Utilizing ultrasound during a cardiac resuscitation can be difficult to implement and interpret. In this video we will review a case that was difficult to interpret due to the pathological findings.
Remember the binary questions when interpreting any cardiac ultrasound:
1 - Is there cardiac motion?
2 - Is the global function normal?
If the global function is not normal is it:
2a - Hyperdynamic?
2b - Depressed?
2c - Severely depressed?
3 - Is there fluid surrounding the heart (Pericardial effusion)?
3a - Is there a pericardial effusion is there diastolic collapse of the RA or RV free wall?
4- Do any the chambers of the heart appear NOT to be of normal size?
5 - Is the IVC collapsed?
5a - If not is there respiratory variation with greater than 50% collapse?
6 - Anything else?
In this video we will see sonographic views showing cardiac standstill (systole) with a clotted hemopericardium.
Very good! Thanks
Thanks, you rock!!!
Would maybe have been easier to see if less gain. However, clotted blood like that can fool you. At first glance at the still, I thought "enlarged RV, septal hypertrophy" But following the effusion on the video is what makes it clearer. Very good teaching case! As to the comment about that being stomach, I think that is less likely, due to the tissue homgeneity at the diaphragm. The anechoic areas were likely refluxed blood due to collapsed RV from the hemopericardium. The one thing I would say about this case is that it demonstrates the need for very rapid POCUS. I took care of a Marine shot through the heart with large hemopericardium, and in that case, we were able to aspirate a lot of it. That being said, if it doesn't occur in a trauma center, it won't change outcome to aspirate it probably, because they just bleed more.
Thank you
Дякую. Гарний приклад прикроватного використання УЗД
Thnks
Tranks a lot for this Video, but i think that structur above the pericardium is Stomach und not the Liver.
👍👌