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Role of ultrasound nurse in critical care

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Role of ultrasound nurse in critical care

  1. 1. ROLE OF ULTRASOUND NURSE IN CRITICAL CARE Presenter : Jyothis George NIS JPNATC Moderator : Dr. Deepak Aggarwal
  2. 2. INTRODUCTION Ultrasonography has evolved to become one of the most versatile modalities for diagnosing and guiding treatment of critically ill patients.
  3. 3. Point of care This modality is likely useful in resource challenged countries as it is non-invasive, economical, repeatable and can be performed at the bedside
  4. 4. ULTRASOUND-HEAD • Detecting any breakage in scalp, bone injury • To see the MLS or hematoma in post operative decompressive craniotomy patients
  5. 5. ULTRASOUND-HEAD CT view USG view
  6. 6. eyes • used in head injury patients • To detect size, reaction of patients whose eye examination not possible • To detect ONSD –indicator of raised ICP
  7. 7. Orbital ultrasound RACOON EYES USG VIEWED EYE
  8. 8. OPTIC NERVE SHEATH DIAMETER • Increased ONSD correlates with increased ICP • Upper limit of normal ONSD vary with age… – Adults: < 5 mm – Children > 1 Y: < 4.5 mm – Children < 1 Y < 4 mm • ONSD 5 – 5.7 mm: may indicate ICP > 20 mmHg, especially if symptomatic – > 5 mm is 100% sensitive for elevated ICP – All patients with elevated ICP have ONSD > 5mm
  9. 9. NECK- ULTRASOUND • In intubated patients the position of ET tube ,TT tube can be confirmed. • Assist in procedures like percutaneous tracheostomy, CVP line insertion.
  10. 10. Neck-airway
  11. 11. Central vein insertion
  12. 12. Lung- ultrasound • Lung movement, diaphragm, pleura • pneumothorax(absent/diminished lung movement), • hemothorax(presence of fluid), position of chest tube • Early detection of plural effusion(multiple B-lines) and pulmonary edema than x-ray
  13. 13. Lung ultrasound
  14. 14. M- mode—LUNG SCAN BARCODE SIGN SEASHORE SIGN
  15. 15. HEMOTHORAX
  16. 16. Cardiac &hemodynamics • Volume status- indirect measurement of CVP by detecting IVC diameter
  17. 17. IVC Longitudinal – USG view
  18. 18. USG Finding- Normovolemia
  19. 19. USG FINGINGS… hypovolemia
  20. 20. USG FINDINGS… HYPERVOLEMIA
  21. 21. Abdomen and pelvis • Presence of fluid in abdomen
  22. 22. • Urinary retention and amound of urine in bladder
  23. 23. vascular • Vascular – Diagnosing deep venous thrombosis
  24. 24. THERAPEUTIC Pericardiocentesis Bedside Percutaneous nephrostomy Guided arterial and central or peripheral vascular access For guided thoracocentesis and abdominal paracentesis Guided drainage of collections
  25. 25. others detecting fractures and foreign bodies
  26. 26. NURSING ROLE  Ultrasonography is rapid ,easy and repeatable procedure  USG can be used as an alternative non invasive method to other various invasive procedures  So early detection of any abnormal condition is possible by a bed side ultrasound nurse, can be helpful in the management of critically ill patient.

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