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33 - Use of Echocardiography and Ultrasound in Trauma

Published online by Cambridge University Press:  18 January 2010

Colin Royse
Affiliation:
Department of Anaesthesia and Pain Management, Department of Pharmacology, Royal Melbourne Hospital, University of Melbourne, Carlton, Victoria, Australia
Alistair Royse
Affiliation:
Department of Anaesthesia and Pain Management, Department of Pharmacology, Royal Melbourne Hospital, University of Melbourne, Carlton, Victoria, Australia
Charles E. Smith
Affiliation:
Case Western Reserve University, Ohio
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Summary

Objectives

  1. Identify the wide range of uses of ultrasound in trauma.

  2. Understand the concept of “hemodynamic state” assessment.

  3. Understand how echocardiography interpretation can guide clinical management.

  4. Understand the basics of focused abdominal sonography in trauma (FAST) and other surface ultrasound diagnostic studies.

  5. Understand how to get started using ultrasound.

SUMMARY

The use of ultrasound in trauma anesthesia is increasing rapidly, including transesophageal echocardiography, transthoracic echocardiography, and a multitude of surface ultrasound applications including the FAST scan, and assessment for pneumothorax, pleural effusion, and deep vein thrombosis. It is being used as a guide for a number of procedures including vascular access, nerve blocks, pleural drainage, and percutaneous tracheostomy. This chapter will focus on hemodynamic assessment with echocardiography, as well as surface ultrasound diagnostic skills, whereas ultrasound-guided procedures are considered further in Chapter 32.

HOW MANY WAYS CAN ULTRASOUND BE USED DURING TRAUMA ANESTHESIA?

The key to successful use of ultrasound during trauma anesthesia is to understand that it provides rapid diagnostic information to assist patient management. The FAST scan (focused abdominal sonography in trauma) is well established in the emergency department for the assessment of abdominal trauma. Although this is a useful test, it is a small part of ultrasound use that is available in trauma. Hemodynamic state evaluation is a process of categorizing the underlying hemodynamic conditions by using echocardiography as an adjunct to our conventional clinical monitors. This is the single most useful area of ultrasound application in trauma. Better diagnostic information will translate into improved management.

Type
Chapter
Information
Trauma Anesthesia , pp. 514 - 527
Publisher: Cambridge University Press
Print publication year: 2008

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References

Kusumoto, F, Muhiudeen, I, Keucherer, H, Cahalan, M, Schiller, N.Response of the interatrial septum to transatrial pressure gradients and its potential for predicting pulmonary capillary wedge pressure: An interoperative study using transesophageal echocardiography in patients during mechanical ventilation. J Am Coll Cardiol 1993;21:721–8.CrossRefGoogle Scholar
Royse, CF, Seah, JL, Donelan, L, Royse, AG.Point of care ultrasound for basic haemodynamic assessment: Novice compared with an expert operator. Anaesthesia 2006;61(9):849–55.CrossRefGoogle ScholarPubMed
Royse, CF, Royse, AG, Soeding, PF, Blake, DW.Shape and movement of the interatrial septum predicts change in pulmonary capillary wedge pressure. Ann Thorac Cardiovasc Surg 2001;7(2):79–83.Google ScholarPubMed
Royse, C, Donnan, G, Royse, A.Pocket guide to perioperative and critical care echocardiography. New York: McGraw-Hill, 2006.Google Scholar

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  • Use of Echocardiography and Ultrasound in Trauma
    • By Colin Royse, Department of Anaesthesia and Pain Management, Department of Pharmacology, Royal Melbourne Hospital, University of Melbourne, Carlton, Victoria, Australia, Alistair Royse, Department of Anaesthesia and Pain Management, Department of Pharmacology, Royal Melbourne Hospital, University of Melbourne, Carlton, Victoria, Australia
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.036
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  • Use of Echocardiography and Ultrasound in Trauma
    • By Colin Royse, Department of Anaesthesia and Pain Management, Department of Pharmacology, Royal Melbourne Hospital, University of Melbourne, Carlton, Victoria, Australia, Alistair Royse, Department of Anaesthesia and Pain Management, Department of Pharmacology, Royal Melbourne Hospital, University of Melbourne, Carlton, Victoria, Australia
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.036
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Use of Echocardiography and Ultrasound in Trauma
    • By Colin Royse, Department of Anaesthesia and Pain Management, Department of Pharmacology, Royal Melbourne Hospital, University of Melbourne, Carlton, Victoria, Australia, Alistair Royse, Department of Anaesthesia and Pain Management, Department of Pharmacology, Royal Melbourne Hospital, University of Melbourne, Carlton, Victoria, Australia
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.036
Available formats
×