EM · Procedural & diagnostic ED skills

Point-of-care ultrasound: biliary and renal (and the incidental AAA)

Also known as POCUS biliary · POCUS renal · Point-of-care ultrasound right upper quadrant · Bedside gallbladder ultrasound · Hydronephrosis ultrasound · Emergency renal ultrasound · RUQ ultrasound

Point-of-care ultrasound of the biliary tree, the kidneys and the incidental abdominal aortic aneurysm — the right-upper-quadrant scan for gallstones (hyperechoic with acoustic shadowing), gallbladder wall thickening over 3 millimetres, the sonographic Murphy sign and the common bile duct over 7 millimetres; the renal scan for hydronephrosis (graded mild to severe), stones and cysts; and the aorta measured in every older flank-pain patient to catch the aneurysm that masquerades as colic. Technique with the curvilinear probe and an appropriate depth; the differentials (the non-visualised post-prandial gallbladder, bowel gas, ascites); and the diagnostic accuracy (POCUS rules cholecystitis in, it does not rule it out). ACEM-primary, globally tagged.