Trick of the Trade: Ultrasound-guided supraclavicular central line

Emergency physicians are procedural experts in central venous access. The subclavian vein is the best site for such access, because it has been shown to have the lowest rate of iatrogenic infections and deep venous clots

Bedside ultrasonography has really revolutionized how we obtain vascular access over the past 10 years. Identifying the subclavian vein using ultrasonography, however, is still technically challenging. The vein is located just posterior to the clavicle, which often gets in the way of the linear transducer.

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By Michelle Lin, MD|2016-11-11T19:00:20-08:00Nov 10, 2010|Tricks of the Trade, Ultrasound|

Retinal detachment on ultrasound

I just wanted to revisit the Trick of using bedside ultrasonography to diagnose retinal detachments. Be sure to use plenty of ultrasound gel and use the linear tranducer.

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By Michelle Lin, MD|2019-01-28T23:21:35-08:00Oct 19, 2010|Ophthalmology, Tricks of the Trade, Ultrasound|

Trick of the trade: I got ultrasound gel in my eye!

Bedside ultrasonography is increasingly being used in the ED to examine the eye. For instance, it can be used to detect a retinal detachment, vitreous hemorrhage, and high intracranial pressure. The technique involves applying ultrasound gel on the patient’s closed eyelid. A generous amount of gel should be used to minimize the amount of direct pressure applied on the patient’s eye by the ultrasound probe.

Sometimes, however, no matter how careful you and the patient are, some gel accidentally contacts the eye itself.

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By Michelle Lin, MD|2019-01-28T23:23:16-08:00Sep 15, 2010|Tricks of the Trade, Ultrasound|

Trick of The Trade: Peritonsillar Abscess Drainage 2.0

Back in September of 2009 Michelle shared valuable Tricks of The Trade regarding drainage of peritonsillar abscesses. Today we revisit the topic and add two more tricks to avoid hitting “big red” a.k.a. the internal carotid artery.

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By Demian Szyld, MD EdM|2019-07-30T15:36:32-07:00Jun 30, 2010|ENT, Tricks of the Trade, Ultrasound|

Article review: Long axis view for IJ line placement

As bedside ultrasonography is becoming a staple in central line placement (especially of internal jugular lines), emergency physicians now can minimize complications, such as carotid artery puncture and a pneumothorax. Traditionally, the US probe is positioned along the short-axis of the IJ during the procedure (see right).

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By Michelle Lin, MD|2016-11-11T19:01:39-08:00Feb 1, 2010|Ultrasound|

Tricks of the Trade: Diagnosing retinal detachment with ultrasound

In a sneak peek of my ACEP News’ Tricks of the Trade column, Dr. Patrick Lenaghan, Dr. Ralph Wang, and I will discuss how bedside ultrasonography can significantly improve your ocular exam.

Here is a classic example. A patient presents with acute onset right eye pain and blurry vision. She possibly has a field cut in her vision. Her pupils are a teeny 2 mm in size in the brightly-lit Emergency Department. You are having a hard time getting a good fundoscopic exam to comfortably rule-out a retinal detachment.

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By Michelle Lin, MD|2019-01-28T23:53:04-08:00Dec 9, 2009|Ophthalmology, Tricks of the Trade, Ultrasound|

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