eus教學(1)。急診超音波之介紹 & 超音波基本認識

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Emergency Ultrasound (EUS)教學(1) Emergency Ultrasound (EUS)教學(1) 急診超音波之介紹 & 超音波基本認識 新光醫院急診醫學科 新光醫院急診醫學科 陳國智醫師 中華民國醫用超音波學會指導醫師

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990506_EUS上課講義EUS教學(1)。急診超音波之介紹 & 超音波基本認識

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Emergency Ultrasound (EUS)(1) &

?

50M, MVA patient, HR 130bpm, BP 70/40 Internal bleeding ? g

85M, sudden onset right flank pain, 8/10R Renal colic or AAA ? l li

48F, RUQ pain with fever , p Cholecystitis ?

28F low abdominal pain with shock EIA (+) 28F, shock, Ectopic pregnancy ?

EUS (Emergency Ultrasound) ( g y )Hx & PEimpression PEimpression EUSYes or No

(FAST)

(AAA)

(Hydronephrosis)

(Cardiac Arrest)

Hyperechoic Hypoechoic

Isoechoic Anechoic

Acoustic shadow:

Lateral shadow:

Acoustic enhancement:

(artifacts)

: &

:

: 62.310.3 mm : 20.3 5.1 mm : < 2 mm (: 4~7 mm)

: a 40.87.8mm b 30.66.8mm c 83.610.6mm Spleen index a * b > 20 cm2 c * b > 30 cm2

: 25mm 14mm 15mm

: :

2 mm

: 10.2 9.6 cm : 4.2 6.9 cm

: 10.6 9.8 cm : 4.8 6.2 cm

* * * 0 75 0.75 Error 15~30 %

()

()

:

W4 (Hand-on practice)

()

Hand-on Practice1. Describe 2. 2 Demo 3. Do3

1

2

: 1. 1 2. 3. 4.

: 20 (1, 2)

(A)1. 1 (10 positive exam 10%) iti 2. (10 positive exam 10%) 3. (FAST) (10 positive exam 20%) 4. (10 positive exam 20%) 5. (10 positive exam for IUP & FHB 20%) 6. (10 positive exam for obstructive uropathy & urinary retension 20%) 7. (10 positive exam 10%) 8.US-assisted paracentesis or thoracentesis ((10 )

(B) 1.Liver 1 Liver tumor 2.Pneumobilia 3.PVT thrombosis 4.Unexplained 4 Unexplained jaundice 5.Cardiac activity during CPR 6.Global LV systolic function evaluation 7.Intravascular volume status evaluation (IVC) 8.US-assisted pericardiocentesis 9.Evaluation f hematuria 9 E l ti of h t i 10.Evaluation of acute renal failure 11.Renal 11 Renal cyst and tumor 12.Pneumothorax 12 Pneumothorax 13.Solid organ injury 14.GI-tract: target sign or pseudokidney sign 15.GI-tract: bowel obstruction 16.Soft tissue abscess evaluation and drainage 17.Soft tissue foreign bodies evaluation 18.Joint effusion evaluation and drainage 19.US-assisted lumbar puncture 20.Ovarian cyst 21.Myoma uteri 22.

PGY/Intern/Clerk

FAST

Aloka SSD 900 Toshiba Nemio

Aloka & Procedure

Aloka

Aloka Gel

; ; 2; ; ; ; ; ;

Toshiba ; Freeze; ; Cable; "" ; ; ; Leader ;

Aloka ; Freeze ; ; ; ; ; ; ;

Troubleshooting Printer ?1 2

Troubleshooting Printer ?3 4

Troubleshooting Printer ?5 6

EUS-98 EUS 98: : : DVD recorder: :

?

-Novice Novice

-Emergency Emergency Medicine

-Emergency Emergency Medicine

-Critical Critical Care

Take Home Message Hx & PEimpression Yes or No

The EndJuice119.pixnet.net [email protected]