Ngokuthuthukiswa kwemithi ephuthumayo kanye nokuthandwa kobuchwepheshe be-ultrasound, i-point-of-care ultrasound isetshenziswe kabanzi emithini ephuthumayo.Ilungele ukuxilongwa okusheshayo, ukuhlolwa okusheshayo kanye nokwelashwa kweziguli eziphuthumayo, futhi isetshenziswe ezimweni eziphuthumayo, ezinzima, ezihlukumezekile, i-vascular, obstetrics, i-anesthesia nezinye izinto ezikhethekile.
Ukusetshenziswa kwe-poc ultrasound ekuxilongweni nasekuhlolweni kwalesi sifo kuye kwanda kakhulu eminyangweni yezimo eziphuthumayo yangaphandle.I-American College of Emergency Physicians idinga ukuthi odokotela basebenzise ubuchwepheshe be-ultrasound obuphuthumayo.Odokotela bezimo eziphuthumayo eYurophu naseJapan basebenzise kakhulu i-poc ultrasound ukusiza ukuxilongwa nokwelashwa.Njengamanje, ukusetshenziswa kwe-poc ultrasound ngodokotela bomnyango wezimo eziphuthumayo e-China akulingani, futhi eminye iminyango yezimo eziphuthumayo yezibhedlela isiqalile ukuqeqesha nokukhuthaza ukusetshenziswa kwe-poc ultrasound, kuyilapho iningi leminyango yezimo eziphuthumayo yezibhedlela lisangenalutho kulokhu.
I-Emergency ultrasound iyisici esilinganiselwe kakhulu sokusetshenziswa kwemithi ye-ultrasound, elula uma kuqhathaniswa, elungele wonke udokotela ophuthumayo ongayisebenzisa.Okufana njengokuthi: ukuhlolwa kokuhlukumezeka, i-aneurysm ye-aorta yesisu, ukusungulwa kokufinyelela kwe-vascular nokunye.
Isicelo sepocultrasound emnyangweni ophuthumayo
1.Ukuhlolwa kokuhlukumezeka
Odokotela bezimo eziphuthumayo basebenzisa i-poc ultrasound ukukhomba uketshezi lwamahhala ngesikhathi sokuhlolwa kokuqala kweziguli ezinesifuba noma ukuhlukumezeka kwesisu.Ukuhlolwa kwe-ultrasound okusheshayo kokuhlukumezeka, kusetshenziswa i-ultrasound ukuthola ukopha kwe-intraperitoneal.Inqubo esheshayo yokuhlolwa isiphenduke indlela ekhethwayo yokuhlolwa okuphuthumayo kokulimala kwesisu, futhi uma ukuhlolwa kokuqala kungalungile, ukuhlolwa kungaphinda kuphindwe njengesidingo somtholampilo.Ukuhlolwa okuqondile kokushaqeka ukopha kubonisa ukopha kwesisu okudinga ukuhlinzwa.Ukuhlolwa kwe-ultrasound okugxilile kokuhlukumezeka okunwetshiwe kusetshenziswa ezigulini ezinokulimala kwesifuba ukuhlola izingxenye ze-subcostal ezihlanganisa inhliziyo kanye nohlangothi lwangaphambili lwesifuba.
2.I-echocardiography eqondiswe kumgomo kanye nokuhlolwa kokushaqeka
Ukuhlolwa kwenhliziyo nge-poc ultrasound kusebenzisa i-echocardiography ehloselwe umgomo, inani elilinganiselwe lemibono evamile ye-echocardiographic, ukuze kube lula ukuhlola okusheshayo kodokotela abaphuthumayo kwesakhiwo senhliziyo nokusebenza ezigulini ezinezinkinga ze-hemodynamic.Ukubuka okuyisihlanu okujwayelekile kwenhliziyo kufaka phakathi i-axis ende ye-parasternal, i-axis emfushane ye-parasternal, amagumbi amane a-apical, amagumbi amane e-subxiphoid, kanye nokubukwa kwe-vena cava ephansi.Ukuhlaziywa kwe-Ultrasound kwama-valve e-mitral kanye ne-aortic kungabuye kufakwe ekuhlolweni, okungakwazi ukuhlonza ngokushesha imbangela yokuphila kwesiguli, njengokungasebenzi kahle kwe-valve, ukwehluleka kwe-ventricular kwesokunxele, nokungenelela kusenesikhathi kulezi zifo kungasindisa impilo yesiguli.
3.I-pulmonary ultrasound
I-pulmonary ultrasound ivumela odokotela abaphuthumayo ukuba bahlole ngokushesha imbangela ye-dyspnea ezigulini futhi banqume ukuba khona kwe-pneumothorax, i-pulmonary edema, i-pneumonia, isifo se-pulmonary interstitial, noma i-pleural effusion.I-ultrasound yamaphaphu ehlanganiswe ne-GDE ingahlola ngempumelelo imbangela nobukhulu be-dyspnea.Ezigulini ezigula kakhulu ezine-dyspnea, i-pulmonary ultrasound inomphumela ofanayo wokuxilonga ku-CT scan yesifuba futhi iphakeme kune-X-ray yesifuba eseceleni kombhede.
