Kugwiritsa ntchito ndi chitukuko cha POC ultrasound mu dipatimenti yadzidzidzi

Ndi chitukuko cha mankhwala odzidzimutsa komanso kutchuka kwa teknoloji ya ultrasound, point-of-care ultrasound yakhala ikugwiritsidwa ntchito kwambiri pamankhwala odzidzimutsa.Ndikoyenera kwa matenda ofulumira, kuunika mwamsanga ndi chithandizo cha odwala mwadzidzidzi, ndipo amagwiritsidwa ntchito pazidzidzi, zoopsa, zoopsa, mitsempha, obstetrics, anesthesia ndi zina zapadera.

Kugwiritsa ntchito poc ultrasound pakuzindikira ndikuwunika kwa matendawa kwakhala kofala kwambiri m'madipatimenti odzidzimutsa akunja.American College of Emergency Physicians imafuna madokotala kuti adziwe luso ladzidzidzi la ultrasound.Madokotala azadzidzidzi ku Europe ndi Japan agwiritsa ntchito kwambiri poc ultrasound kuthandiza kuzindikira ndi kuchiza.Pakadali pano, kugwiritsa ntchito poc ultrasound ndi madotolo adzidzidzi ku China sikuli kofanana, ndipo madipatimenti ena azadzidzidzi azipatala ayamba kuphunzitsa ndikulimbikitsa kugwiritsa ntchito poc ultrasound, pomwe madipatimenti ambiri azadzidzidzi azipatala akadali opanda kanthu pankhaniyi.
Emergency ultrasound ndi gawo lochepa kwambiri pakugwiritsa ntchito mankhwala a ultrasound, osavuta, oyenera dokotala aliyense wadzidzidzi kuti agwiritse ntchito.Monga: kufufuza zoopsa, m'mimba kung'ambika aneurysm, mtima mwayi kukhazikitsidwa ndi zina zotero.

Kugwiritsa ntchito kwapocultrasound mu dipatimenti yodzidzimutsa

1.Kuwunika kwa zoopsa

Madokotala azadzidzidzi amagwiritsa ntchito poc ultrasound kuti azindikire zamadzimadzi aulere pakuwunika koyambirira kwa odwala omwe ali ndi vuto la chifuwa kapena m'mimba.Kuwunika kwachangu kwa ultrasound kwa kuvulala, pogwiritsa ntchito ultrasound kuzindikira magazi a intraperitoneal.Njira yofulumira yowunikirayi yakhala njira yabwino kwambiri pakuwunika mwadzidzidzi kuvulala kwam'mimba, ndipo ngati kuyesa koyambirira kuli koipa, kuyezetsako kumatha kubwerezedwa ngati kofunikira kuchipatala.Kuyeza kwabwino kwa kugwedezeka kwa magazi kumasonyeza kutuluka kwa magazi m'mimba komwe kumafuna opaleshoni.Kuwunika kwa ultrasound kwa kuvulala kwakanthawi kumagwiritsidwa ntchito kwa odwala omwe ali ndi vuto la pachifuwa kuti ayang'ane zigawo za subcostal kuphatikiza mtima ndi mbali yakutsogolo ya chifuwa.

2.Goal-directed echocardiography and shock assessment
Kuyeza kwa mtima ndi poc ultrasound kumagwiritsa ntchito echocardiography yoyang'ana zolinga, chiwerengero chochepa cha mawonedwe a echocardiographic, kuti athandize madokotala adzidzidzi kufufuza mofulumira kwa mtima ndi ntchito kwa odwala omwe ali ndi vuto la hemodynamic.Mawonedwe asanu a mtima akuphatikizapo parasternal axis yaitali, parasternal short axis, apical four chambers, subxiphoid four chambers, and inferior vena cava view.Kusanthula kwa ultrasound kwa ma valve a mitral ndi aortic kungaphatikizidwenso pakuwunika, komwe kumatha kuzindikira mwachangu chomwe chimayambitsa moyo wa wodwalayo, monga kulephera kwa valve, kulephera kwa minyewa yamanzere, komanso kulowererapo koyambirira kwa matendawa kungapulumutse moyo wa wodwalayo.

3.Pulmonary ultrasound
Pulmonary ultrasound imalola madokotala odzidzimutsa kuti awone chomwe chimayambitsa dyspnea mwa odwala ndikuzindikira kupezeka kwa pneumothorax, pulmonary edema, chibayo, pulmonary interstitial matenda, kapena pleural effusion.Pulmonary ultrasound kuphatikiza ndi GDE imatha kuwunika bwino chomwe chimayambitsa komanso kuuma kwa dyspnea.Kwa odwala omwe ali ndi vuto la dyspnea, pulmonary ultrasound imakhala ndi zotsatira zofanana ndi chifuwa cha CT scan ndipo ndi yabwino kuposa chifuwa cha chifuwa cha X-ray.

