Nekuvandudzwa kwemishonga yekukurumidzira uye kufarirwa kwehunyanzvi hwe ultrasound, point-of-care ultrasound yakashandiswa zvakanyanya mukurapa kwekukurumidzira.Yakanakira kuongororwa nekukurumidza, kuongororwa nekukurumidza uye kurapwa kwevarwere vekukurumidzira, uye yakashandiswa kune yekukurumidzira, yakaoma, kukuvadzwa, vascular, obstetrics, anesthesia uye mamwe hunyanzvi.
Iko kushandiswa kwepoc ultrasound mukuongororwa uye kuongororwa kwechirwere kwave kwakajairika mumadhipatimendi ekune dzimwe nyika.IAmerican College yeEmergency Physicians inoda kuti varapi vagone hunyanzvi hwekuita ultrasound.Vanachiremba vekuEurope neJapan vakashandisa zvakanyanya poc ultrasound kubatsira kuongororwa uye kurapwa.Parizvino, kushandiswa kwepoc ultrasound navanachiremba vedhipatimendi rekukurumidzira muChina hakuna kuenzana, uye mamwe madhipatimendi ekukurumidzira ezvipatara atanga kudzidzisa nekusimudzira kushandiswa kwepoc ultrasound, nepo mazhinji emadhipatimendi ekukurumidzira ezvipatara achiri asina chinhu mune izvi.
Emergency ultrasound ishoma chikamu che ultrasound mushonga application, iri nyore, yakakodzera kune wese chiremba wekukurumidzira kushandisa.Zvakadai se: kuongororwa kwekushungurudzika, abdominal aortic aneurysm, vascular access kugadzwa uye zvichingodaro.
Kushandiswa kwepocUltrasound mubazi rekukurumidzira
1.Trauma assessment
Vanachiremba vekukurumidzira vanoshandisa poc ultrasound kuti vaone mvura yemahara panguva yekutanga kuongororwa kwevarwere vane chipfuva kana kukuvadzwa mudumbu.Rapid ultrasound ongororo yekukuvara, uchishandisa ultrasound kuona kubuda kweropa.Nzira yekukurumidza yekuongororwa yave nzira inosarudzwa yekuongororwa kwekukurumidzira kwekukuvadzwa kwemudumbu, uye kana kuongorora kwekutanga kusina kunaka, kuongorora kunogona kudzokororwa sezvinodiwa nekliniki.Kuongororwa kwakanaka kwehemorrhagic shock kunoratidza kubuda ropa mudumbu kunoda kuvhiyiwa.Iyo yakanangidzirwa ultrasound assessment yekuwedzera kushungurudza inoshandiswa kune varwere vane chifuva chechipfuva kuti vaongorore subcostal zvikamu zvinosanganisira mwoyo uye anterior side of chest.
2.Goal-directed echocardiography uye shock assessment
Kuongororwa kwemoyo ne poc ultrasound kunoshandisa echocardiography yakanangana nechinangwa, nhamba shoma yeakajairika echocardiographic maonero, kuita kuti varapi vekukurumidzira vaongorore nekukurumidza kwechimiro chemoyo uye basa kune varwere vane hemodynamic kusagadzikana.Maonero mashanu akajairwa emoyo anosanganisira parasternal refu axis, parasternal short axis, apical four chambers, subxiphoid four chambers, uye inferior vena cava maonero.Ultrasound kuongororwa kwemitral uye aortic valves inogonawo kuiswa mukuongorora, iyo inogona kukurumidza kuziva chikonzero chehupenyu hwemurwere, zvakadai sekushaya simba kwevhavha, kukundikana kwe ventricular yakasara, uye kupindira kwekutanga kwezvirwere izvi zvinogona kuponesa hupenyu hwomurwere.
3.Pulmonary ultrasound
Pulmonary ultrasound inobvumira vanachiremba vekukurumidzira kuti vakurumidze kuongorora chikonzero che dyspnea muvarwere uye kuona kuvapo kwepneumothorax, pulmonary edema, pneumonia, pulmonary interstitial chirwere, kana pleural effusion.Pulmonary ultrasound yakasanganiswa neGDE inogona kunyatso ongorora chikonzero uye kuoma kwe dyspnea.Kune varwere vanorwara zvakanyanya vane dyspnea, pulmonary ultrasound ine yakafanana yekuongorora mhedzisiro kune chest plain scan CT uye iri pamusoro pemubhedha wechipfuva X-ray.
