Measuring Blood Pressure - Measuring Vital Signs

⭐ COVID-19: Putting On Personal Protective Equipment (PPE)

⭐ COVID-19: Removing Personal Protective Equipment (PPE)

Clinical Skills: Administering Vaccinations

Covid-19 Diagnostics

Lumbar puncture procedure

Ultrasound-guided incision and drainage of an abscess

This video demonstrates how to perform local anesthesia for wound repair, including wounds requiring more than one anesthetic injection.
This video is part of a new AMBOSS format without voice/sound – optimized for quick clinical reference.

Local anesthesia for wound repair | AMBOSS

This video demonstrates how to perform single-point local anesthesia infiltration used for localized painful procedures.
This video is part of a new AMBOSS format without voice/sound – optimized for quick clinical reference.

Single-point local anesthesia infiltration | AMBOSS

This video demonstrates how to secure a central venous catheter to the skin using sutures.
This video is part of a new AMBOSS format without voice/sound – optimized for quick clinical reference.

Surgical basics: Securing a central venous catheter | AMBOSS

Surgical Basics: Securing common surgical drains | AMBOSS

Surgical basics: Removing common surgical drains | AMBOSS

Practical skills

Point-of-care ultrasound: Functions and settings of the ultrasound machine

Short video of a subxiphoid ultrasound examination of the heart (a marker indicates the probe position) showing a pericardial effusion
The right atrium (yellow overlay) is seen in the center of the image. The visceral pericardium (epicardium; red line) is clearly separated from the parietal and fibrous pericardium (green line) by a hypoechoic area (blue overlay), which corresponds to a pericardial effusion.

POCUS (heart): pericardial effusion

Short video of a right upper quadrant (RUQ; a marker indicates the probe position) ultrasound examination of the hepatorenal recess (Morison pouch)
The right lobe of the liver (red overlay) is shown on the left, the right kidney (green overlay) in the center of the image. The hepatorenal recess (Morison pouch; yellow) lies between the right kidney and the right lobe of the liver.
Ultrasound can detect even small amounts of fluid in the hepatorenal recess.

POCUS (abdomen): hepatorenal recess normal findings

Short video of three right upper quadrant (RUQ; markers indicate the probe positions) ultrasound examinations showing free fluid in the hepatorenal recess (Morison pouch)
Case 1: The liver (red overlay) is visible near the top left of the image, the right kidney (green overlay) with its hyperechoic capsule is visible in the center and bottom right. A hypoechoic area (blue overlay) consistent with free fluid is visible within the hepatorenal recess (yellow hatching) and extending beyond the liver to the right of the image.
Case 2: The liver (red overlay) is visible near the top left of the image, the right kidney (green overlay) is visible near the bottom left. A hypoechoic area (blue overlay) consistent with free fluid is visible within the hepatorenal recess (yellow hatching) and extending beyond the liver to the right of the image.
Case 3: The liver (red overlay) is visible near the top left of the image, the right kidney (green overlay) with its hyperechoic capsule is visible near the bottom center. A hypoechoic area (blue overlay) consistent with free fluid is visible within the hepatorenal recess (yellow hatching) and extending beyond the liver to the right of the image.
Ultrasound can detect even small amounts of fluid in the hepatorenal recess.

POCUS (abdomen): free fluid in hepatorenal recess (Morison pouch)

Short video of a right upper quadrant (RUQ; a marker indicates the probe position) ultrasound examination (B-mode and contrast-enhanced ultrasound; CEUS), showing a posttraumatic subcapsular hepatic hematoma
The video begins in B-mode, showing the liver parenchyma with the liver veins. Near the top of the image, a heterogeneously hypoechoic region can be differentiated from the underlying normal parenchyma. When CEUS is activated the difference becomes much clearer, sharply differentiating this subcapsular hematoma (red overlay) inferior to the liver capsule (green overlay) from the normal hepatic parenchyma.
CEUS thus facilitates the distinction of a hematoma from normal parenchyma, which is difficult in B-mode.

POCUS (abdomen): posttraumatic subcapsular hepatic hematoma

Short video of a right upper quadrant (RUQ) ultrasound examination (a marker indicates the probe position) showing a posttraumatic subcapsular renal hematoma
The renal parenchyma (green overlay) in the center of the image is clearly compressed by a hematoma (hypoechoic fluid; red overlay) beneath the renal capsule (yellow overlay). The homogeneous, hypoechoic structure (blue overlay) within the capsule on the left corresponds to an intrarenal cyst.

