Ecocardiografia em urgência (original) (raw)
Related papers
Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, 1999
Echocardiography performed in the emergency department must adapt to this new setting for noninvasive diagnostic testing. Emergency physicians require echocardiography to provide rapid diagnosis in life-threatening emergencies. New initiatives are being proposed by emergency physicians in the delivery of this test. Cardiologists now use echocardiography in the emergency-department to make the diagnosis of heart disease earlier and with greater accuracy.
An audit of emergency echocardiography in a district general hospital
International Journal of Cardiology, 1993
Eighty patients (43 M, 37 F), aged 23-89 years who were referred for emergency echocardiography over a 12-month period were prospectively studied in order to determine the reasons for emergency echocardiography and the influence of its results on patient management. The most frequent emergency request was to clarify whether the basis for cardiomegaly in a haemodynamically unstable patient was pericardial effusion or left ventricular dilatation. Other reasons for requests were for assessment for source of systemic emboli, acute complications of myocardial infarction, endocarditis, valve dysfunction and cardiac trauma. As a consequence of the emergency echocardiography. management was immediately influenced in 19 patients. This study has provided information on the specific settings in which emergency echocardiography can be justified.
Performance of emergency physicians in point-of-care echocardiography following limited training
Emergency Medicine Journal, 2014
Objectives The aim of this study was to evaluate if emergency medicine trainees with a short duration of training in echocardiography could perform and interpret bedside-focused echocardiography reliably on emergency department patients. Methods Following a web-based learning module and 3 h of proctored practical training, emergency medicine trainees were evaluated in technical and interpretative skills in estimating left ventricular function, detection of pericardial effusion and inferior vena cava (IVC) diameter measurements using bedside-focused echocardiography on emergency department patients. An inter-rater agreement analysis was performed between the trainees and a board-certified cardiologist. Results 100 focused echocardiography examinations were performed by nine emergency medicine trainees. Agreement between the trainees and the cardiologist was 93% (K=0.79, 95% CI 0.773 to 0.842) for visual estimation of left ventricular function, 92.9% (K=0.80, 95% CI 0.636 to 0.882) for quantitative left ventricular ejection fraction by M-mode measurements, 98% (K=0.74, 95% CI 0.396 to 1.000) for the detection of pericardial effusion, and 64.2% (K=0.45, 95% CI 0.383 to 0.467) for IVC diameter assessment. The Bland-Altman limits of agreement for left ventricular function was −9.5% to 13.7%, and a Pearson's correlation yielded a value of 0.82 (p<0.0001, 95% CI 0.734 to 0.881). The trainees detected pericardial effusion with a sensitivity of 60%, specificity of 100%, positive predictive value of 100% and negative predictive value of 97.9%. Conclusions Emergency medicine trainees were found to be able to perform and interpret focused echocardiography reliably after a short duration of training.
Echocardiography Services: An Overview
ARQUIVOS BRASILEIROS DE CARDIOLOGIA - IMAGEM CARDIOVASCULAR, 2015
Introduction: Due to an increasing growth in the number of echocardiographists in Brazil, as well as in echocardiography services, it has become paramount understanding the status quo of this practice in our country. Objective: Perceive an accurate profile of echocardiographic services offered in Brazil. Methods: A survey was carried out through the Internet with members from the Departament of Cardiovascular Imaging. They answered specific questions about infrastructure, services provided, number of tests, training and professional qualification. Results: Among the 429 participating centers, only those that answered the whole questionnaire were taken into account (n = 157). Of these 157 centers, 55 offer specialized training in echocardiography, and most of them is located in the Brazilian southeastern region. It was observed that 146 services (93%) have at least one professional certified in echocardiography by the Departament of Cardiovascular Imaging of the Brazilian Society of Cardiology. Conclusion: Most echocardiography centers in Brazil have professionals qualified and trained to perform the method.
