Emergency Ultrasound and Procedural Skills
Core concepts
Understand the core emergency ultrasound applications: FAST, cardiac (pericardial effusion, cardiac activity), thoracic (pneumothorax, effusion), biliary, renal, and obstetric. Know the principles of image acquisition, probe selection, and the limitations of ultrasound. Recognize that ultrasound is operator-dependent and must be integrated with clinical findings.
For procedural skills, know the indications, contraindications, and complications of common emergency procedures: central venous access, lumbar puncture, thoracentesis, paracentesis, arthrocentesis, and airway management. Understand informed consent, sterile technique, and the importance of confirming placement.
Traps
Questions test whether you know that a negative FAST does not exclude injury and that ultrasound cannot reliably exclude a small pneumothorax in all cases. Another trap is failing to confirm central line placement or ignoring contraindications such as coagulopathy for certain procedures. Watch for the assumption that ultrasound replaces clinical judgment.
Worked example / rule of thumb
A hypotensive trauma patient with a positive FAST: proceed to operative intervention rather than CT. Rule of thumb: "Ultrasound answers a focused question - use it to rule in, not to rule out, when the clinical picture is concerning."