4.Ukuvuselelwa kwe-Cardiopulmonary
Ukuboshwa kwenhliziyo yokuphefumula kuyisifo esivamile esiphuthumayo esiphuthumayo.Isihluthulelo sokuhlenga ngempumelelo ukuvuswa kwe-cardiopulmonary ngesikhathi nangempumelelo.I-Poc ultrasound ingadalula izimbangela ezingase zibe khona zokuboshwa kwenhliziyo okubuyisela emuva, njengokuphuma okukhulu kwe-pericardial tamponade, ukuvuleka okukhulu kwe-ventricular kwesokudla nge-massive pulmonary embolism, i-hypovolemia, i-tension pneumothorax, i-tamponade yenhliziyo, kanye ne-infarction enkulu ye-myocardial yokulungiswa kwangaphambi kwesikhathi, futhi inikeza amathuba izimbangela.I-poc ultrasound ingakwazi ukubona umsebenzi wenkontileka yenhliziyo ngaphandle kokushaya kwenhliziyo, ihlukanise phakathi kokuboshwa kweqiniso nokungamanga, futhi iqaphe yonke inqubo phakathi ne-CPR.Ngaphezu kwalokho, i-poc ultrasound isetshenziselwa ukuhlola indlela yomoya ukusiza ukuqinisekisa indawo ye-tracheal intubation nokuqinisekisa ukungena komoya owanele kuwo womabili amaphaphu.Esigabeni se-post-resuscitation, i-ultrasound ingasetshenziselwa ukuhlola isimo somthamo wegazi kanye nokuba khona kanye nobukhulu bokungasebenzi kahle kwe-myocardial ngemva kokuvuselela.Ukwelashwa okufanelekile okuketshezi, ukungenelela kwezokwelapha noma ukusekelwa kwemishini kungase kusetshenziswe ngokufanele.
5.Ukwelashwa kokubhoboza okuqondiswa yi-Ultrasound
Ukuhlolwa kwe-Ultrasonic kungabonisa ngokucacile ukwakheka kwezicubu ezijulile zomzimba womuntu, kutholakale ngokunembile izilonda futhi kubheke izinguquko eziguquguqukayo zezilonda ngesikhathi sangempela ukuze kugwenywe izinkinga ezingathi sína, ngakho-ke kwavela ubuchwepheshe bokubhoboza okuqondiswa yi-ultrasound.Njengamanje, ubuchwepheshe bokubhoboza obuqondiswa yi-ultrasound busetshenziswe kabanzi emisebenzini yomtholampilo futhi buye baba isiqinisekiso sokuphepha semisebenzi ehlukahlukene ehlaselayo yasemtholampilo.I-Poc ultrasound ithuthukisa izinga lempumelelo yezinqubo ezihlukahlukene ezenziwa odokotela bezimo eziphuthumayo futhi inciphisa izehlakalo zezinkinga, njenge-thoracopuncture, i-pericardiocentesis, i-anesthesia yesifunda, i-lumbar puncture, ukufakwa kwe-catheter ye-venous ephakathi, umthambo onzima we-peripheral kanye nokufakwa kwe-venous catheter, ukusika nokuphuma kwesikhumba. amathumba, ukubhoboza ngokuhlanganyela, nokuphathwa kwendlela yomoya.
Ukukhuthaza okwengeziwe ukuthuthukiswa kwezimo eziphuthumayopoci-ultrasound eChina
Ukusetshenziswa kwe-poc ultrasound emnyangweni wezimo eziphuthumayo e-China kunesisekelo sokuqala, kodwa kusadingeka kuthuthukiswe futhi kwandiswe.Ukuze kusheshiswe ukuthuthukiswa kwe-poc ultrasound yezimo eziphuthumayo, kuyadingeka ukuthuthukisa ukuqwashisa kodokotela bezimo eziphuthumayo nge-poc ultrasound, ukufunda ekuhlangenwe nakho okuvuthiwe kokufundisa nokuphatha phesheya, nokuqinisa nokumisa ukuqeqeshwa kobuchwepheshe be-ultrasound obuphuthumayo.Ukuqeqeshwa kumasu we-ultrasound eziphuthumayo kufanele kuqale ngokuqeqeshwa kwabahlali abaphuthumayo.Khuthaza umnyango wezimo eziphuthumayo ukuthi umise ithimba lodokotela be-poc ultrasound ezimeni eziphuthumayo futhi usebenzisane nomnyango wezithombe ze-ultrasound ukuze uthuthukise ikhono lomnyango lokusebenzisa i-ultrasound.Ngenani elikhulayo lodokotela bezimo eziphuthumayo abafunda futhi basebenzise ubuchwepheshe be-poc ultrasound, kuzothuthukisa ukuthuthukiswa kwe-poc ultrasound yezimo eziphuthumayo e-China.
Esikhathini esizayo, ngokubuyekezwa okuqhubekayo kwemishini ye-ultrasound kanye nokuthuthukiswa okuqhubekayo kobuchwepheshe be-AI ne-AR, i-ultrasound efakwe ngokufinyelela okwabelwana ngayo ngamafu kanye namakhono e-telemedicine izosiza odokotela bezimo eziphuthumayo benze kangcono.Ngesikhathi esifanayo, kuyadingeka ukuthuthukisa uhlelo olufanele oluphuthumayo lokuqeqeshwa kwe-poc ultrasound kanye nesitifiketi esihlobene nesiqu esisekelwe ezimweni zangempela zezwe laseChina.
Isikhathi sokuthumela: Dec-15-2023
