasound will be discussed and practiced on a phantom chicken breast model (have you ever struggled to place an IV catheter in a patient that is dehydrated, have hematomas, thick skin, or edema? Ultrasound can help!).
By the end of the lectures, participants will be able to:
- Explain the difference between FAST and POCUS and how POCUS should be applied in the clinical setting
- Justify what binary question to ask based on clinical presentation and clinical findings
- Describe the indications of POCUS
- Explain how POCUS is modified based on patient position and type of pathology
- Describe the 5 main sites of abdominal POCUS and normal findings (subxiphoid, left and right paralumbar, bladder, umbilical)
- Describe common pathologies identified with abdominal POCUS (effusion, ileus, bladder volume, pneumoperitoneum, halo sign, renal pelvic dilation)
- Define pleural and lung ultrasound (PLUS) and describe how it is performed
- Explain why knowing PLUS borders is important
- Describe the normal findings of PLUS (glide, bat sign, A lines, B lines, Z lines, lung pulse, curtain sign)
- Describe the different pathologies identified during PLUS (pleural effusion, wet lung, subpleural consolidations, pneumothorax)
- Explain how PLUS is modified and adapted based on patient position and where pathology accumulates.
- Define cardiovascular POCUS
- Describe the normal findings of cardiovascular POCUS (short and long axis views of the heart and chambers, caudal vena cava)
- Describe pathology with cardiovascular POCUS (pericardial effusion, enlarged LA:Ao, caudal vena cava diameter changes, and volume status)
Describe how to perform in plane an out of plane ultrasound-guided vascular access and how to prepare a raw chicken phantom model to practice ultrasound-guided procedures