4.Cardiopulmonary resuscitation
Respiratory cardiac arrest is a common emergency emergency disease.Kiyi yekubudirira kununura inguva uye inobudirira cardiopulmonary resuscitation.Poc ultrasound inogona kuratidza zvingakonzeresa kudzorereka kusungwa kwemoyo, senge yakakura pericardial effusion ine pericardial tamponade, yakanyanya kurudyi ventricular dilation ine yakakura pulmonary embolism, hypovolemia, tension pneumothorax, cardiac tamponade, uye yakakura myocardial infarction yekutanga, uye inopa mikana iyi yekutanga kugadzirisa. zvinokonzera.A poc ultrasound inogona kuona cardiac contractile chiitiko pasina pulse, kusiyanisa pakati pechokwadi nenhema kusungwa, uye kutarisa maitiro ose panguva yeCPR.Mukuwedzera, iyo poc ultrasound inoshandiswa pakuongorora kwemhepo kuti ibatsire kusimbisa nzvimbo ye tracheal intubation uye kuve nechokwadi chemhepo yakakwana mumapapu maviri.Muchikamu chekudzoka shure, ultrasound inogona kushandiswa kuongorora vhoriyamu yeropa uye kuvapo uye kuoma kweiyo myocardial dysfunction mushure mekudzokazve.Kurapa kwakakodzera kwemvura, kupindira kwechiremba kana kutsigirwa kwemichina kunogona kushandiswa zvakakodzera.
5.Ultrasound inotungamirirwa puncture therapy
Ultrasonic kuongororwa inogona kuratidza zvakajeka chimiro chenyama yakadzika yemuviri wemunhu, kunyatsotsvaga maronda uye kuona shanduko ine simba yezvironda munguva chaiyo kudzivirira matambudziko akakomba, saka tekinoroji ye ultrasound inotungamira puncture yakavapo.Parizvino, tekinoroji ye-ultrasound-inotungamirwa yepuncture yakashandiswa zvakanyanya mukudzidzira kwekiriniki uye yave vimbiso yekuchengetedza kune akasiyana kliniki invasive oparesheni.Poc ultrasound inovandudza kubudirira kwemaitiro akasiyana-siyana anoitwa nevarapi vekukurumidzira uye inoderedza kuitika kwematambudziko, akadai se thoracopuncture, pericardiocentesis, regionanesthesia, lumbar puncture, central venous catheter kuiswa, yakaoma peripheral artery uye venous catheter kuiswa, incision uye kubuda kweganda. ma abscesses, kubaya majoini, uye kufambisa mhepo.
Kuwedzera kukurudzira kuvandudzwa kwenjodzipocUltrasound muChina
Iko kushandiswa kwepoc ultrasound mudhipatimendi rekukurumidzira reChina kune yekutanga hwaro, asi ichiri kuda kuvandudzwa uye kufarirwa.Kuti ikurumidze kusimudzira kukurumidza kwepoc ultrasound, zvinodikanwa kuvandudza ruzivo rwevarapi vekukurumidzira pane poc ultrasound, kudzidza kubva kune yakakura dzidziso uye manejimendi ruzivo kune dzimwe nyika, uye kusimbisa uye kuenzanisa kudzidziswa kwe emergency ultrasound tekinoroji.Kudzidziswa mune emergency ultrasound matekiniki kunofanirwa kutanga nekukurumidzira kudzidziswa kwekugara.Kurudzirai dhipatimendi rezvechimbichimbi kuti rimise chikwata chevanachiremba veemergency poc ultrasound uye kushandira pamwe nedhipatimendi rekufungidzira reultrasound kuvandudza kugona kwedhipatimendi kushandisa Ultrasound.Nekuwedzera kwenhamba yevarapi vekukurumidzira vanodzidza uye kugona tekinoroji yepoc ultrasound, inozosimudzira kusimudzira kwe emergency poc ultrasound muChina.
Mune ramangwana, nekuenderera mberi kwekuvandudzwa kwemidziyo ye ultrasound uye kuenderera mberi kwekuvandudzwa kweAI neAR tekinoroji, ultrasound ine gore yakagovaniswa kuwana uye telemedicine kugona kuchabatsira vanachiremba vekukurumidzira kuita zvirinani.Panguva imwecheteyo, zvinodikanwa kugadzira chirongwa chakakodzera chekukurumidzira poc ultrasound chekudzidzisa uye chakabatana chitupa chinoenderana nemamiriro ezvinhu eChina chaiwo.
Nguva yekutumira: Zvita-15-2023
