In this episode, we discuss a video published on our YouTube channel on right heart ultrasound.

We discuss advanced methods to differentiate acute versus chronic right heart enlargement, with emphasis on pulmonary embolism evaluation and risk stratification. They cover when right heart findings are most useful, including known PE and peri-arrest patients too unstable for CT. They review key views for RV size, favoring the apical four-chamber view, with discussion of parasternal and subcostal alternatives and limitations. For RV systolic function, they explain TAPSE and S' (abnormal if TAPSE

Check out youtube.com/@coreultrasound for the full video!

In this episode, Ben and Jailyn discuss how they approach arthrotencesis in ED patients. Watch the Youtube channel for a full run through for how to perform taps on the shoulder, knee, hip, elbow and ankle.

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If you want more education goodness, check out the links below!

Check out our courses here: https://courses.coreultrasound.com

Check out our question bank here: https://courses.coreultrasound.com/collections/q-bank

Check out our FREE content on our website: https://www.coreultrasound.com

Check out our in-person course in San Diego, Ca on Nov 12-14 2026 here: https://www.soundandsurf.com/essentials-2026

Disclaimer: By watching this (or any Core Ultrasound) education video or reading any of our content, you agree not to use this information as medical advice to treat any medical condition in either yourself or others, including but not limited to patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer applies to any and all content produced or discussed by Core Ultrasound. Under no circumstances shall any of the contributors on this website be responsible for damages arising from use of any topic discussed. This content should not be used in any legal capacity whatsoever, including but not limited to establishing "standard of care" in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made by Core Ultrasound. The content of this website is formed by our own opinions and do not represent the views or opinions of any institutions we may be affiliated with.

In this episode, we're thrilled to be joined by Dr. Sophia Fornbacher, ultrasound faculty and assistant professor at Riverside Community Hospital. Recently completing her ultrasound fellowship, Dr. Fornbacher shares her experiences and expertise on two remarkable cases where ultrasound made a critical difference. Spoiler alerts: Cardiac tamponade due to thoracic aortic dissections can trick you (without ultrasound at the bedside), and sometimes, 30cc/kg boluses aren't the best thing to do in patients with diabetic ketoacidosis (or hyperosmolar hyperketotic states)!

When a patient rolls in hypotensive and tachycardic and you don't know why, the RUSH exam may be the most important tool in your hands. RUSH, Rapid Ultrasound in Shock and Hypotension, is a rapid, systematic bedside ultrasound protocol designed for exactly that moment.

The HIMAP mnemonic breaks it down:

(H)eart: The highest-yield component. Look for pericardial effusion/tamponade, right heart strain (think PE), or low EF. (I)VC: Not just a volume status tool, it reflects CVP and helps differentiate obstructive, distributive, and hypovolemic shock. Put a shocked septic patient on pressors and watch the IVC fill up even before you've given a drop of fluid. (M)orrison's Pouch aka the FAST Exam: Free fluid in the abdomen isn't just for trauma. Ruptured ectopic pregnancy, splenic rupture, ruptured bowel, and AAA all show up here. (A)orta: Rare but critical. Ruptured AAA and dissection can present as undifferentiated shock, and dissection matters more than people think, especially in patients with stroke-like symptoms plus pain. (P)ulmonary: Rule out tension pneumothorax

At the bedside, ultrasound is the fastest and most accurate tool available for undifferentiated shock. Learn HIMAP. Use it early.

🎧 Happy scanning.

🌐 Connect with Us 🌐 If you want more education goodness, check out the links below!

Check out our courses here: https://courses.coreultrasound.com

Check out our question bank here: https://courses.coreultrasound.com/collections/q-bank

Check out our FREE content on our website: https://www.coreultrasound.com

Check out our in-person course in San Diego, Ca on Nov 12-14 2026 here: https://www.soundandsurf.com/essentials-2026

Disclaimer: By watching this (or any Core Ultrasound) education video or reading any of our content, you agree not to use this information as medical advice to treat any medical condition in either yourself or others, including but not limited to patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer applies to any and all content produced or discussed by Core Ultrasound. Under no circumstances shall any of the contributors on this website be responsible for damages arising from use of any topic discussed. This content should not be used in any legal capacity whatsoever, including but not limited to establishing "standard of care" in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made by Core Ultrasound. The content of this website is formed by our own opinions and do not represent the views or opinions of any institutions we may be affiliated with.