POCUS (abdomen): posttraumatic subcapsular renal hematoma

Short video of a left upper quadrant (LUQ; a marker indicates the probe position) ultrasound examination of the splenorenal recess (Koller pouch)
The left hemidiaphragm (white line) and the spleen (red overlay) can be seen on the left of the image. The left kidney (green overlay) can be seen in the center of the image. The splenorenal recess (Koller pouch; yellow overlay) lies between the left kidney and the spleen.
Ultrasound can detect even small amounts of fluid in the splenorenal recess.

POCUS (abdomen): splenorenal recess normal findings

Short video of three left upper quadrant (LUQ; markers indicate the probe positions) ultrasound examinations showing free fluid in the splenorenal recess (Koller pouch)
Case 1: The spleen (red overlay) is visible as a relatively homogeneous structure at the top left of the image, the left kidney (green overlay) with its hyperechoic capsule and more heterogeneous appearance is visible in the center and bottom right. At the beginning of the video, there is no evidence of free fluid in the splenorenal recess (yellow shading). Fanning the ultrasound beam ventrally (by tilting the transducer dorsally) reveals a homogeneous, hypoechoic area consistent with free fluid (blue overlay) medial to the spleen. At the end of case 1, we again see the classic view of the splenorenal recess, which does not show the pathology.
Case 2: The spleen (red overlay) is visible at the top left, the left kidney (green overlay) at bottom right. In the initial view there is again no evidence of free fluid in the splenorenal recess (yellow hatching). As in case 1, fanning the ultrasound beam ventrally reveals a homogeneous, hypoechoic area consistent with free fluid (blue overlay).
Case 3: The spleen (red overlay) is visible at the top of the image, the left kidney (green overlay) at the bottom. A hypoechoic area (blue overlay) consistent with free fluid extends from the splenorenal recess (yellow hatching) towards the top right of the image (anatomically inferior to the spleen).
Ultrasound can detect even small amounts of fluid in the splenorenal recess.

POCUS (abdomen): free fluid in splenorenal recess (Koller pouch)

Short video of a left upper quadrant (LUQ; a marker indicates the probe position) ultrasound examination (B-mode and contrast-enhanced ultrasound; CEUS) showing a posttraumatic subcapsular splenic hemorrhage
The video begins in B-mode, showing the relatively homogeneous structure of the spleen (red overlay) at the top and left of the image with the more heterogeneous left kidney (green overlay) near the bottom right. Near the top of the image, subcapsular blood can be seen as a thin hypoechoic region (blue overlay) directly under the hyperechoic splenic capsule. When CEUS is activated, this subcapsular hematoma and more subtle intraparenchymal hemorrhages are much more clearly delineated.

POCUS (abdomen): posttraumatic subcapsular splenic hemorrhage

Short video of a lower abdomen ultrasound examination of the male pelvis in transverse and sagittal plane view (markers indicate the probe positions)
The first part of the video (transverse plane view) shows the bladder (blue overlay) and the inferior prostate (green overlay) with small calcifications (yellow overlay). Fanning the ultrasound beam cranially from this position (by tilting the transducer caudally) visualizes the paired seminal glands (red overlay). 
In the second part of the video, the bladder (blue overlay) is still central in the sagittal plane view. Posterior to the bladder, the rectum (yellow overlay) and the prostate with the seminal glands (red overlay) can be seen, with the rectovesical pouch lying in-between (dashed green overlay)
The female analogue to the rectovesical pouch is the rectouterine pouch (of Douglas), which is located between the rectum and uterus. Examination of either pouch is performed to detect free fluid in the abdomen.

POCUS (male pelvis): normal findings

Short video of an ultrasound examination of the lungs in anterior thoracic (parasternal) transducer position (a marker indicates the probe position) showing a pneumothorax
At the location of a pneumothorax, normal lung sliding is abolished. The interface between the pneumothorax and adjacent sliding lung is known as the “lung point sign.” Pneumothorax on the left side in the video is identified by the presence of repetitive uniformly spaced horizontal lines (A-lines; reverberation artifact) deep to the pleural line (green overlay) and the absence of the normal B-lines that are visible in lung on the right. Although A-lines can be seen both in pneumothorax and normal lung tissue, B-lines are not seen in pneumothorax since they are generated from visceral pleura,
In M-mode, normal sliding lung appears as the seashore sign, in which the pleura and overlying chest wall are seen as horizontal echogenic waves and the lung has a grainy, sand-like appearance. In pneumothorax, lung sliding is abolished and the grainy appearance is replaced by parallel lines, which are termed the “barcode” or “stratosphere sign.”

