Masui. The Japanese journal of anesthesiology
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Patients with cardiac disease have high mortality rates, mainly owing to shock. Therefore, evaluation of cardiac function is one of the most challenging issues in the intensive and critical care unit. Cardiac point-of-care tests using ultrasound, such as focus assessed transthoracic echo (FATE) and rapid ultrasound in shock (RUSH). are useful for diagnosis and initial care of such patients. ⋯ A simple measurement method is described to evaluate the left and right ventricular function using mitral annular plane systolic excursion (MAPSE), mitral septal separation (MSS), and tricuspid annular plane systolic excursion (TAPSE). Next the RUSH protocol is discussed, which is useful for evaluation and care of patients with hypovolemic, cardiogenic, obstructive, or distributive shock. RUSH involves evaluation of the three main components : the pump (cardiac function, volume, pericardial function), the trunk (inferior vena cava, pleural fluid, lining), and the pipes (abdominal aneurysm, aortic dissection, deep vein thrombosis).
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Historical Article
History of Resuscitation :4. Development of Resuscitation in the Mid-18 Century-4 : External Stimulation to the Body.
From the mid-18th century, several different stimulations were used to attempt to resuscitate apparently dead people. These include sound, smell, and light stimulation to the ear, nose and eyes, rubbing the body surface and spirit given to the oral cavity. ⋯ Galvani. Charles Kite developed the first electrical machine to stimulate the heart, and by 1800, it was found that the most effective site for applying electricity was over the heart.
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Point-of-care ultrasonography has become widely used in diagnosis and managements of patients. In the field of anesthesiology, ultrasound guided nerve blocks and central venous catheterization (CVC), and transesophageal echocardiography (TEE) have become popular. Now, ultrasound devices are familiar to anesthesiologists. ⋯ Because of less invasive technique, whole body ultrasound evaluation is suitable to use when anesthesiologists may have questions whether the patient's condition is good or not. No doubt that point-of-care ultrasonography by anesthesiologists themselves in pre-anesthesia. clinic can be the useful decision making tool of anesthesia plan. To be tomorrow's anesthesiologists, please start point-of-care pre-anesthetic ultrasonographic assessment.
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The evaluation of the lung has usually been considered off-limits for ultrasound, because ultrasound energy is rapidly dissipated by air. Lung ultrasound is not useful for the evaluation of the pulmonary parenchyma and the pleural line. However ultrasound machines have become more portable, with decreased start-up time, while simultaneously providing improved image quality and ease of image acquisition. ⋯ Since lung ultrasound abnormalities, however, are well defined and easy to recognize, learn and reproduce, operator dependence is minimal. So let's try lung ultrasound. In this article, the author will discuss the examination method for adequate lung ultrasonographic images, lung ultrasonographic findings and signs, leading to the diagnosis.
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Historical Article
History of Tracheal Intubation :5. Use for Resuscitation in Neonates.
In the 18th century, tracheal intubation was introduced to clinical practice, mainly in patients with airway obstruction in children due to diphtheria, and in patients who were apparently dead. In this article, I describe the fourth reason for tracheal intubation :a newborn with apnea. ⋯ Jean Anne Henri Depaul (1811-1883), Heinrich Alexander Pagenstecher (1825-1889), and Alban Alphonse Ambroise Ribemont-Dessaignes (1847-1940) intubated the trachea. Tracheal intubation might have been widely performed by midwives, because Chaussier had educated them at his school.