Ultrasound Podcast

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.