Ultrasound

We perform over 450 bedside ultrasounds in the ED monthly

Brookdale offers some of the most comprehensive ultrasound training for our ED physicians. You will be well-prepared for any bedside scan after your training

Key Features of our Ultrasound Program:

  • Three Ultrasound Fellowship-trained faculty
  • Dedicated Ultrasound month in your first and second years of residents
    • First year residents focus on the foundations of ultrasound, including FAST exams, cardiac echo and pulmonary effusion
    • Second year residents focus on in-depth evaluations of disease including, but not limited to, detailed cardiac function analysis, critical patient FAST exams (trauma/resus setting), pulmonary edema/effusion
  • State-of-the-art new ultrasound machines, including Zonare for accurate bedside investigations
  • QPath wireless archiving system, dedicated to quality analysis and logging for residents to keep track of their scans
  • Weekly Image of the Week (see below!) and presentations prepared by the ultrasound resident and shared to all residents for in-depth review and shared learning

39 y/o F, no pmhx, G2P1, 14 weeks pregnant presenting in cardiac arrest.

What differentials immediately run through your mind?

What do you see in the image below?

psax-pre-tpa.gif

AP4C pre TPA

Notice large R ventricle with bowing of septum into L ventricle on PSAX image above, along with hypodynamic heart in second picture.

Given patient’s current pregnancy with hypercoagulable state, no previous medical hx and sudden collapse, PE was high on differential list. When specifically questioned, family remarked that patient has been complaining R lower leg pain for past 3 days and SOB earlier in the day before ED presentation.

It was decided to give tPa to patient considering likely etiology with no absolute contraindications. Images below are post tPa.

PSAX post TPA.gif

No further bowing of septum. R ventricle has decreased in size compared to pre-tPa images.

 

AP4C post TPA.gif

Heart no longer hypodynamic.