Application of ultrasound in emergency medicine and resuscitation

Budimski, Mihaela

doi:10.5937/JRB1811131B

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Journal Resuscitatio Balcanica

2018, vol. 4, br. 11, str. 131-136

Primena ultrazvuka u urgentnoj medicini i resuscitaciji

Budimski Mihaela

Dom zdravlja Subotica

e-adresa: dzsupiar@gmail.com

Ključne reči: ultrazvuk; urgentna medicina; reverzibilni uzroci srčanog zastoja

Sažetak

CILJ: Cilj rada je prikaz koncepta zbrinjavanja osoba u srčanom za-stoju i dostignućima primene ultrazvuka u srčanom zastoju po-redivši postojeće protokole za urgentno zbrinjavanje sa pro-tokolima koji razvijamo u Resuscitacionom Savetu Srbije a u saradnji sa drugim nacionalnim savetima, mogućnost odlo-žene primene ultrazvuka u cilju dalje definitivne dijanostike i uspostavljanja terapijskih procedura kao i primenu ultrazvu-ka tokom transporta i "prolonged field care" u vanbolničkim uslovima (transport duži od 45 min) ili rad u "remot area" brd-sko-planinskim područjima. METODOLOGIJA: U metodologiji rada je pregledana dostupna literatura (knjige, objavljeni članci) iz oblasti primene ultrazvuka u urgentnoj me-dicini. Kao pretraživač je korištena bibliografska baza MEDLINE. REZULTATI: Prema najnovijim smernicama Evropskog resuscitacionog sa-veta primena ultrazvuka se preporučuje za utvrđivanje rever-zbilnih uzroka srčanog zastoja. Procedure koje se sprovode ra-di utvrđivanja reverzibilnih uzroka srčanog zastoja spadaju u crvene procedure i ovi pacijenti zahtevaju urgentno zbrinjava-nje. Ultrasonografija ima mesto u dijagnostikovanju sledećih reverzibilnih uzroka srčanog zastoja: tenzioni pneumotoraks, hipoksemija, hipovolemija, tamponada srca i plućna trombo-embolija. Procedure koje se rade u žutoj i zelenoj zoni daju mo-gućnost odložene primene ultrazvuka u cilju dalje definitivne dijagnostike i uspostavljanja terapijskih procedura kao i pri-menu ultrazvuka tokom transporta i "prolonged field care" u vanbolničkim uslovima (transport duži od 45 min) Ili rad u "re-mot area" brdsko-planinskim područjima. Jedna od procedura koja se radi u žutoj ili zelenoj zoni je primena FAST protokola.. ZAKLJUČAK: Primena ultrazvuka u urgentnoj medicini, prema dostupnoj li-teraturi, ukazuje na benefit sprovođenja ovih dijagnostičkih procedura u cilju bržeg i boljeg zbrinjavanja kritično obolelih pacijenta. Edukovanost lekara koji se bave urgentnom medi-cinom iz oblasti ultrasonografije, dovodi do smanjenja kadrov-skih resursa a efikasnijeg tretmana pacijenata i do mogućno-sti sprovođenja spasonosnih (crvenih procedura) kod životno ugrožavajućih stanja.

Abstract

Aim: The aim of this paper is to show the concept of the treatment of the patients in cardiac arrest and the achievements and advantages of the use of ultrasound in cardiac arrest, comparing existing protocols for emergency care with the protocols we developed in the Resuscitation Council of Serbia and in cooperation with other national councils, the possibility of delayed application of ultrasound in order to further final diagostics and the establishment of therapeutic procedures as well as the use of ultrasound during transport and prolonged field care under out-of-hospital conditions (transport longer than 45 min) or work in the “remote area” in mountain areas. METHODOLOGY: The methodology of work reviewed literature (books, published articles) in the field of the application of ultrasound in emergency medicine. The bibliography database MEDLINE was used as a browser. THE RESULTS: According to the latest guidelines of the European Resuscitation Council, the use of ultrasound is recommended for the determination of reversible causes in cardiac arrest. Procedures that are carried out to determine reversible causes of cardiac arrest fall under red-eye procedures and these patients require urgent care. Ultrasonography has a place in diagnosing the following reversible causes of cardiac arrest: tension pneumothorax, hypoxemia, hypovolaemia, cardiac tamponade and pulmonary thromboembolism. Procedures that work in the yellow and green zone give the possibility of delayed application of ultrasound aiming for final diagnostics and establishment of therapeutic procedures. The use of ultrasound can be beneficial during transportation and prolonged field care in outhospital conditions (transport longer than 45 min) or work in the remote areas in mountains. One of the procedures in the yellow or green zone is the application of the FAST protocol. CONCLUSION: The use of ultrasound in emergency medicine, according to available literature, points to the benefit of implementing these diagnostic procedures in order to better and better manage critically ill patients. The education of the physiscians dealing with emergency medicine in the field of ultrasonography leads to a decrease in human resources and more efficient treatment of patients and to the possibility of implementing salvage (red procedures) in life-threatening conditions.

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O članku

jezik rada: srpski
vrsta rada: originalan članak
DOI: 10.5937/JRB1811131B
objavljen u SCIndeksu: 12.05.2019.

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