Ultrasound – Tips, tricks, and skills for everyday use

Updated 12 Feb 2020

Download the lecture notes here: Download

 

Steps to getting a diagnostic or intervention-quality image:

  1. Choose the transducer best-suited to the task based on frequency and footprint of the transducer
  2. Achieve a good transducer-patient interface (ultrasound gel)
  3. Adjust the transducer position to center the structure of interest in the screen in the horizontal (left to right) plane
  4. Adjust the depth to center the structure of interest in the vertical (top to bottom) plane
  5. Adjust the frequency to the highest frequency that penetrates to the needed depth and shows good detail
  6. Adjust the gain so you see black, grey, and white images clearly. Images that are very dark (lots of black and not much detail) the gain is too low. Images that are very bright (too much white and the image looks washed out) the gain is too high. If the image remains too dark after turning up the gain, try a lower frequency setting.
  7. Adjust the focus point to at or just below the structure of interest
  8. When placing a needle into a target structure remember: higher frequencies help to differentiate between structures that are stacked one on top of another, while the focus point is going to help differentiate between structures that are side-by-side at the same depth

 

USEFUL VIDEO LINKS:

  1. TAP block (for abdominal wall)
  2. Femoral nerve block: Part 1   Part 2   Part 3
  3. Sciatic nerve block: Part 1   Part 2   Part 3
  4. Brachial plexus block: Part 1   Part 2   Part 3

 

REFERENCES AND SUGGESTED READING

  1. Warrit K, Griffenhagen G, Goh C, et al. Comparison of ultrasound-guided lumbar plexus and sciatic nerve blocks with ropivacaine and sham blocks with saline on perianesthetic analgesia and recovery in dogs undergoing tibial plateau leveling osteotomy surgery. Vet Anaesth Analg. 2019 Sep;46(5):673-681.
  2. Subramaniam S, Bober J, Chao J, et al. Point-of-care Ultrasound for Diagnosis of Abscess in Skin and Soft Tissue Infections. Acad Emerg Med. 2016 Nov;23(11):1298-1306.
  3. Drożdżyńska M, Monticelli P, Neilson D, et al. Ultrasound-guided subcostal oblique transversus abdominis plane block in canine cadavers. Vet Anaesth Analg. 2017 Jan;44(1):183-186.
  4. Viscasillas J, Gregori T, Castiñeiras D, et al. Description and evaluation of four ultrasound-guided approaches to aid spinal canal puncture in dogs. Vet Anaesth Analg. 2016 Jul;43(4):444-52
  5. Fathi M, Moezzi M, Abbasi S, et. al. Ultrasound-guided hematoma block in distal radial fracture reduction: a randomised clinical trial. Emerg Med J. 2015 Jun;32(6):474-7.
  6. Gregori T, Viscasillas J, Benigni L. Ultrasonographic anatomy of the sacrococcygeal region and ultrasound-guided epidural injection at the sacrococcygeal space in dogs. Vet Rec. 2014 Jul 19;175(3):68.
  7. Portela DA, Romano M, Briganti A. Retrospective clinical evaluation of ultrasound guided transverse abdominis plane block in dogs undergoing mastectomy. Vet Anaesth Analg. 2014 May;41(3):319-24.
  8. Berger T, Garrido F, Green J, et al. Bedside ultrasound performed by novices for the detection of abscess in ED patients with soft tissue infections. Am J Emerg Med. 2012 Oct;30(8):1569-73
  9. Brull R, Macfarlane AJ, Tse CC. Practical knobology for ultrasound-guided regional anesthesia. Reg Anesth Pain Med. 2010 Mar-Apr;35(2 Suppl):S68-73.
  10. Campoy L, Bezuidenhout AJ, Gleed RD, et al. Ultrasound-guided approach for axillary brachial plexus, femoral nerve, and sciatic nerve blocks in dogs. Vet Anaesth Analg. 2010 Mar;37(2):144-53.
  11. Echeverry DF, Gil F, Laredo F, et al. Ultrasound-guided block of the sciatic and femoral nerves in dogs: a descriptive study. Vet J. 2010 Nov;186(2):210-5.
  12. Focused Ultrasound Techniques for the Small Animal Practitioner