1. ROLE OF ULTRASOUND
NURSE IN CRITICAL CARE
Presenter : Jyothis George
NIS JPNATC
Moderator : Dr. Deepak Aggarwal

2. INTRODUCTION
Ultrasonography has evolved to become
one of the most versatile modalities for
diagnosing and guiding treatment of critically
ill patients.

3. Point of care
This modality is likely useful in resource
challenged countries as it is non-invasive,
economical, repeatable and can be performed at
the bedside

4. ULTRASOUND-HEAD
• Detecting any breakage in scalp, bone injury
• To see the MLS or hematoma in post operative
decompressive craniotomy patients

5. ULTRASOUND-HEAD
CT view USG view

6. eyes
• used in head injury patients
• To detect size, reaction of patients whose eye
examination not possible
• To detect ONSD –indicator of raised ICP

7. Orbital ultrasound
RACOON EYES USG VIEWED EYE

8. OPTIC NERVE SHEATH DIAMETER
• Increased ONSD correlates with increased
ICP
• Upper limit of normal ONSD vary with age…
– Adults: < 5 mm
– Children > 1 Y: < 4.5 mm
– Children < 1 Y < 4 mm
• ONSD 5 – 5.7 mm: may indicate ICP > 20
mmHg, especially if symptomatic
– > 5 mm is 100% sensitive for elevated
ICP
– All patients with elevated ICP have
ONSD > 5mm

9. NECK- ULTRASOUND
• In intubated patients the position of ET tube ,TT tube
can be confirmed.
• Assist in procedures like percutaneous tracheostomy,
CVP line insertion.

10. Neck-airway

11. Central vein insertion

12. Lung- ultrasound
• Lung movement, diaphragm, pleura
• pneumothorax(absent/diminished lung movement),
• hemothorax(presence of fluid), position of chest tube
• Early detection of plural effusion(multiple B-lines) and
pulmonary edema than x-ray

13. Lung ultrasound

14. M- mode—LUNG SCAN
BARCODE SIGN SEASHORE SIGN

15. HEMOTHORAX

16. Cardiac &hemodynamics
• Volume status- indirect measurement of CVP by
detecting IVC diameter

17. IVC Longitudinal – USG view

18. USG Finding- Normovolemia

19. USG FINGINGS… hypovolemia

20. USG FINDINGS… HYPERVOLEMIA

21. Abdomen and pelvis
• Presence of fluid in abdomen

22. • Urinary retention and amound of urine in bladder

23. vascular
• Vascular
– Diagnosing deep venous thrombosis

24. THERAPEUTIC
Pericardiocentesis
Bedside Percutaneous nephrostomy
Guided arterial and central or peripheral vascular access
For guided thoracocentesis and abdominal paracentesis
Guided drainage of collections

25. others
detecting fractures and foreign bodies

26. NURSING ROLE
 Ultrasonography is rapid ,easy and repeatable
procedure
 USG can be used as an alternative non invasive
method to other various invasive procedures
 So early detection of any abnormal condition is
possible by a bed side ultrasound nurse, can be
helpful in the management of critically ill
patient.