超声心动图实用手册Practical Manual of Echocardiography_部分30精品.pdf

“Quick echo in the emergency department”: What the EM physician needs to know and do 1 2 Dimitry Bosoy and Alexander Tsukerman 1Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY, USA 2Emergency Medical Associates, New York, NY, USA CHAPTER 19 Focused cardiac ultrasonography (FOCUS) has been a bedside tool in the emergency department for years. Advances in ultrasound technology and the resultant creation of very small, portable, echocardiogram machines (hand carried ultrasound (HCU) devices) have made echocar- diography a quick and easy bedside tool in the emergency department (Figure 19.1). FOCUS provides a great deal of anatomical and functional information. This modality is accurate, quick, noninvasive and readily available in most emergency departments. Physicians in the emergency department utilize FOCUS as an extension of the physical examination. Goal of FOCUS The goal of FOCUS in a symptomatic emergency department patient is to assess the following: Presence of pericardial effusion. Global cardiac systemic function. Identification of right ventricular diastolic collapse or strain and left ventricular enlargement. Determining intravascular volume. Guidance of pericardiocentesis and confirmation of transvenous pacing wire placement. Practical Manual of Echocardiography in the Urgent Setting, First Edition. Edited by Vladimir Fridman and Mario J. Garcia. © 2013 John Wiley Sons, Ltd. Published 2013 by John Wiley Sons, Ltd. 248 Quick echo in the emergency department | 249 Figure 19.1 An example of a hand carried ultrasound device. Pericardial effusions Are very easily identified by echocardiography. Detection of pericardial fluid requires knowledge of basic cardiac