Ultrasonografía focalizada en situaciones de urgencia
Focus ultrasound in emergency
Rev. chil. anest; 50 (1), 2021
Publication year: 2021
“Point of Care Ultrasonography” offers numerous clinical advantages in guiding patient management by answering specific questions and as a support tool for invasive procedures. By avoiding unnecessary transfers and more complex examinations, it also has logistical benefits. Its use has spread beyond the field of radiology to various medical specialties, constituting a valuable tool for anesthetic work. Patients in emergency care are one of the several groups that benefit from this relatively new tool that allows to complement the clinical examination of the patient by providing additional information after the physical examination. To optimize its use, it is necessary to know some basic concepts of ultrasound physics, as well as types of transducers, ultrasound modalities, terminology and some concepts of obtaining images (window, plane, vision). The ultrasound-guided procedures for vascular access and some ultrasound-assisted examinations are described. Besides, a brief description of the FOCUS Echocardiography (Focus Oriented Cardiac Ultrasound) is given, as there is a special article for it. Pleural, full stomach, extended FAST, resuscitation, airway and optic nerve ultrasonographies are described with further detail. Finally, some simple and validated protocols for the use of anesthesiologists, emergency physicians and intensivists are listed and briefly described, which make this technique ideal for use at the bedside in time-dependent situations: FOCUS, FAST, RUSH, ACES FATE, BLUE, FALL and FEEL.
La “ultrasonografía en el punto de atención” ofrece numerosas ventajas clínicas al orientar el manejo del paciente al responder preguntas concretas y como herramienta de apoyo para procedimientos invasivos. También presenta ventajas logísticas al evitar traslados innecesarios y exámenes más complejos. Su uso se ha extendido más allá del campo de la radiología a diversas especialidades médicas, constituyendo una herramienta valiosa para el quehacer anestésico. Los pacientes en situaciones de urgencia son uno de tantos grupos beneficiados con esta relativamente nueva herramienta, permitiendo complementar el examen clínico del paciente, profundizando la información que entrega el examen físico. Para optimizar su utilización es necesario conocer algunos conceptos básicos de física del ultrasonido, tipos de transductores, modalidades ecográficas, terminología y algunos conceptos de obtención de imágenes (ventana, plano, visión). Se describe el procedimientos ecoguiado para accesos vasculares y algunos exámenes asistidos con ultrasonografía. Brevemente la ecocardiografía FOCUS ( pues hay un artículo especial para ello.