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Paeds Vivasinvestigations-procedures-and-technology

Paeds Vivas · investigations-procedures-and-technology

Paediatric ultrasound and point of care ultrasound — branching viva

Branching viva on paediatric point-of-care ultrasound: probe selection and image-quality controls, the lung ultrasound artefact repertoire and the BLUE protocol, the focused assessment with sonography in trauma and its limited sensitivity in children, the intussusception and pyloric sonographic signs, ultrasound-guided vascular access, and focus-assessed cardiac ultrasound in shock.

branching clinical structured oral1 min readVerification in progress

Target exams

RACP DCEMRCPCH ClinicalRCPSC Pediatrics
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Target exams

RACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Emergency department: a febrile, grunting 8-month-old needs a bedside lung ultrasound to distinguish community-acquired pneumonia from bronchiolitis. The examiner asks how you would choose the probe and set the image, what artefact repertoire you would read, and how the BLUE protocol interprets the pattern — then branches to a 6-year-old unstable trauma victim with a positive FAST, to the sonographic signs of intussusception and pyloric stenosis, to ultrasound-guided difficult vascular access, and finally to a focus-assessed cardiac scan in the shocked child.

Opening question

This febrile, grunting 8-month-old needs a bedside lung ultrasound to distinguish community-acquired pneumonia from bronchiolitis. Walk me through how you would choose the probe, set the image-quality controls, and run the scan, and tell me the artefact repertoire you would read at each zone. [1] [3]

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References7ShowHide
  1. [1]Singh Y, Tissot C, Fraga MV, et al International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC) Critical Care, 2020.PMID 32093763
  2. [2]Lichtenstein DA, Mezière GA Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol Chest, 2008.PMID 18403664
  3. [3]Lichtenstein DA Lung ultrasound in the critically ill Annals of Intensive Care, 2014.PMID 24401163
  4. [7]Liang T, Roseman E, Gao M, et al The Utility of the Focused Assessment With Sonography in Trauma Examination in Pediatric Blunt Abdominal Trauma: A Systematic Review and Meta-Analysis Pediatric Emergency Care, 2021.PMID 30870341
  5. [9]Piotto L, Gent R, Taranath A, et al Ultrasound diagnosis of hypertrophic pyloric stenosis - Time to change the criteria Australasian Journal of Ultrasound in Medicine, 2022.PMID 35978726
  6. [10]Kleidon TM, Schults JA, Royle RH, et al First-Attempt Success in Ultrasound-Guided vs Standard Peripheral Intravenous Catheter Insertion: The EPIC Superiority Randomized Clinical Trial JAMA Pediatrics, 2025.PMID 39869351
  7. [11]Conlon TW, Baker D, Bhombal S Cardiac point-of-care ultrasound: Practical integration in the pediatric and neonatal intensive care settings European Journal of Pediatrics, 2024.PMID 38236402
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