Acil Sağlık Hizmetlerinde Ultrason Kullanımı

Halen sayısız durumun teşhis ve tedavisini kolaylaştırmak için kullanılan ultrasonografi (US) teknolojisi, 1940’larda tıp alanına girmiştir. US teknolojisindeki gelişmelerle orantılı olarak tıbbın neredeyse tüm branşlarında giderek yaygınlaşmaktadır. Bu nedenle, hastane öncesi acil sağlık hizmeti sağlayıcıları, hastaların alandan hastaneye nakledilmesi sırasında ambulanslarda bile çoğunlukla küçük boyutlu taşınabilir cihazları rutin olarak kullanmakta, bu da hastaların teşhis ve triyaj süresini azaltıp, hayatta kalma oranlarını nispeten artırmaktadır. Bununla birlikte, gerekli eğitim faaliyetlerinin eksikliğinden dolayı, US cihazlarının uygun şekilde kullanılması, hastane öncesi acil sağlık hizmeti sağlayıcıları için profesyonel bir zorluk teşkil etmektedir. US kullanımını hedefleyen bazı hizmet içi eğitim programları olmasına rağmen, daha işlevsel ve ideal bir yaklaşım, US alanında hem teorik hem de pratik bilgilerin üniversitelerdeki ilgili bölümlerin eğitim müfredatlarına entegre edilmesi olmalıdır. Hastane öncesi alandaki yaşamı tehdit eden koşullara odaklanması beklenen bu türde hazırlanacak olası bir program esas olarak pragmatik olmalıdır.

Ultrasonography Use in Emergency Health Services

Ultrasonography (US) technology, which is currently used to facilitate the diagnosis and treatment of myriad conditions, was introduced into the field of medicine in 1940s. US has been increasingly spreading to nearly all branches of medicine in proportion to the developments in US technology. Therefore, pre-hospital emergency healthcare providers routinely use small size portable devices, even in ambulances, during the transfer of patients from the field to the hospital, which reduces the diagnosis and triage time of the patients and increases the survival rates relatively. However, due to the lack of necessary training activities, proper use of US devices constitutes a professional challenge for pre-hospital emergency healthcare providers. Although there are some in-service training programs targeting the use of US, a more functional and ideal approach should be to integrate both the theoretical and practical knowledge pertaining to US into the educational curricula of the related departments in the universities. A possible program should be mainly pragmatic by focusing on the life-threatening conditions in the pre-hospital area.

