Test yourself
IVC: a big vein is not a fluid order
4 questions. Pick an answer to see whether you are right and why. Your score appears at the end.
Question 1Where do you measure the IVC diameter?
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Answer c. Guidelines measure just beyond the hepatic vein junction, about 2 cm from the right atrium, at end expiration, in long axis.
Question 2An IVC of 2.5 cm collapses less than 50% with a sniff. What does this suggest?
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Answer d. A wide IVC with little collapse suggests a high right atrial pressure. It does not tell you the cause, so look at the right ventricle, the pericardium and the lungs.
Question 3A ventilated patient has a plethoric IVC. What do you conclude?
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Answer b. Positive pressure raises intrathoracic pressure and distends the IVC. In ventilated patients, a dilated IVC alone does not guide fluid decisions.
Question 4A hypotensive patient has a plethoric IVC and bilateral B-lines. What is the best reading?
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Answer c. A full IVC with widespread B-lines suggests raised filling pressures and lung water. More fluid risks harm. Look at the heart for poor function or tamponade.
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Four or five delegates per instructor, FAMUS-accredited faculty and long, supervised time on the probe.
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