Jailyn Avila and Ben Smith discuss a recent Core Ultrasound YouTube lecture on diagnosing pericardial effusions and cardiac tamponade with point-of-care ultrasound, emphasizing its importance in emergency medicine and cardiac arrest. The Reason trial (PMID: 27693280; Romolo Gasparin et al) demonstrates improved survival to ROSC when pericardial effusion is identified with ultrasound—a finding that contrasts sharply with Beck's triad, which shows poor sensitivity. Emergency department–based studies reveal that all three Beck's triad signs are rarely present simultaneously. The RUSH/HIMAP approach offers a structured assessment framework. Blind pericardiocentesis in PEA without prior ultrasound confirmation should be avoided. Key tamponade findings include: a dilated plethoric IVC with minimal collapse, RV diastolic collapse (including RVOT assessment and M-mode timing with valve opening), right atrial diastolic collapse, and ultrasound assessment of pulsus paradoxus—a finding more useful for ruling out tamponade than confirming it.

Jailyn and Ben kick off a new podcast format where they discuss the full-length lectures published on the Core Ultrasound YouTube channel — adding commentary, clinical pearls, and behind-the-scenes discussion that doesn't make it into the edited videos.

Why this new podcast format? The YouTube videos are kept concise, but a lot of valuable clinical discussion gets left on the cutting room floor. This podcast fills that gap.

In this episode, they break down their approaches to ultrasound-guided thoracentesis, with a detour into related tips for paracentesis.

• Static vs. Dynamic approach

  • Static: Identify the pocket, mark the spot, proceed with a landmark technique
  • Dynamic: Watch the needle in real-time as it enters the fluid
  • When to use each: Large effusions → static often sufficient; small or complex effusions → dynamic preferred

• Identifying the right pocket

  • Find the largest fluid pocket that is cephalad enough to clear the diaphragm and caudal enough to avoid pneumothorax
  • Watch diaphragm excursion with respiration to confirm safe needle trajectory
  • Avoid inadvertent liver/spleen biopsy

• Probe and needle technique for thoracentesis

  • Use a phased array or curvilinear probe to find the effusion, then switch to linear for the procedure
  • Orient transducer in the intercostal space (sagittal, rotated)
  • In-plane (long axis) approach recommended — short axis is mechanically difficult due to the ribs
  • Probe orientation: oblique when lateral, nearly horizontal when posterior

• Paracentesis pearls

  • Out-of-plane technique can work well, given the larger pockets typical in the ED
  • Curvilinear probe makes needle identification harder vs. linear
  • For small-volume paras (e.g., ruling out SBP), dynamic approach is strongly preferred

• Color Doppler before you needle

  • Scan the intended trajectory with color Doppler to rule out intercostal arteries or abdominal wall vessels (e.g., inferior epigastrics, caput medusa)
  • Release probe pressure nearly completely when looking for veins — they collapse easily and can be missed

Resources Mentioned

• 🎥 Full lecture video: Core Ultrasound YouTube Channel
• 📚 Premium courses: courses.coreultrasound.com

Thanks for listening — and happy scanning!

How to Obtain Cardiac Output (5 Minute Sono Series)

In this video, we'll guide you through the steps to calculate the cardiac output using the stroke volume and the patients heart rate. Learn how to capture VTI images with an A5C view and PW Doppler, calculate heart rate from the E-wave peaks, and combine stroke volume to determine cardiac output. Ideal VTI measurements and best practices for achieving accurate results are also covered. Join us for this informative session and happy scanning!

🌐 Connect with Us 🌐

If you want more education goodness, check out the links below!

Check out our courses here: https://courses.coreultrasound.com

Check out our question bank here: https://courses.coreultrasound.com/collections/q-bank

Check out our FREE content on our website: https://www.coreultrasound.com

Check out our longitudinal, year-long, and virtual ultrasound fellowship here: https://academy.ultrasoundleadershipacademy.com

Disclaimer: By watching this (or any Core Ultrasound) education video or reading any of our content, you agree not to use this information as medical advice to treat any medical condition in either yourself or others, including but not limited to patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer applies to any and all content produced or discussed by Core Ultrasound. Under no circumstances shall any of the contributors on this website be responsible for damages arising from use of any topic discussed. This content should not be used in any legal capacity whatsoever, including but not limited to establishing "standard of care" in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made by Core Ultrasound. The content of this website is formed by our own opinions and do not represent the views or opinions of any institutions we may be affiliated with.

In this video, Jailyn explores the techniques and tips for diagnosing appendicitis using ultrasound. Learn about the preferred probes, patient preparation, and step-by-step guidance on locating the appendix. She covers common landmarks, such as the iliac artery, and important diagnostic criteria, including measurements and signs of inflammation. Real case examples demonstrate normal and abnormal findings, including appendicitis and perforated appendicitis. This comprehensive guide is essential for healthcare professionals aiming to enhance their diagnostic skills in ultrasound imaging.

🌐 Connect with Us 🌐

If you want more education goodness, check out the links below!