4.Kutsitsimula kwa mtima
Kupuma kwa mtima kumangidwa ndi matenda ofala mwadzidzidzi.Chinsinsi chopulumutsira bwino ndikutsitsimutsa kwapanthawi yake komanso kothandiza kwa cardiopulmonary.Poc ultrasound imatha kuwulula zomwe zingayambitse kumangidwa kwa mtima wosinthika, monga kutulutsa kwakukulu kwa pericardial tamponade, kutsika kwambiri kwa ventricular kumanja ndi pulmonary embolism, hypovolemia, tension pneumothorax, tamponade yamtima, ndi kuwongolera kwamphamvu kwa myocardial, ndikupereka mwayi wowongolera izi. zimayambitsa.Poc ultrasound imatha kuzindikira zochitika za mtima wa contractile popanda kugunda, kusiyanitsa pakati pa kumangidwa koona ndi zabodza, ndikuyang'anira ndondomeko yonse pa CPR.Kuphatikiza apo, poc ultrasound imagwiritsidwa ntchito pakuwunika kwa mpweya kuti ithandizire kutsimikizira malo a tracheal intubation ndikuwonetsetsa kuti mpweya wokwanira m'mapapo onse awiri.Mu gawo la post-resuscitation, ultrasound ingagwiritsidwe ntchito poyesa kuchuluka kwa magazi ndi kukhalapo ndi kuopsa kwa matenda a myocardial pambuyo potsitsimula.Chithandizo choyenera chamadzimadzi, chithandizo chamankhwala kapena chithandizo chamagetsi chingagwiritsidwe ntchito moyenerera.

5.Ultrasound motsogozedwa ndi puncture therapy
Kuwunika kwa akupanga kumatha kuwonetsa bwino minofu yakuya ya thupi la munthu, kupeza bwino zotupazo ndikuwona kusintha kwamphamvu kwa zotupa munthawi yeniyeni kuti tipewe zovuta zazikulu, kotero ukadaulo wotsogola wa ultrasound unakhalapo.Pakadali pano, ukadaulo wotsogozedwa ndi ultrasound wagwiritsidwa ntchito kwambiri m'machitidwe azachipatala ndipo wakhala chitsimikizo chachitetezo pamachitidwe osiyanasiyana obwera kuchipatala.Poc ultrasound imapangitsa kupambana kwa njira zosiyanasiyana zochitidwa ndi madokotala azadzidzidzi ndikuchepetsa kuchuluka kwa zovuta, monga thoracopuncture, pericardiocentesis, anesthesia yachigawo, lumbar puncture, central venous catheter kuika, zovuta zotumphukira mtsempha wamagazi ndi venous catheter kuika, incision ndi ngalande pakhungu. zilonda, kubowola pamodzi, ndi kuyendetsa ndege.

Komanso kulimbikitsa chitukuko cha mwadzidzidzipocultrasound ku China

Kugwiritsa ntchito poc ultrasound mu dipatimenti yadzidzidzi yaku China kuli ndi maziko, komabe ikufunika kupangidwa ndikutchuka.Pofuna kufulumizitsa chitukuko cha poc ultrasound yadzidzidzi, m'pofunika kupititsa patsogolo chidziwitso cha madokotala odzidzimutsa pa poc ultrasound, kuphunzira kuchokera ku maphunziro okhwima ndi otsogolera okhwima kunja, ndi kulimbikitsa ndi kuyimitsa maphunziro a teknoloji yadzidzidzi ya ultrasound.Maphunziro a njira zadzidzidzi za ultrasound ayenera kuyamba ndi maphunziro adzidzidzi.Limbikitsani dipatimenti yowona za ngozi kuti ikhazikitse gulu la madokotala a zadzidzidzi poc ultrasound ndi kugwirizana ndi dipatimenti yojambula zithunzi za ultrasound kuti dipatimentiyi ikhale ndi luso logwiritsa ntchito ultrasound.Ndi kuchuluka kwa madotolo azadzidzidzi omwe amaphunzira ndikudziwa luso la poc ultrasound, zidzalimbikitsanso chitukuko cha poc ultrasound ku China.
M'tsogolomu, ndi kusinthidwa kosalekeza kwa zida za ultrasound ndi kupititsa patsogolo kosalekeza kwa AI ndi teknoloji ya AR, ultrasound yokhala ndi mwayi wogawana nawo mtambo ndi telemedicine ingathandize madokotala adzidzidzi kuchita bwino.Nthawi yomweyo, ndikofunikira kupanga pulogalamu yophunzitsira yadzidzidzi poc ultrasound ndi ziphaso zokhudzana ndi ziyeneretso zochokera kudziko lenileni la China.