Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

‘Water challenge’ to improve diagnostic accuracy in gastric point‐of‐care ultrasound

‘Water challenge’ to improve diagnostic accuracy in gastric point‐of‐care ultrasound Gastric point‐of‐care ultrasound (POCUS) is an emerging clinical tool. Two important learning elements in using this skill are: (a) identifying the gastric antrum, including discerning it from other structures, and (b) differentiating an empty stomach from one that contains a small volume of late‐stage solids (Fig. 1a). The latter is vital if gastric POCUS is to be used to help minimise the risk of aspiration of gastric contents [1]. When faced with challenging sono‐anatomy, novice operators may find difficulty in image interpretation and experienced help may not always be available, as gastric POCUS is yet to gain widespread adoption. To solve this problem, the ‘water challenge’ has been developed, in which the patient drinks 40–50 ml of water followed by immediate rescanning in the right lateral decubitus (RLD) position. A previously unidentified gastric antrum should immediately become visible to the operator if present in the sonovisual field. In addition, an empty antrum can be confirmed or ruled out because any solid matter can be visualised as ‘hyperechoic floaters’ in the now water‐filled hypoechoic antrum (Fig. 1b–d). Below, a clinical case is presented to illustrate the utility of this technique.1FigureImages from point‐of‐care ultrasound, obtained in right lateral decubitus position using 5–2 MHz curvilinear probe on http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Anaesthesia Reports Wiley

‘Water challenge’ to improve diagnostic accuracy in gastric point‐of‐care ultrasound

Sidhu, N. S.
Anaesthesia Reports , Volume 10 (2) – Jul 1, 2022
Download PDF
2 pages

Loading next page...
 
/lp/wiley/water-challenge-to-improve-diagnostic-accuracy-in-gastric-point-of-g6D0O5xlxK
Publisher
Wiley
Copyright
2022 © Association of Anaesthetists
eISSN
2637-3726
DOI
10.1002/anr3.12192
Publisher site
See Article on Publisher Site

Abstract

Gastric point‐of‐care ultrasound (POCUS) is an emerging clinical tool. Two important learning elements in using this skill are: (a) identifying the gastric antrum, including discerning it from other structures, and (b) differentiating an empty stomach from one that contains a small volume of late‐stage solids (Fig. 1a). The latter is vital if gastric POCUS is to be used to help minimise the risk of aspiration of gastric contents [1]. When faced with challenging sono‐anatomy, novice operators may find difficulty in image interpretation and experienced help may not always be available, as gastric POCUS is yet to gain widespread adoption. To solve this problem, the ‘water challenge’ has been developed, in which the patient drinks 40–50 ml of water followed by immediate rescanning in the right lateral decubitus (RLD) position. A previously unidentified gastric antrum should immediately become visible to the operator if present in the sonovisual field. In addition, an empty antrum can be confirmed or ruled out because any solid matter can be visualised as ‘hyperechoic floaters’ in the now water‐filled hypoechoic antrum (Fig. 1b–d). Below, a clinical case is presented to illustrate the utility of this technique.1FigureImages from point‐of‐care ultrasound, obtained in right lateral decubitus position using 5–2 MHz curvilinear probe on

Journal

Anaesthesia Reports – Wiley

Published: Jul 1, 2022

Keywords: gastric ultrasound; point‐of‐care ultrasound; ultrasonography

References

  • Point‐of‐care gastric ultrasound and aspiration risk assessment: a narrative review
    Perlas, A; Arzola, C; Van de Putte, P
  • Pre‐operative fasting in adults and children: clinical practice and guidelines
    Fawcett, WJ; Thomas, M