PDF

___

Ayar O, Gülsoy U.Ultrasonografi Fiziği. 1st ed. Ankara: Rekmay Basımevi; 2003.
Newman PG, Rozycki GS. The history of ultrasound. Surg Clin North Am. 1998;78:179-195.
Nixdorff U. The inaugurator of transmitted echocardiography: Prof. Dr Wolf-Dieter Keidel. Eur J Echocardiogr. 2009;10:48-49.
Ludwig GD, Struthers FW. Considerations underlying the use of ultrasound to detect gallstones and foreign bodies in tissue. Naval Me dical Research Institute. 1949;4:1-6.
Francis M, Neha P. Historical Timeline of International Events. In: Tintinalli JE, Cameron P, Holliman CJ, editors. EMS a Practical Global Guidebook. 1st ed. USA: People’s Medical Publishing House; 2010. s. 19-38.
Çatak İ. Hastane öncesi alanda ve ambulansta paramediklerin inferior vena kavayı ultrasonla değerlendirme beceri düzeyinin ölçülmesi. Yüksek Lisans Tezi, Selçuk Üniversitesi Sağlık Bilimleri Enstitüsü, 2019.
Goldberg BB, Goodman GA, Clearfield HR. Evaluation of ascites by ultrasound. Radiology. 1970;96:15-22.
Aufschnaiter M, Kofler H. Sonographische Akutdiagnostik beim Polytrauma [Sonographic acute diagnosis in polytrauma]. Aktuelle Traumatol. 1983;13:55-57.
Plummer D. Principles of emergency ultrasound and echocardiography. Ann Emerg Med. 1989;18:1291-1297.
Jehle D, Davis E, Evans T, et al. Emergency department sonography by emergency physicians. Am J Emerg Med. 1989;7:605-611.
Fowler JR. A history of point-of-care ultrasound in emergency medicine. Turkiye Klin Emerg Med-Spec Top. 2018;4:1-4.
Akgür FM, Aktuğ T, Kovanhkaya A, et al. Initial evaluation of children sustaining blunt abdominal trauma: ultrasonography vs. diagnostic peritoneal lavage. Eur J Pediatr Surg. 1993;3:278-280.
American College of Emergency Physicians. Council resolution on ultrasound. ACEP News. 1990;9:11.
Mateer J, Plummer D, Heller M, et al. Model curriculum for physician training in emergency ultrasonography. Ann Emerg Med. 1994;23:95-102.
Rozycki GS. Surgeon-performed ultrasound: its use in clinical practice. Ann Surg. 1998;228:16-28.
Temel Ultrasonografi Kursu https://www.tatdus.org/haber/sivas-7-8-ekim temel-ultrasonografikursu adresinden 21.11.2020 tarihinde edinilmiştir.
Sonoschool https://www.atuder.org.tr/en/menu/31/sono-school adresinden 17.10.2020 tarihinde edinilmiştir.
Lapostolle F, Petrovic T, Lenoir G, et al. Usefulness of hand-held ultrasound devices in out-of-hospital diagnosis performed by emergency physicians. Am J Emerg Med. 2006;24:237-242.
Walcher F, Weinlich M, Conrad G, et al. Prehospital ultrasound imaging improves management of abdominal trauma. Br J Surg. 2006;93:238-242.
Lichtenstein D, Courret JP. Feasibility of ultrasound in the helicopter. Intensive Care Med. 1998;24:1119.
Price DD, Wilson SR, Murphy TG. Trauma ultrasound feasibility during helicopter transport. Air Med J. 2000;19:144-146.
Price WG, Heegaard FW, Franziska B. Ultrasound in Prehospital and Austere Environments. In: Ma O, Mateer J, Blaivas M, editors. Ma and Mateer’s Emergency Ultrasound. 3rd ed. New York: McGraw-Hill Education; 2014. s. 47-60.
Cardinale L, Priola AM, Moretti F, et al. Effectiveness of chest radiography, lung ultrasound and thoracic computed tomography in the diagnosis of congestive heart failure. World J Radiol. 2014;6:230-237.
Volpicelli G, Mussa A, Garofalo G, et al. Bedside lung ultrasound in the assessment of alveolar-interstitial syndrome. Am J Emerg Med. 2006;24:689-696.
Hastane Öncesi Ultrasonografi Eğitimi https://sivasnumunedh.saglik.gov. tr/TR,408635/temel-ultrasonografi-egitimi.html. adresinden 9.9.2020 tarihinde edinilmiştir.
Hastane Öncesi Ultrasonografi Eğitimi http://usg.parhad.org/ankara ultrason-egitimi.php adresinden 12.9.2020 tarihinde edinilmiştir.
O’Dochartaigh D, Douma M, MacKenzie M. Five-year Retrospective Review of Physician and Non-physician Performed Ultrasound in a Canadian Critical Care Helicopter Emergency Medical Service. Prehosp Emerg Care. 2017;21:24-31.
Unlüer EE, Yavaşi O, Kara PH, et al.Paramedic-performed Focused Assessment with Sonography in Trauma (FAST) in the emergency department. Ulus Travma Acil Cerrahi Derg. 2011;17:113-116.
Taylor J, McLaughlin K, McRae A, et al. Use of prehospital ultrasound in North America: a survey of emergency medical services medical directors. BMC Emerg Med. 2014;14:6.
Mura D, Montomoli M, Masellis D, et al. Implementation of prehospital emergency ultrasound: the Sassari prehospital emergency ultrasound project. Crit Ultrasound J. 2014;6:1.
Chin EJ, Chan CH, Mortazavi R, et al. A pilot study examining the viability of a Prehospital Assessment with UltraSound for Emergencies (PAUSE) protocol. J Emerg Med. 2013;44:142-149.
Press GM, Miller SK, Hassan IA, et al. Evaluation of a training curriculum for prehospital trauma ultrasound. J Emerg Med. 2013;45:856-864.
Blanco P, Martínez Buendía C. Point-of-care ultrasound in cardiopulmonary resuscitation: a concise review. J Ultrasound. 2017;20:193-198.
Nelson BP, Chason K. Use of ultrasound by emergency medical services: a review. Int J Emerg Med. 2008;1:253-259.
Nelson BP, Sanghvi A. Out of hospital point of care ultrasound: current use models and future directions. Eur J Trauma Emerg Surg. 2016;42:139-150.
Lewiss RE, Hoffmann B, Beaulieu Y, et al. Point-of-care ultrasound education: the increasing role of simulation and multimedia resources. J Ultrasound Med. 2014;33:27-32.
Ketelaars R, Reijnders G, van Geffen GJ, et al. ABCDE of prehospital ultrasonography: a narrative review. Crit Ultrasound J. 2018;10:17.
Stawicki SP, Howard JM, Pryor JP, et al. Portable ultrasonography in mass casualty incidents: The CAVEAT examination. World J Orthop. 2010;1:10-19.
Breitkreutz R, Price S, Steiger HV, et al. Focused echocardiographic evaluation in life support and peri-resuscitation of emergency patients: a prospective trial. Resuscitation. 2010;81:1527-1533.
Price S, Ilper H, Uddin S, et al. Peri-resuscitation echocardiography: training the novice practitioner. Resuscitation. 2010;81:1534-1539.