My hand felt like it was shaking, sweat was beginning to bead on my forehead, and my eyes were beginning to go cross as I stared at what seemed like fifty shades of static grey. As the probe slid gracefully across the volunteer’s right axillary line, the instructor had me stop and there it was…Morrison’s pouch. What at first looked like static on a TV, now looked like something recognizably anatomic. The fifty shades of hell was over for now. Letting myself exhale and finally relax somewhat, I muttered something unrepeatable in polite company beneath my breath. There it was; my first ultrasound image…I was hooked. I took the probe off of the volunteer’s side and found that little spot between the liver and kidney again, just to make sure I had it down. I finished the rest of the basic FAST (Focused Assessment with Sonography in Trauma) exam with relative ease and went on to do it several more times. I was still nervous and sweating through my shirt though.
The reason I was sweating is because I was being taught by some of the most experienced ultrasound instructors from University of Maryland Medical Center, as well as Sentara Norfolk General Hospital. I was also with several colleagues and outstanding HEMS operators…so I feel my anxiety was warranted.
I just want to stop here and say thank you to East Coast Helicopter Operations for this amazing opportunity to finally get my hands on an ultrasound unit. Seriously, check them out. They host FREE FOAM-style conferences for public safety helicopter operators and it really was worth it. They are dedicated to FOAM and they graciously let me tag along as it is typically only for HEMS providers and other helicopter crewmembers.
I repeated the FAST a few more times before I finally relinquished the probe to the instructor. Happily enough, the Sonosite reps and the instructor allowed us to play around with the ultrasound machine afterward.
So this happened…
That’s Branden ultrasounding his eye. First he probed…is that the word…no, imaged for his optic nerves (which can be used to diagnose increased intracranial pressure) which was fairly easy to find in a controlled setting and measure. We also experimented with checking pupillary response in a closed eye with ultrasound (we shined a light in his other eye) and it worked! He could not remember where he had heard of doing this but here is a link to, of course, non other than the Ultrasound Podcast, which discusses it.
This is what happens when we are left to our own devices…
That’s yours truly ultrasounding my right MCA (middle cerebral artery). Yes, I know what you’re thinking; that is the wrong probe and the wrong setting but we are new at this! We eventually figured it all out and got a very good picture of the MCA. Why would you ever want to ultrasound for the MCA? I will let Jason Bowman explain that in his next post– yes a cliffhanger for a blog…such a cliché’!
*Remember folks, we do not take money from any manufacturers, or directly endorse any specific company’s medical equipment, ultrasound or otherwise. We endorse ultrasound and its use among pre-hospital providers. Any mention of a specific medical equipment company is due to an author’s specific experience/preference and not because of monetary compensation. Any advertisement you see on our blog is from the blogs host site. We will at times endorse certain organizations at our discretion. We are endorsing E.C.H.O. because they are true to the FOAM spirit and they kick ass!