急诊超声对于休克患者的鉴别诊断(刘继海).pptx

急诊科医生主导的床旁超声技术在急诊临床中的应用;主要内容;急诊超声技术的开展带来的冲击;急诊超声 vs. 普通超声;急诊超声应用范畴;与医疗质量息息相关;急诊超声有别于传统的超声检查;病例;可能的诊断;RUSH Exam;;Step 1—Evaluation of the Pump;Evaluation of the Pump;Normal subxiphoid;Normal parasternal long;Normal parasternal short;Normal parasternal short at level of aortic valve;Normal apical 4;Normal apical 2;Pericardial effusion;Cardiac tamponade;‘‘Squeeze of the pump’’;Normal parasternal long;Normal parasternal short;An easy system of grading ;Benefits;‘‘Strain of the pump’’;Right Ventricle Strain;Thrombus in RA;Differential Diagnosis;Step 2: Evaluation of the Tank;Evaluation of the Tank;‘‘Fullness of the tank’’;M-mode Doppler;How to determine？;High cardiac filling pressure;Two caveats to this rule exist;‘‘Leakiness of the tank’’;Right upper quatrant;Left upper quadrant;Pelvic free fluid;‘‘Tank compromise’??: pneumothorax;pneumothorax;‘‘Tank overload’’: pulmonary edema;B-lines;Step 3—Evaluation of the Pipes;AAA;Aortic Dissection;Aortic Dissection;‘‘Clogging of the pipes’’: venous thromboembolism;Summary;病例2;急诊超声评估结果（1）;急诊超声评估结果（2）;急诊超声评估结果（3）;急诊超声未来发展方向;急诊医学的明天更美好