Check out our courses here: https://courses.coreultrasound.com

Check out our question bank here: https://courses.coreultrasound.com/com

Check out our FREE content on our website: https://www.coreultrasound.com

Disclaimer: By watching this (or any Core Ultrasound) education video or reading any of our content, you agree not to use this information as medical advice to treat any medical condition in either yourself or others, including but not limited to patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer applies to any and all content produced or discussed by Core Ultrasound. Under no circumstances shall any of the contributors on this website be responsible for damages arising from use of any topic discussed. This content should not be used in any legal capacity whatsoever, including but not limited to establishing "standard of care" in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made by Core Ultrasound. The content of this website is formed by our own opinions and do not represent the views or opinions of any institutions we may be affiliated with.

oin Jailyn Avila as she provides a comprehensive guide on placing a radial arterial line using ultrasound guidance. This five-minute(ish) tutorial covers the necessary equipment, including the linear transducer and radial artery catheterization set, as well as the sterilization protocols required for the procedure. Jailyn walks through each step of needle insertion, sequential needle tip tracking, guidewire placement, and catheter advancement. She also shares valuable tips on identifying blood vessels, ensuring accurate catheter positioning, and securing the line. Additionally, Jailyn highlights important considerations such as patient prep and the use of local anesthetics to enhance patient comfort.

🌐 Connect with Us 🌐

If you want more education goodness, check out the links below!

Check out our courses here: https://courses.coreultrasound.com

Check out our question bank here: https://courses.coreultrasound.com/collections/q-bank

Check out our FREE content on our website: https://www.coreultrasound.com

Check out our longitudinal, year-long, and virtual ultrasound fellowship here: https://academy.ultrasoundleadershipacademy.com

Disclaimer:

By watching this (or any Core Ultrasound) education video or reading any of our content, you agree not to use this information as medical advice to treat any medical condition in either yourself or others, including but not limited to patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer applies to any and all content produced or discussed by Core Ultrasound. Under no circumstances shall any of the contributors on this website be responsible for damages arising from use of any topic discussed. This content should not be used in any legal capacity whatsoever, including but not limited to establishing "standard of care" in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made by Core Ultrasound. The content of this website is formed by our own opinions and do not represent the views or opinions of any institutions we may be affiliated with.

In this week's video, we delve into how to diagnose aortic stenosis using Point of Care Ultrasound at the bedside.

After watching this video, you'll know how to identify and quantify aortic stenosis, understand its severity, and recognize why it's considered the deadliest valvular disease.

Discover techniques ranging from basic visual inspections to advanced methods like the continuity equation, all tailored for bedside clinicians. Plus, get insights on using ultrasound for effective diagnosis. Ideal for emergency room settings and beyond.

Happy scanning!

By watching this (or any Core Ultrasound) education video or reading any of our content, you agree not to use this information as medical advice to treat any medical condition in either yourself or others, including but not limited to patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer applies to any and all content produced or discussed by Core Ultrasound. Under no circumstances shall any of the contributors on this website be responsible for damages arising from use of any topic discussed. This content should not be used in any legal capacity whatsoever, including but not limited to establishing "standard of care" in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made by Core Ultrasound. The content of this website is formed by our own opinions and do not represent the views or opinions of the any institutions we may be affiliated with.

Exploring the Lip Liner Sign: Avoiding False Positives in FAST Examinations with Dr. Sophia Fornbacher In this episode, host Jailyn Avila sits down with Dr. Sophia Fornbacher, a fellowship-trained emergency medicine physician, to discuss the intricacies of the lip liner sign—a recently published artifact that can lead to false positives in FAST (Focused Assessment with Sonography for Trauma) examinations. They delve into their experiences and thoughts on the FAST exam's relevance in various clinical settings, and the importance of recognizing artifacts like the lip liner sign to improve diagnostic accuracy. Additionally, they touch on other related signs and nomenclatures, while also reflecting on their teaching experiences and their approach to ultrasound education.

🌐 Connect with Us 🌐

If you want more education goodness, check out the links below! Check out our longitudinal, year-long and virtual ultrasound fellowship here: https://academy.ultrasoundleadershipacademy.com

Check out our FREE content on our website: https://www.coreultrasound.com

Check out our courses here: https://courses.coreultrasound.com

Check out our question bank here: https://courses.coreultrasound.com/collections/q-bank

Disclaimer: By watching this (or any Core Ultrasound) education video or reading any of our content, you agree not to use this information as medical advice to treat any medical condition in either yourself or others, including but not limited to patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer applies to any and all content produced or discussed by Core Ultrasound. Under no circumstances shall any of the contributors on this website be responsible for damages arising from use of any topic discussed. This content should not be used in any legal capacity whatsoever, including but not limited to establishing "standard of care" in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made by Core Ultrasound. The content of this website is formed by our own opinions and do not represent the views or opinions of the any institutions we may be affiliated with.