ultrasound
<guided>
Procedures
03.11.2014
brigham & women's hospital
dept of emergency medicine // division of emergency ultrasound
AIRWAY
paracentesis
thoracentesis
SUBCLAVIAN CENTRAL LINE
airway
before
during
after
Airway
<before> surgical preparation
<during> endotracheal intubation
<after> post-tube placement
AIRWAYSURGICAL PREP
AIRWAYSURGICAL PREP
AIRWAYSURGICAL PREP
AIRWAYSURGICAL PREP
Kristensen MS. Ultrasonography in the management of the airway. Acta
Anaesthesiol Scand. 2011 Nov;55(10):1155-73.
AIRWAYSURGICAL PREP
AIRWAYSURGICAL PREP???
AIRWAYSURGICAL PREP
Aslani A et al. Accuracy of identification of the cricothyroid membrane in female subjects using palpation: An observational study. Anesth Analg 2012 May; 114:987.
AIRWAYSURGICAL PREP
AIRWAYSURGICAL PREP
AIRWAYintubation
airwaYintubation
AIRWAYintubation
AIRWAYINTUBATION
AIRWAYintubation
TRUE protocol (2011) during emergent intubation
---
93% concordance: wave-capnography
median operating time: 9sec
---
Chou recommends real-time US to
confirm airway during CPR in trained hands
AIRWAYINTUBATION
indirect confirmation
use other modalities to corroborate
AIRWAYTUBE PLACEMENT
AIRWAYTUBE PLACEMENT
[probe] linear or curvilinear
AIRWAYTUBE PLACEMENt
AIRWAYtube Placement
AIRWAYtube placement
AIRWAYTube placement
AIRWAYsummary
<before> surgical preparation
<during> endotracheal intubation
<after> post-tube placement
AIRWAY
paracentesis
thoracentesis
SUBCLAVIAN CENTRAL LINE
paraCENTESISprep
PARACENTESIS
Paracentesistechnique
PARACENTESISTECHNIQUE
Paracentesisstats
PARACENTESISpitfalls
AIRWAY
paracentesis
thoracentesis
SUBCLAVIAN CENTRAL LINE
THORACENTESISprep
THORACENTESISTECHNIQUE
thoracentesisstats
Thoracentesistechnique
THORACENTESISpitfalls
AIRWAY
paracentesis
thoracentesis
SUBCLAVIAN CENTRAL LINE
Subclavian Linesanatomy
rob swatski
SUBCLAVIAN LINESanatomy
Subclavian linesprep
[probe] linear
[preset] vascular
[parts] clavicle, 1st rib
[position] infraclavicular, supraclavicular
[picture] SC artery, SC vein, pleura, IJ, ---| |---
SUBCLAVIAN LINESTECHNIQUE
SUBCLAVIAN LINESTECHNIQUE
SUBCLAVIAN LINESTECHNIQUE
INFRACLAVICULARapproach
infraclaviculartechnique
infraclavicularTECHNIQUE
INFRACLAVICULARTECHNIQUE
INFRACLAVICULARTECHNIQUE
infraclavicularTECHNIQUE
SUBCLAVIAN LINESANATOMY
SUBCLAVIAN LINESSTATs
Fragou M, et al. Real-time ultrasound-guided subclavian vein cannulation versus the landmark method in critical care patients: a prospective randomized study. Crit Care Med. 2011 Jul;39(7):1607-12.
Fragou, M. et al. Real-time ultrasound-guided subclavian vein cannulation versus the landmark method in critical care patients: a prospective randomized study. Crit Care Med. 2011 Jul;39(7):1607-12.
subclavian linesstats
Success rates US vs Landmark
SUBCLAVIAN LINESstats
Gualtieri E, Deppe SA, Sipperly ME, Thompson DR. Subclavian venous
catheterization: greater success rate for less experienced operators using
ultrasound guidance. Crit Care Med. 1995 Apr;23(4):692-7..
supraCLAVICULARapproach
SUBCLAVIAN LINESANATOMY
SupraCLAVICULARtechnique
SupraclavicularTECHNIQUE
SUBCLAVIAN LINESpitfalls
Limitations
airway
paracentesis
thoracentesis
subclavian lines
Thanks
Questions??
Copy of ultrasound assisted procedures
By wilma chan
Copy of ultrasound assisted procedures
#ultrasound, #procedures, #emergencymedicine
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