Word of the Day – “Morisons Pouch”

Word of the Day

Morisons Pouch

morissonNamed after the British surgeon James Rutherford Morison, Morison’s pouch is also known as the hepatorenal recess or the subhepatic recess (the space that separates the liver from the right kidney). This recess is free of fluid under normal circumstances, but can fill with fluid under certain conditions such as hemoperitoneum or ascites. This space can best be visualized via ultrasound. According to the Textbook of Pediatric Emergency Medicine, “The amount of intraperitoneal fluid needed for detection by ultrasound has been reported to be as little as 100 mL and will depend on the source of the bleeding and patient positioning.” In adults, any low frequency probe is adequate to visualize the space. However, in pediatric trauma patients who have small intercostals spaces a microconvex probe should be used to avoid rib shadowing. Morison’s Pouch is one of the 4 views of the FAST exam.

References: Textbook of Pediatric Emergency Medicine 6th Edition pages 1732-1733. Edited by Gary Robert Fleisher and Steven Ludwig

To learn more about Morison’s Pouch, and how to identify it during your evaluations, check out upcoming Abdominal hands-on training course that will provide hours of hands-on scanning.

Ultrasounds could replace radiography for detecting pneumonia in children

Pediatric UltrasoundUltrasounds could be an equally accurate method for detecting pneumonia in children compared with chest x-rays.

That’s according to a recent study which compared ultrasonography with chest radiography for detecting pneumonia in children.

It suggests that this could mean that more children could be diagnosed, especially in resource-limited settings.

The children would also be exposed to less radiation.

The research was carried out by Dr Lilliam Ambroggio at Cincinnati Children’s Hospital Medical Center, Cincinnati, USA.


The study enrolled patients aged 3 months to 18 years with a clinically ordered CT or admitted to the hospital with a respiratory condition.

Main exposures were chest ultrasound and x-ray findings read by four radiologists blinded to the clinical diagnosis of the patient.

The authors were able to determine the accuracy of both methods by comparing them to the CT reference standard.

The researchers found that, when compared with chest X-rays, ultrasound may be more sensitive (identifying more true positive results) and less specific (less true negative results) than chest x-rays in detecting consolidations and pleural effusions, both common indicators of pneumonia.

However overall the two techniques were statistically equivalent.

Dr Ambroggio said:

Ultrasound and chest radiography in our study were statistically equivalent, suggesting the potential for chest ultrasonography to replace chest x-rays in detecting pneumonia in children, particularly in outpatient and resource-limited settings.

“The advent of ultrasound technology in the diagnosis of pneumonia in developing countries is potentially easier to establish as the infrastructure needed to perform and interpret a chest ultrasound is much less than what is needed to perform a chest radiograph.”

The research was presented at the annual meeting of the European Society for Pediatric Infectious Diseases in Dublin.

Want to learn more about U/S evaluation of the lung & bowel?  Attend the Pediatric Emergency or Pediatric Ultrasound courses coming up June 25-26.

Reference: MSN News; http://news.ie.msn.com/ireland/ultrasounds-could-replace-radiography-for-detecting-pneumonia-in-children

Intersocial Accreditation Commission (IAC) presents Helpful Resources

Intersocial Accreditation Commission (IAC) presents Helpful Resources

Intersocial Accreditation Commission (IAC) presents Helpful Resources




On Demand Webcasts

24/7 access…FREE of charge…Learn at your leisure from trained accreditation specialists. The IAC has created a series of webcasts entitled Accreditation On Demand. Now you can learn about accreditation at your leisure, 24 hours a day/7 days a week, for free. Accreditation On Demand is simple and easy to use; just choose the topic you wish to learn more about, sit back and listen.

Topics Include:

[NEW!] Policies, Procedures and Final Reports: What’s Required and Why

| View the webcast»

Recorded from a previous live webinar sponsored by the IAC and SVU. Note: This webcast was recorded from a previous webinar, no CE credit is available.

Related Documents | Webcast Handouts: Policies, Procedures and Final Reports»

Reimbursement Issues in the Vascular Laboratory | View the webcast»

Recorded from a previous live webinar sponsored by the IAC and SVU. Note: This webcast was recorded from a previous webinar, no CE credit is available.

Related Documents | Webcast Handouts: Reimbursement»

Performing Quality Assurance in the Vascular Lab | View the webcast»

Recorded from a previous live webinar sponsored by the IAC and SVU. Note: This webcast was recorded from a previous webinar, no CE credit is available.

Related Documents | Meet Q&A: Performing QA in the Vascular Lab (Answers from questions asked during the webinar)

Cardiovascular Imaging Lab Accreditation: What You Need to Know Now | View the webcast»

Recorded from a previous live webinar sponsored by the IAC and ACC. Note: To view this webcast, you must complete the free registration form on ACC website. You will then given the URL and a password to view/listen to the webinar.


INSTRUCTIONS FOR VIEWING WEBCASTS:Select a link above to view a webcast. The link with either open a new browser window or will automatically open a .wmv file. If a new window opens, you can select playback to watch the recording automatically or download the file as an ARF. Note: You will need to download the ARF player prior to closing the browser window if you choose the download option.If the link is a wmv file, the webcast will open and play immediately using Windows Media Player [Macintosh users may view it using QuickTime or Windows Media Player for Mac]. Then just sit back and listen. Please note: You may need to adjust your computer volume to hear the audio.

If you have any problems using Accreditation On Demand, technical support is available by contacting webinars@intersocietal.org. Accreditation On Demand . . . Learning about the process of accreditation has never been so easy!

