US-Guided IV Access
Prep
- High-frequency linear probe
- Sterile gel or Tegaderm over probe
- Tourniquet applied
- Select vein (compress to confirm not artery)
Technique
- Short axis: vein appears as circle
- Centre vein on screen
- Insert needle at 45°, advance under vision
- See needle tip enter vein
- Flatten angle, advance cannula
NOTE
Use dominant hand for needle, non-dominant for probe
EFAST (Extended FAST)
Four views:
- RUQ - hepatorenal (Morison's pouch)
- LUQ - splenorenal
- Subxiphoid - pericardial
- Suprapubic - pelvic free fluid
Plus: 5. Bilateral lungs - pneumothorax (absent sliding)
<Diagram src="/figures/ultrasound/efast-views.jpg" alt="EFAST probe positions" caption="EFAST views: RUQ, LUQ, subxiphoid, suprapubic, and lung views" />CAUTION
FAST negative doesn't rule out solid organ injury
Positive Findings
- Free fluid = black (anechoic) stripe
- Pericardial effusion = fluid around heart
- Pneumothorax = absent lung sliding, barcode sign
Checklist Complete