Včasih je potrebno uporabiti zdravila za umiritev nemirnega zdravnika. Našel sem zelo zanimiv podcast, ki opiše kakšne metode in zdravila uporabljajo drugje po svetu.
After all the recent sono news from the chest, I thought to share this VIP (very important paper) by Volpicelli et al: “International evidence-based recommendations for point-of-care lung ultrasound “. Follow the link to read it all. Below you can find some peds specific bits and pieces.
Neonatology and pediatrics
P-D4-S1 (strong: level B): Lung ultrasound is a clinically useful diagnostic tool in neonates with suspected respiratory distress syndrome (RDS).
P-D4-S2 (strong: level B): All the following sonographic signs are likely to be present in neonates with RDS:
- Pleural line abnormalities
- Absence of spared areas
- Bilateral confluent B-lines
P-D4-S3 (strong: level B): Lung ultrasound is as accurate as chest radiography in the diagnosis of RDS in neonates.
P-D4-S4 (strong: level B): Lung ultrasound is a clinically useful diagnostic tool in suspected transient tachypnea of the newborn (TTN).
P-D4-S5 (strong: level B): The sonographic signs for TTN are bilateral confluent B-lines in the dependent areas of the lung (‘‘white lung’’) and normal or near-normal appearance of the lung in the superior fields.
P-D4-S6 (strong: level B): Lung ultrasound is as accurate as chest radiography in diagnosis of TTN.
P-D4-S7 (strong: level B): Lung ultrasound is a clinically useful diagnostic tool in pediatric patients with suspected pneumonia.
P-D4-S8 (strong: level A): The ultrasound signs of lung and pleural diseases described in adults are also found in pediatric patients.
P-D4-S9 (strong: level A): Lung ultrasound is as accurate as chest radiography in diagnosis of pneumonia in pediatric patients.
In newborns, lung ultrasound signs are similar to those previously described in adults, although these signs will be context specific. Lung ultrasound allows diagnosis of RDS with accuracy similar to CXR even if there is no correlation between the different radiographic stages of RDS and ultrasound findings. Lung ultrasound demonstrates very unique findings in the diagnosis of TTN, whereas CXR is nonspecific.
Many studies showed that the ultrasound signs of lung and pleural diseases described in adults are also found in pediatric patients. In suspected pneumonia, lung ultrasound has demonstrated to be no less accurate than CXR. These data suggest that, when there is clinical suspicion of pneumonia, a positive lung ultrasound excludes the need to perform CXR.
From Facebook and Buenos Aires, Diego Pelayo shares with us probably the best way of goint to surgery:
Doreta Norris, patient with breast cancer, came to operating room by her own foot dancing with her doctors and nurses before being subjected to a double mastectomy in Piedmont Henry Hospital. It was her way of placating the nerves.
Doreta is now cancer free.
You can check out his venous blood gas over at Emergucate's Lab Case 28 here.
|Click to enlarge|
No VAQ of the week this week given we've got a blood gas and an ECG to look at.