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Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 4/2019

01-04-2019 | Ultrasound | Continuing Professional Development

Synopsis of the point-of-care ultrasound assessment for perioperative emergencies

Author: Robert Chen, MD, FRCPC

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 4/2019

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Abstract

This module will introduce the concept of a point-of-care ultrasound (POCUS) examination for perioperative clinicians. A focused cardiac examination of ventricular filling and function is presented. An examination of the inferior vena cava is also reviewed as a tool to assess volume status. Finally, a brief examination of the lung and pleura is explored to aid the clinician in situations of patient hypoxia and difficult ventilation. Limited ultrasound cardiorespiratory examinations can be performed by non-cardiologists and non-radiologists. Information drawn from POCUS may aid in diagnosis and early rescue in perioperative care. Point-of-care ultrasound is likely to become standard of care for anesthesiologists in the same way that stethoscopy is presently.
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Literature
1.
go back to reference Mulvagh SL, Bhagra A, Nelson BP, Narula J. Handheld ultrasound devices and the training conundrum: how to get to “seeing is believing”. J Am Soc Echocardiogr 2014; 27: 310-3.CrossRefPubMed Mulvagh SL, Bhagra A, Nelson BP, Narula J. Handheld ultrasound devices and the training conundrum: how to get to “seeing is believing”. J Am Soc Echocardiogr 2014; 27: 310-3.CrossRefPubMed
2.
go back to reference Weiner MM, Geldard P, Mittnacht AJ. Ultrasound-guided vascular access: a comprehensive review. J Cardiothorac Vasc Anesth 2013; 27: 345-60.CrossRefPubMed Weiner MM, Geldard P, Mittnacht AJ. Ultrasound-guided vascular access: a comprehensive review. J Cardiothorac Vasc Anesth 2013; 27: 345-60.CrossRefPubMed
3.
go back to reference Perlas A. Evidence for the use of ultrasound in neuraxial blocks. Reg Anesth Pain Med 2010; 35(2 Suppl): S43-6.CrossRefPubMed Perlas A. Evidence for the use of ultrasound in neuraxial blocks. Reg Anesth Pain Med 2010; 35(2 Suppl): S43-6.CrossRefPubMed
4.
go back to reference Neumar RW, Otto CW, Link MS, et al. Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010; 122(18 Suppl 3): S729-67.PubMed Neumar RW, Otto CW, Link MS, et al. Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010; 122(18 Suppl 3): S729-67.PubMed
6.
go back to reference McKenney MG, McKenney KL, Compton RP, et al. Can surgeons evaluate emergency ultrasound scans for blunt abdominal trauma? J Trauma 1998; 44: 649-53.CrossRefPubMed McKenney MG, McKenney KL, Compton RP, et al. Can surgeons evaluate emergency ultrasound scans for blunt abdominal trauma? J Trauma 1998; 44: 649-53.CrossRefPubMed
7.
go back to reference American College of Emergency Physicians. Emergency ultrasound guidelines. Ann Emerg Med 2009; 53: 550-70.CrossRef American College of Emergency Physicians. Emergency ultrasound guidelines. Ann Emerg Med 2009; 53: 550-70.CrossRef
8.
go back to reference Salen PN, Melanson SW, Heller MB. The focused abdominal sonography for trauma (FAST) examination: considerations and recommendations for training physicians in the use of a new clinical tool. Acad Emerg Med 2000; 7: 162-8.CrossRefPubMed Salen PN, Melanson SW, Heller MB. The focused abdominal sonography for trauma (FAST) examination: considerations and recommendations for training physicians in the use of a new clinical tool. Acad Emerg Med 2000; 7: 162-8.CrossRefPubMed
9.
go back to reference Durham B. Emergency medicine physicians saving time with ultrasound. Am J Emerg Med 1996; 14: 309-13. Durham B. Emergency medicine physicians saving time with ultrasound. Am J Emerg Med 1996; 14: 309-13.
10.
go back to reference Burnette RE Jr, Butler RC. Ruptured ectopic pregnancy after elective termination of intrauterine pregnancy discovered by use of ultrasonography in the emergency department. Acad Emerg Med 2000; 7: 830-3.CrossRefPubMed Burnette RE Jr, Butler RC. Ruptured ectopic pregnancy after elective termination of intrauterine pregnancy discovered by use of ultrasonography in the emergency department. Acad Emerg Med 2000; 7: 830-3.CrossRefPubMed
11.
go back to reference Socransky S; Emergency Department Targeted Ultrasound Interest Group, Canadian Association of Emergency Physicians. Emergency department targeted ultrasound. update. CJEM 2006; 2006(8): 170-4. Socransky S; Emergency Department Targeted Ultrasound Interest Group, Canadian Association of Emergency Physicians. Emergency department targeted ultrasound. update. CJEM 2006; 2006(8): 170-4.
12.
go back to reference Pace J, Arntfield R. Focused assessment with sonography in trauma: a review of concepts and considerations for anesthesiology. Can J Anesth 2018; 65: 360-70.CrossRefPubMed Pace J, Arntfield R. Focused assessment with sonography in trauma: a review of concepts and considerations for anesthesiology. Can J Anesth 2018; 65: 360-70.CrossRefPubMed
13.
go back to reference Denault A, Vegas A, Royse C. Bedside clinical and ultrasound-based approaches to the management of hemodynamic instability - Part I: focus on the clinical approach: continuing professional development. Can J Anesth 2014; 61: 843-64.CrossRefPubMed Denault A, Vegas A, Royse C. Bedside clinical and ultrasound-based approaches to the management of hemodynamic instability - Part I: focus on the clinical approach: continuing professional development. Can J Anesth 2014; 61: 843-64.CrossRefPubMed
