Normal Values

Aorta

Normal diameter: ≤3 cm

Aneursymal: >3 cm

Anything > 3 cm should be documented as aneurysmal, however, risk of rupture is low until you reach 4-5 cm

Cardiac

Normal aortic root diameter: ≤3.5 cm

We don’t usually worry too much until 4 cm or greater

Fractional shortening of the left ventricle: 25-45%

<15% consistent with severe LV dysfunction (EF < 30%)

E-Point Septal Separation (EPSS)

≤ 6 mm = normal

≥ 7 mm = LV dysfunction

≥ 13 mm = severe LV dysfunction

Normal IVC collapsibility (caval index): ~50% (extremes or helpful, middles are not as helpful)

Pericardial effusion size (measure at maximal width)

Small <10 mm

Moderate 10-15 mm

Large >15 mm

***** Remember, even small effusions can cause tamponade if they rapidly accumulate!

Gallbladder

Normal wall thickness: <4 mm (0.4 cm)

Averages 9 mm in cholecystitis

Normal common bile duct diameter: <4 mm (0.4 cm) PLUS 1 mm for every decade over 40.

For example:

Normal CBD in 40 yo: <4 mm

Normal CBD in 50 yo: <5 mm

Normal CBD in 60 yo: <6 mm

Normal CBD in 70 yo: <7 mm

etc., etc.

It is also common for the CBD to be very dilated if the patient has had a prior cholecystectomy

Pelvic Ultrasound

Remember that for the purposes of ED Ultrasound, the yolk sac is the first sign of a definitive intrauterine pregnancy in patients not undergoing fertility treatments!

Thoracic Ultrasound

Normal number of B-lines

<3 per field bilaterally

Can be normal finding at lung bases

Aorta

Gallbladder

Cardiac

Thoracic

Pelvic