TAILIEUCHUNG - General ultrasound In the critically ill - part 10

Kém nhồi máu cơ tim, tràn khí màng phổi, tràn dịch màng phổi hoặc viêm phổi có thể đôi khi gây nhầm lẫn và đề xuất các trường hợp khẩn cấp phẫu thuật bụng. Mỗi Tất cả trong tất cả, mặc dù khái niệm này là không thường xuyên | 178 Chapter 28 Analytic Study of Frequent and or Severe Situations Thoracic Disorders with Abdominal Expression Inferior myocardial infarct pneumothorax pleural effusions or pneumonia can sometimes mislead and suggest surgical abdominal emergencies. Each of these diagnoses can be handled by ultrasound. Exploration of a Thoracic Pain Pain is assumed to be intense since the patient is managed by the intensivist. Aortic aneurysm aortic dissection pericarditis myocardial infarct and esophageal rupture give characteristic ultrasound signs as well as the thoracic disorders seen above pneumothorax pleural effusion pneumonia . Ultrasound Exploration of Acute Dyspnea ultrasound exploration of acute dyspnea is not yet routine. All the skill of the operator is required here since the examination performed in a distressed patient should neither delay nor mislead the treatment. This assumes an on-site ultrasound device a small one not too small adapted to the emergency. Obviously the operator must be experienced. These points assembled little time is lost. If no time must be lost ultrasound examination can be performed instead of the physical and radiographic examinations possibly saving time. Therefore regardless of clinical and even radiological data which are sometimes precious but other times misleading ultrasound provides objective data that allow the physician to identify the cause of the dyspnea by detecting Pneumothorax Acute pulmonary edema Cardiogenic or lesional origin of pulmonary edema Substantial pleural effusion Alveolar consolidation Atelectasis Pulmonary embolism Pericardial tamponade Exacerbation of a chronic obstructive pulmonary disease Obstacle visible at the cervical trachea Acute gastric dilatation Acute hypovolemia with the cause identified at the same time digestive fluid sequestration internal hemorrhage A nude profile sometimes seen in dyspnea accompanying sepsis with possibly ultrasound-visible site of sepsis or metabolic acidosis All in all although

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