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Opinie ratowników medycznych o możliwości wykorzystania badania ultrasonograficznego w zespołach ratownictwa medycznego

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Bujnowska M., Zakrzewska-Blusiewicz M.
Zeszyty Naukowe Państwowej Wyższej Szkoły Zawodowej im. Witelona w Legnicy
|
2017
|
issue 3(24)
PL
Badanie ultrasonograficzne w diagnostyce przedszpitalnej w Polsce jest właściwie niewykorzystywane ze względu na brak odpowiednich aktów prawnych zobowiązujących do posiadania aparatów USG w zespołach ratownictwa medycznego oraz ze względu na brak odpowiednich szkoleń. W USA oraz Europie Zachodniej USG standardowo wykorzystuje się w celu identyfikacji i diagnostyki odwracalnych przyczyn zatrzymania krążenia. Celem pracy była analiza przydatności badania ultrasonograficznego w warunkach przedszpitalnych na podstawie opinii ratowników medycznych pracujących w Zespołach Ratownictwa Medycznego. Do badań włączono 68 ratowników medycznych pracujących w pięciu stacjach pogotowia ratunkowego. Badania przeprowadzono za pomocą autorskiej ankiety. Wyniki pokazują, że ratownicy medyczni byliby skłonni do podjęcia szkolenia w zakresie protokołów ultrasonograficznych przydatnych w medycynie ratunkowej jedynie w sytuacji pozyskania na ten cel środków zewnętrznych. Za przydatne w ocenie ultrasonograficznej uznali cztery elementy składające się na badanie w protokole eFAST: ujawnienie płynu w jamie otrzewnowej oraz jamach opłucnowych, potwierdzenie odmy opłucnowej i ujawnienie wolnego płynu w worku osierdziowym (tamponady osierdzia). Elementy badania echokardiograficznego ( protokoły FATE, FEEL) zostały uznane za nieprzydatne, podobnie jak potwierdzenie za pomocą ultrasonografii położenia rurki intubacyjnej i teletransmisja obrazów ultrasonograficznych.
EN
Ultrasound diagnosis in pre-hospital treatment in Poland is virtually non-existent because of the lack of relevant legislation obliging emergency medical teams to have ultrasound pocket machines and due to the lack of proper training. In the US and Western Europe, USG is normally used for identification and diagnosis of reversible causes. The aim of this study was to evaluate the usefulness of ultrasound in pre-hospital treatment based on the results of a survey conducted among paramedics working in Medical Rescue Teams. The study included 68 medical rescuers working in five emergency stations. The study was conducted using a proprietary questionnaire. Conclusions. The results show that the paramedics would only be willing to undertake training in the field of ultrasound protocols useful in emergency medical treatment in the case of obtaining funds for that purpose from some external sources. They recognize four elements of the study protocol Efast, which include disclosure of fluid in the peritoneal and pleural cavities, confirmation of pneumothorax and disclosure of free fluid in the pericardial sac (pericardial tamponade), to be useful for ultrasound evaluation. Echocardiographic elements (FATE and FEEL protocols) are considered as useless, similarly to confirmation by ultrasound endotracheal tube position and telematics ultrasound images.
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Evaluating the diagnostic accuracy of ultrasonography in differential diagnosis of adnexal tumours

100%
Smoleń A., Stachowicz N., Czekierdowski A.
Family Medicine & Primary Care Review
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2016
|
issue 3
340-344
3
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Simplified vs modified (reduced) ultrasound 6 joint score in assessing disease activity in rheumatoid arthritis patients

100%
Gabal M. M. A., Eldin A. B., Elserwy M. A., Mohammed M. A.
European Journal of Clinical and Experimental Medicine
|
2024
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vol. 22
|
issue 1
36-44
EN
Introduction and aim. With increasing ultrasound US assessment opportunities for tight rheumatoid arthritis (RA) management, more simplified accurate US-assessment is desired in clinical practice. Aim of the work is assessing modified vs simplified ultrasound 6-joint scores relevance in assessing rheumatoid arthritis disease activity. Material and methods. Fifty-five RA patients were subjected to detailed history, clinical, and musculoskeletal examination with disease activity assessment by clinical disease activity index, simple disease activity index and disease activity score in 28 joints. Complete blood count, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, anti-cyclic citrullinated peptide antibodies were done. Patients underwent US examination (gray-scale and power Doppler) for wrist, 2nd and 3rd metacarpophalangeal and knee joints bilaterally. Synovitis composite score was added. Two US indices were constructed: simplified S6 and modified M6 joint scores. Results. Statistical significant positive correlations were high between S6/M6 score parameters (total, grey-scale (GS), power doppler (PD), Composite) and disease activity markers. Both M6 and S6 scores differentiated mild-moderate and moderate-severe disease activity patients. However, only S6 score differentiated remission from mild disease activity patients. Conclusion. Ultrasound 6-joint scores (especially simplified S6) were rapid, easy and sensitive ultrasound tools assessing rheumatoid arthritis disease activity in clinical practice.
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