POCUS (lung): pneumothorax

Point-of-care ultrasound for abdominal aortic aneurysm

Short video of an ultrasound examination of the abdominal aorta in long axis view (a marker indicates the probe position)
The right lobe of the liver (yellow) can be seen on the left edge of the image. The aorta (red) is visible posterior to the liver as a pulsating, almost anechoic lumen with a smooth border. Centrally, the unpaired branches of the aorta (celiac trunk and superior mesenteric artery) are visible.

POCUS (abdomen): abdominal aorta normal findings

Short video of an ultrasound examination of the abdominal aorta in short axis view (a marker indicates the probe position) showing an aneurysm with a thrombus that narrows the lumen.
The abdominal aorta is seen in cross-section in the center of the image. The anechoic area in the lumen of the aorta corresponds to the expected appearance of flowing blood; the semilunar structure on the right side of the lumen is a thrombus (yellow overlay).

POCUS (abdomen): aortic aneurysm

Point-of-care ultrasound of the inferior vena cava

Short video of an ultrasound examination of the inferior vena cava in long axis view (a marker indicates the probe position)
The liver (red overlay) is visible near the top of the image, and the right atrium (yellow overlay) can be seen on the left edge. The anechoic lumen with a smooth border posterior to the liver is the inferior vena cava (IVC; blue overlay). The caliber of the IVC changes with respiration.

POCUS (abdomen): inferior vena cava normal findings

Point-of-care ultrasound of the gallbladder

Short video of a right upper quadrant (RUQ) ultrasound of the right lung (a marker indicates the probe position) showing B-lines and pleural effusion
On the left and center of the image, vertical hyperechoic columns (B-lines; white overlay) arise from the hyperechoic horizontal pleural line (green overlay). On the right of the image, hypoechoic fluid (pleural effusion; blue overlay) can be seen in the pleural space, anterior and superior to the right hemidiaphragm (red overlay).
Up to two B-lines per field of view (within a single intercostal space) can be a normal finding. A pleural effusion is always pathological.

POCUS (lung): B-lines and pleural effusion

Short video of three lung ultrasound examinations in anterior thoracic (parasternal and intercostal) transducer positions (markers indicate the probe positions) 
Case 1: male patient, right intercostal transducer position 
Case 2: female patient, left intercostal transducer position 
Case 3: male patient, right parasternal transducer position 
All three examinations show B-lines (vertical, hyperechoic diverging columns indicated by white overlay) that arise from the horizontal hyperechoic pleural line (light blue line) and move with respiration (swinging flashlight appearance). B-lines are reverberation artifacts.
Up to two B-lines per field of view (within a single intercostal space) can be a normal finding. Multiple (≥ 3) B-lines may be seen in edema or fibrosis of the pulmonary interlobar septae in conditions such as pulmonary edema and chronic interstitial lung disease. B-lines are absent in pneumothorax.

POCUS (lung): B-lines

Short video of an ultrasound examination of the lower left hemithorax (a marker indicates the probe position) showing pleural effusion
An anechoic pleural effusion (blue overlay) is visible in the costodiaphragmatic recess (costophrenic sulcus) near the middle of the video. On the left side of the video, aerated lung is visible. Since ultrasound waves are not transmitted through normal aerated lung, the lung is recognized by to and fro movement of the hyperechoic pleural line (green overlay) during respiration and the presence of horizontal lines (A-lines; reverberation artifact; yellow overlay) deep to the pleural line.
A pleural effusion (collection of fluid in the pleural space between the lungs and the chest wall) is a pathological finding.

Practical skills and procedures

Practical skills

Measuring blood pressure and vital signs

Putting on and removing personal protective equipment (PPE)

Vaccine administration

Covid-19 diagnostics

Lumbar puncture

Ultrasound-guided incision and drainage of an abscess

Local anesthesia infiltration

Securing lines and drains

Removing a drain

Point-of-care ultrasound

Functions and settings of the ultrasound machine

FAST and eFAST

Subxiphoid view

RUQ view

LUQ view

Pelvic view

Limited lung ultrasound

Abdominal aorta

Inferior vena cava

Gallbladder and biliary tract

Acute heart failure

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