14.
go back to reference Vegas A, Denault A, Royse C. A bedside clinical and ultrasound-based approach to hemodynamic instability - Part II: bedside ultrasound in hemodynamic shock: continuing professional development. Can J Anesth 2014; 61: 1008-27.CrossRefPubMed Vegas A, Denault A, Royse C. A bedside clinical and ultrasound-based approach to hemodynamic instability - Part II: bedside ultrasound in hemodynamic shock: continuing professional development. Can J Anesth 2014; 61: 1008-27.CrossRefPubMed
15.
go back to reference Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015; 28(1–39): e14. Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015; 28(1–39): e14.
16.
go back to reference Denault AY, Langevin S, Lessard MR, Courval JF, Desjardins G. Transthoracic echocardiographic evaluation of the heart and great vessels. Can J Anesth 2018; 65: 449-72.CrossRefPubMed Denault AY, Langevin S, Lessard MR, Courval JF, Desjardins G. Transthoracic echocardiographic evaluation of the heart and great vessels. Can J Anesth 2018; 65: 449-72.CrossRefPubMed
17.
go back to reference Hope MD, de la Pena E, Yang PC, Liang DH, McConnell MV, Rosenthal DN. A visual approach for the accurate determination of echocardiographic left ventricular ejection fraction by medical students. J Am Soc Echocardiogr 2003; 16: 824-31.CrossRefPubMed Hope MD, de la Pena E, Yang PC, Liang DH, McConnell MV, Rosenthal DN. A visual approach for the accurate determination of echocardiographic left ventricular ejection fraction by medical students. J Am Soc Echocardiogr 2003; 16: 824-31.CrossRefPubMed
18.
go back to reference Kircher BJ, Himelman RB, Schiller NB. Noninvasive estimation of right atrial pressure from the inspiratory collapse of the inferior vena cava. Am J Cardiol 1990; 66: 493-6.CrossRefPubMed Kircher BJ, Himelman RB, Schiller NB. Noninvasive estimation of right atrial pressure from the inspiratory collapse of the inferior vena cava. Am J Cardiol 1990; 66: 493-6.CrossRefPubMed
19.
go back to reference Goffi A, Kruisselbrink R, Volpicelli G. The sound of air: point-of-care lung ultrasound in perioperative medicine. Can J Anesth 2018; 65: 399-416.CrossRefPubMed Goffi A, Kruisselbrink R, Volpicelli G. The sound of air: point-of-care lung ultrasound in perioperative medicine. Can J Anesth 2018; 65: 399-416.CrossRefPubMed
20.
go back to reference Cavayas YA, Girard M, Desjardins G, Denault AY. Transesophageal lung ultrasonography: a novel technique for investigating hypoxemia. Can J Anesth 2016; 63: 1266-76.CrossRefPubMed Cavayas YA, Girard M, Desjardins G, Denault AY. Transesophageal lung ultrasonography: a novel technique for investigating hypoxemia. Can J Anesth 2016; 63: 1266-76.CrossRefPubMed
21.
go back to reference Pelosi P, Corradi F. Ultrasonography in the intensive care unit: looking at the world through colored glasses. Anesthesiology 2012; 117: 696-8.CrossRefPubMed Pelosi P, Corradi F. Ultrasonography in the intensive care unit: looking at the world through colored glasses. Anesthesiology 2012; 117: 696-8.CrossRefPubMed
22.
go back to reference You-Ten KE, Siddiqui N, Teoh WH, Kristensen MS. Point-of-care ultrasound (POCUS) of the upper airway. Can J Anesth 2018; 65: 473-84.CrossRefPubMed You-Ten KE, Siddiqui N, Teoh WH, Kristensen MS. Point-of-care ultrasound (POCUS) of the upper airway. Can J Anesth 2018; 65: 473-84.CrossRefPubMed
23.
go back to reference Perlas A, Chan VW, Lupu CM, Mitsakakis N, Hanbidge A. Ultrasound assessment of gastric content and volume. Anesthesiology 2009; 111: 82-9.CrossRefPubMed Perlas A, Chan VW, Lupu CM, Mitsakakis N, Hanbidge A. Ultrasound assessment of gastric content and volume. Anesthesiology 2009; 111: 82-9.CrossRefPubMed
24.
go back to reference Geeraerts T, Launey Y, Martin L, et al. Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injury. Intensive Care Med 2007; 33: 1704-11.CrossRefPubMed Geeraerts T, Launey Y, Martin L, et al. Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injury. Intensive Care Med 2007; 33: 1704-11.CrossRefPubMed
25.
go back to reference Rigamonti A, Ackery A, Baker AJ. Transcranial Doppler monitoring in subarachnoid hemorrhage: a critical tool in critical care. Can J Anesth 2008; 55: 112-23.CrossRefPubMed Rigamonti A, Ackery A, Baker AJ. Transcranial Doppler monitoring in subarachnoid hemorrhage: a critical tool in critical care. Can J Anesth 2008; 55: 112-23.CrossRefPubMed
26.
go back to reference Mehta M, Jacobson T, Peters D, et al. Handheld ultrasound versus physical examination in patients referred for transthoracic echocardiography for a suspected cardiac condition. JACC Cardiovasc Imaging 2014; 7: 983-90.CrossRefPubMed Mehta M, Jacobson T, Peters D, et al. Handheld ultrasound versus physical examination in patients referred for transthoracic echocardiography for a suspected cardiac condition. JACC Cardiovasc Imaging 2014; 7: 983-90.CrossRefPubMed
Metadata
Title
Synopsis of the point-of-care ultrasound assessment for perioperative emergencies
Author
Robert Chen, MD, FRCPC
Publication date
01-04-2019
Publisher
Springer International Publishing
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 4/2019
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-019-01303-0

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