Echocardiography in Different Clinical Situations Appropriate use to do Better
Journal of Cardiology & Cardiovascular Therapy, 2019
In the last 5 decades the utilization of ultrasound has greatly developed into echocardiography, generating a confused picture of the echocardiographic technique, with patients who do not always receive the right echocardiogram. Previous publications have reported a proposal for reclassification of Echocardiography based on function, competence, applications, proper machines and purposes is intended to give a coherent and adequate definition of requirements, in order to have appropriate use of the technique related to place where it is used, the clinical situation, the related function, the information expected, the exam indications and the educational pathway and requirements for the accreditation of the operators and echo-labs. In this paper we revisit these proposals emphasizing the importance to use echo properly and appropriately as well as the need to acquire accreditation through a defined educational pathway and training and the possibilities to use it widely in different clinical conditions.
Uso da ecocardiografia à beira do leito no cuidado do paciente grave - Parte 1
Jornal Brasileiro de Medicina de Emergência, 2023
The use of echocardiography by physicians who are not echocardiographers has become common throughout the world across highly diverse settings where the care of acutely ill patients is provided. Echocardiographic evaluation performed in a pointof-care manner can provide relevant information regarding the mechanism of causes of shock, for example, increasing the rates of correct diagnosis and allowing for faster informed decision-making than through evaluation methods. Considering that the accurate diagnosis of life-threatening situations is essential for professionals working with acutely ill patients, several international associations recommend that physicians responsible for critically ill patients acquire and develop the ability to perform bedside ultrasound examinations, including echocardiographic examinations. However, there is no consensus in the literature regarding which specific applications should be included in the list of skills for nonechocardiographer physicians. Taking into account the multiplicity of applications of echocardiography in different scenarios related to acutely ill patients; the differences in the published protocols, with regard to both the teaching methodology and competence verification; and the heterogeneity of training among highly diverse specialties responsible for their care at different levels, this consensus document aimed to reflect the position of representatives of related Brazilian medical societies on the subject and may thus serve as a starting point both for standardization among different specialties and for the transmission of knowledge and verification of the corresponding competencies.
Use of the cardiac ultrasound at emergency room for general physicians
Revista Médica de Risaralda, 2021
Ultrasonography at the Emergency Room (ER) becomes a useful tool for emergency doctors, especially when they need to attend to diseases that require faster treatment. This is an ideal non-invasive exam which is cheap and can be implemented in real time to obtain instantly the missing information. The quick recognition of the causes of the cardiac instability will lead to better results for conditions such as cardio-pulmonary resuscitation (CPR). The aim of this article is to show the usefulness of cardiac ultrasonography and to briefly teach general practitioners at ER about it.
American Journal of Emergency Medicine, 2014
To determine the ability of emergency physicians to detect complex abnormalities on point-ofcare (POC) echocardiograms. Methods: Single-blinded, nonrandomized, cross-sectional study. Twenty-five different emergency medicine clinical scenarios (video clips and digital images) covering a variety of echocardiographic abnormalities were presented to a group of emergency physician sonologists. The echocardiographic abnormalities included right ventricular dysfunction, left ventricular systolic dysfunction, diastolic dysfunction, regional wall motion abnormalities, Doppler abnormalities of pericardial tamponade physiology, left ventricular hypertrophy, hypertrophic cardiomyopathy, and aortic abnormalities. All emergency physician sonologists were blinded to the study hypothesis. They reviewed echocardiography video clips and images individually, and their interpretations were compared with the criterion standard (expert echocardiographer interpretations). Results: A total of 200 echocardiography studies (video clips and images) were independently reviewed by 8 emergency physician sonologists with varying POC echocardiography experiences. Emergency physicians accurately identified left ventricular systolic dysfunction 94% of the time, diastolic dysfunction (100%), and right ventricular dysfunction 80% of the time. Regional wall motion abnormalities were detected only 50% of the time. Doppler echocardiographic abnormalities of pericardial tamponade physiology were accurately identified 57% of the time. Emergency physicians who performed more than 250 POC echocardiograms were found to be more accurate in identifying complex echocardiographic abnormalities. Conclusions: Our study results suggest that with increased experience, emergency physicians can accurately identify most of complex echocardiographic abnormalities.