eus教學(1)。急診超音波之介紹 & 超音波基本認識
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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TRANSCRIPT
Emergency Ultrasound (EUS)(1) &
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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
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