Standardize Emergency Medicine Education in Hospitals


Can you hear that? No, but you can certainly see it…Sound waves, being used to assist in diagnostic and procedural applications within the Emergency Department. When it comes to Ultrasound in the Emergency Department, recently it seems there has been a rapid growth in acceptance and utilization within the healthcare community. One of the caveats commonly we have seen when hospitals are looking to integrate ultrasound into practice is physicians will have their interest sparked at annual assembly meetings that offer a great “taste” of ultrasound, from there hospitals will purchase the necessary equipment, and then utilization of the technology is not fully integrated into practice. This in part could be due to the lack of standardization in ultrasound education. Understandably, physicians, particularly those who have recently joined physician networks have their original training in ultrasound from more than one source which can lead to a not truly defined set of protocols when using diagnostic ultrasound.

Think of it as the “telephone game” you played as a child; one person receives their training and is looking to then educate their fellow staff. Often times with just an annual assembly’s worth of ultrasound education, some information will either be forgotten or perhaps new information will be added…and so the probe get passed further and further down the educational line inevitably ending in possible patient complication/ liability. An issue like this was recently addressed by a hospital group who mandated all staff receive Ultrasound Guided Vascular access training from the same source to establish set protocols within their network.  Gulfcoast ultrasound Institute was Pediatric Ultrasoundcommissioned to handle this task. While this group opted for a hybrid course that consisted of both streaming video content and custom live hands on course at their facility, GUI also offers educational avenues through a multitude of options designed to enhance patient outcome. Shortly after this event had taken place GUI was contacted and informed that the previous complications associated with vascular access had significantly dropped since integrating ultrasound into practice! With the price of ultrasound equipment dropping along with the increase in portability, it has become the perfect time for hospitals to integrate ultrasound into practice or enhance their current continuing education protocol.

Gulfcoast Ultrasound has spent the last 28 years developing programs for hospital networks, physicians, and sonographers to fulfill CME requirements.  Whether a facility prefers live, online, or self-directed education we can work with you to meet your needs. Gulfcoast Ultrasound Institute may assist healthcare professionals in the following ways:

  • CME Credit: Gulfcoast Ultrasound Is accredited through the ACCME and approved to provide AMA PRA Category 1 Credits (for physicians and Sonographers), ACEP credits, AANA Credits, SDMS Credits (Ultrasound / X-ray), ASRT Credits (X-Ray)
  • Consistency: By establishing set protocols for physicians and sonographers in your hospital group complication rates and liability payouts can be expected to decrease.
  • Increase Employee Value $$: By cross training current employees facilities can expect increased profits by being able to perform ultrasound exams in multiple specialties.
  • Board Preparation: Gulfcoast Ultrasound specializes in board examination preparations with education available as self directed products, live courses, and online education.
  • Maintenance of Certification / Reimbursement: Gulfcoast Ultrasound offers tools and resources to fulfill certification, and lab accreditation requirements for physicians and sonographers.

Breakdown of the education formats Gulfcoast Ultrasound has available to meet your education needs include:

Online E-Learning Classroom: (Emergency Medicine)

  • Online Classroom access on any deviceCovers all topics presented in the regularly scheduled live three    day Introduction to Emergency Ultrasound course
  • For groups: one person can be set up as the “administrator” and will have access to track the progress of participants, ensuring protocols are being established.
  • 6 month access provides flexibility for those who cannot travel to attend the live Introduction to Emergency Ultrasound course.
  • Optional coordination of onsite hands-on scanning workshops.
  • E-courses in other specialties available by January 2013.
  • Multi person / group discounts available

Live Hands-On Courses:

  • Ultrasound CME Seminars at Gulfcoast UltrasoundCourses are designed with lectures in the morning and hands-on in the afternoon
  • Instructors: Gulfcoast Ultrasound faculty is comprised of nationally recognized experts within the ultrasound profession. Gulfcoast Ultrasound courses are presented with the perfect blend of physician’s clinical experience and sonographer’s expertise.
  • Hands-on Ratio:  GUI sets the bar with hands-on scanning: never exceeds a 3:1 ratio of participants to instructors.
  • Multi-participant discounts from the same facility available!
  • Both AMA PRA Category 1 Credits and ACEP credits awarded upon course completion.
  • A signed log of cases performed and/or interpreted provided for hospital credentialing / certification purposes.

Live On-Site Courses:

  • Cost-effective, custom-designed courses presented at your facility or local meeting venue eliminates travel costs and coverage issues.
  • Ideal for groups of five or more participants
  • Blended education formats also available (combined online lectures and onsite hands-on)

Self-Directed Products:

  • Rapid Ultrasound for Shock & Hypotension - DVDDVD’s: Gulfcoast Ultrasound has developed a line of DVD Video Lectures specifically tailored to the needs of each specialty group. With DVD’s broken down by specialty it allows hospitals to create a custom library for physicians looking to incorporate ultrasound and better improve patient outcomes.
  • CD Case Studies: Interactive case studies designed to improve interpretation skills and fulfill CME requirements.
  • Registry Preparation: The Gulfcoast Ultrasound PASS packages are the perfect combination of study materials to successfully pass the ultrasound certification board examinations. PASS products can help all HCA physicians and sonographers attain ultrasound certification to ensure reimbursement for exams performed and /or interpreted
  • All products come with optional CME credit (groups can have a private web portal set up allowing departments to acquire CME credits all at the same time)

Whether healthcare providers are seeking consistency in ultrasound training, fulfillment of CME credits, certification / Lab accreditation requirements, or registry preparation, Gulfcoast Ultrasound Institute can help! Gulfcoast Ultrasound has provided continuing medical education for over 130,000 physicians, sonographers, and other healthcare professionals who have successfully integrated the skills learned into clinical practice.