Lung Cardiac and vascular Ultrasound-1.pptx

Document Details

ComfortingMothman3162

Uploaded by ComfortingMothman3162

Florida International University

Tags

ultrasound cardiac nurse anesthesiology

Full Transcript

Lung And Cardiac Ultrasound Vicente Gonzalez, DNP CRNA, APRN Florida International University Department of Nurse Anesthesiology Objectives Become familiar with the uses of ultrasound in the perioperative setting Discuss how the use of ultrasound can enhance patient care and safety...

Lung And Cardiac Ultrasound Vicente Gonzalez, DNP CRNA, APRN Florida International University Department of Nurse Anesthesiology Objectives Become familiar with the uses of ultrasound in the perioperative setting Discuss how the use of ultrasound can enhance patient care and safety List the uses of ultrasound in the perioperative setting Explain how using ultrasound enhances patient care History In the early part of the 21st century ultrasound equipment became more compact and portable Other uses of ultrasound in the peri-operative setting began to get explored Lung Gastric Spine Trauma ICU Airway evaluation Artifacts Speed of sound in tissues is assumed to be 1540 m/s. This is an average of different tissues Sound waves are assumed to travel in a straight line from and back to transducer Tissue at different angles and echogenic properties change the angle of return Refractive and reflective properties of tissue generate shadows Equipment Several machines and transducers are available for perioperative use Equipment used for Point-of-Care-UltraSound (POCUS) not only provide basic images but the more advanced ones have capabilities such as 3D imaging, pulse doppler etc. The 3 basic types of transducers are linear, phased array and curvilinear, each has a specific use for which they are best suited Linear Shallow structures, usually high definition due to high frequency Phased array Lower frequencies, better at spatial depth good for thoracic organs Curvilinear More depth of field used to image deeper structures in abdomen Trans-Thoracic Echocardiography (TTE) Focused Cardiac Ultrasound (FOCUS) It is a qualitative exam Can be used to evaluated the quality of the heart, valves and vessels Used in conjunction with a physical exam Is limited in scope Can be used to narrow down list of possible diagnosis (and therefore anesthetic management) FOCUS Information obtained includes Global biventricular systolic function Atrial and Ventricular chamber size Valvular abnormalities Pericardial effusion or tamponade Volume response FOCUS views Views Emergency Use of US Uses of POCUS include the use of FOCUS to examine multi-organ system evaluation In emergency shock situation a systematic approach must be taken to do things in a consistent manner that covers RUSH Rapid Ultrasound in Shock Evaluation of the pump, tank and pipes (see table next slide) Allows for rapid diagnosis of problems and management of intraoperative shock Copyrights apply Lung US Use linear transducer Can diagnose Pnemothorax Pleural effusion Pneumonia Pulmonary edema Esophageal or endobronchial intubation Detection of pneumothorax is equal to or superior to CXR Copyrights apply Copyrights apply Vascular access Ultrasound can be used to cannulate peripheral as well as central venous access It can also be used to cannulate for intra-arterial blood pressure monitoring. Most of the vessels are superficial and the techniques used are similar to those used for nerve blocks Internal Jugular Anatomic Variations Frequency of Anatomical Variations Summary Advantages of perioperative ultrasound use include versatility (eg, diagnosis of pathology, precise needle or catheter placement), rapid acquisition of images, ability to perform repeated examinations, portability of ultrasound machines and probes, and absence of ionizing radiation risks. Disadvantages include costs of initial purchase and maintenance of equipment and training and availability of skilled clinicians who can perform and instantaneously interpret ultrasound images. References Romero-González, Gregorio & Manrique, Joaquín & Roblero, Maria & Husain- Syed, Faeq & de la Espriella-Juan, Rafael & Ferrari, Fiorenza & Bover, Jordi & Ortiz, Alberto & Ronco, Claudio. (2022). PoCUS in Nephrology: A new tool to improve our diagnostic skills. Clinical Kidney Journal. 16. 10.1093/ckj/sfac203 Via, Gabriele et al. “International evidence-based recommendations for focused cardiac ultrasound.” Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 27 7 (2014): 683.e1-683.e33.

Use Quizgecko on...
Browser
Browser