Need for USG•In critically ill patients physical examination is quite limited and inaccurate•USG has potential to reinvigorate physical examn, improving accuracy•Imp attributes: portability, lack of radiation, repeatability, absence of consumables, being battery powered•Information can be stored for documentation, transmission, consultationCan J Surg 2000;43:207–211Am J Med Sci 1990; 299:175–178Crit Care Med 2006; 34:2153–2157
Whether we should be doing it ???Biltdkillhld btf th•Basic ultrasound skills should be part of the armamentarium of critical care•Far from being competitive or conflicting, it is complementary•Brief (10 hrs) formal training in handheld ECHO system, ii iblfliid TTE i94%dintensivists able to perform limited TTE in 94% and interpreted correctly in 84%- changed management in 37% of patients•ACEP/ SCCM guidelines include USG by intensivistsIntensive Care Med (2008) 34:243–249J Cardiothorac Vasc Anesth 1998; 12:10–15ACEP Emergency Ultrasound Guidelines, 2001
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What is Ultrasound?•Human sensitivity: 20 - 20,000 Hz•Ultrasound: >20,000 Hz•Diagnostic Ultrasound: 2.5 - 14 MHz•Frequency is determined by the sound source only and not by the medium in which the sound isand not by the medium in which the sound is traveling