ULTRASOUND, ECHO AND FAST
FOREIGN BODY ULTRASOUND
PromptUltrasound settings for foreign body
ResponseHF linear probe
Frequency range >12 MHz
Frequency range >12 MHz
PromptParameters to adjust for optimum settings
ResponsePre-sets - MSK or soft tissue
Focus
Depth
Gain
Focus
Depth
Gain
PromptPros/cons of US guided foreign body removal in ED
ResponsePro:
No radiation
Able to visualise location, size and depth. Plan procedure and approach
Visualise adjacent structures to avoid injury (Eg: neurovascular)
Visualise non-radiopaque FB (eg wood/plastic)
Able to use in real time to guide and confirm removal of FB
Able to assess for complications from FB Eg Granuloma formation, Collection
Con:
Operator dependent - technique, transducer, experience level
Best in first 24h, late presentation has inflammation and scarring increasing difficulty
Once skin incised s/c air may prevent visualisation
Visualisation depends on echogenicity of FB
Calcification in sot tissue may look like FB
Factors may obscure FB - Haematoma, SC emphysema
Inability to obtain transducer contact (eg Large laceration)
Artefact may obscure FB
No radiation
Able to visualise location, size and depth. Plan procedure and approach
Visualise adjacent structures to avoid injury (Eg: neurovascular)
Visualise non-radiopaque FB (eg wood/plastic)
Able to use in real time to guide and confirm removal of FB
Able to assess for complications from FB Eg Granuloma formation, Collection
Con:
Operator dependent - technique, transducer, experience level
Best in first 24h, late presentation has inflammation and scarring increasing difficulty
Once skin incised s/c air may prevent visualisation
Visualisation depends on echogenicity of FB
Calcification in sot tissue may look like FB
Factors may obscure FB - Haematoma, SC emphysema
Inability to obtain transducer contact (eg Large laceration)
Artefact may obscure FB