Ultrasound by ICU Nurse

814 views

Published on

Published in: Health & Medicine, Business
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
814
On SlideShare
0
From Embeds
0
Number of Embeds
62
Actions
Shares
0
Downloads
0
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide
  • Continue this clinical scenario when you are describing the ABCDE by usg .give this clinical scenario in each block and use the word Visual stethoscope
  • The probe is oriented transversely to the vessel, and the vessel appears as a circular anechoic structure. n Needle appears as a hyper echoic “dot” on the ultrasound screen.• Tip of the needle is harder to localize
  • In plane A vein appears as a tubular anechoic structure. The needle is inserted parallel to the probe directly under the center and therefore lies completely within the plane of imaging Provides a better needle slope positioning and can monitor the needle throughout the procedure• Tip of the needle is easier to localize
  • Ultrasound by ICU Nurse

    1. 1. Ultrasound by ICU Nurse Sanjeev Bhoi MD FACEE Additional Professor Department of Emergency Medicine AIIMS Trauma Centre
    2. 2. 0730hrs ICU 44 yrs old presents to the ICU with Motor Vehicle crash . Arrival Vital Signs BP: 80/64mmHg, HR- 130, RR-24, Confused, cold and clammy How will you manage the patient??
    3. 3. Initial Assessment and Management • Triage-Red • Primary Survey • FAST • Secondary Survey Treat first that kills first
    4. 4. Why US in EMED? TIME CRITICAL In a disease in which there is a golden hour, every minute counts! AUTLS
    5. 5. Point of Care Ultrasound • Goal Directed • Highly focused • Limited Examination • Binary questions • Binary answers
    6. 6. Who should be doing in acute care? Journal of Emergencies trauma and Shock ,January 2013
    7. 7. who should be doing in ED? Non-radiologist vs Radiologist
    8. 8. Ultrasound Algorithm 9/30/2013 ITC-2012 AUTLS
    9. 9. A 9/30/2013 ITC-2012
    10. 10. B 9/30/2013 ITC-2012
    11. 11. 9/30/2013 ITC-2012
    12. 12. Pneumothorax 9/30/2013
    13. 13. C 9/30/2013 ITC-2012
    14. 14. THE RUSH EXAM Leaking tank Internal blood loss – Haemothorax / Hemo-peritoneum (Hypo-volumic shock) in trauma by FAST exam (Focused Assessment with Sonography in Trauma) (ED sensitivity - 92% & specificity - 100% for hemothorax) How much fluid can FAST detect? • 250 cc total • 100 cc in Morison’s pouch
    15. 15. D E 9/30/2013 ITC-2012
    16. 16. DISABILITY AUTLS
    17. 17. • ASSESS PUPIL AND PUPILLARY REFLEX
    18. 18. Seeing through Closed Eye
    19. 19. Pupillary size
    20. 20. ICP RAISED ?
    21. 21. Optic Nerve Sheath Diameter AUTLS
    22. 22. OUT OF PLANE
    23. 23. IN PLANE
    24. 24. ACUTE CARE SONOGRAPHY FOR NURSES Brachial pl. Block in ED Sea-Shore sign
    25. 25. “Unlearn and keep Learning”

    ×