Emergency Medicine, Nepean Hospital, Sydney, New South Wales, Australia.
Emergency Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Emerg Med Australas. 2020 Aug;32(4):694-696. doi: 10.1111/1742-6723.13546. Epub 2020 Jun 16.
Lung ultrasound (LUS) plays a critical role in the SARS-CoV-2 pandemic. Evidence is mounting on its utility to diagnose, assess the severity and as a triage tool in the ED. Sonographic features correlate well to computed tomography (CT) chest findings and a bedside LUS performed by a trained clinician along with clinical examination, could be an alternative to chest X-ray and CT chest in these highly infectious patients. In this article, we have described a step-by-step approach to LUS in COVID patients and the CLUE (COVID-19 LUS in the ED) protocol, which involves an anatomical parameter, the severity of lung changes, objectively scored using the validated LUS scoring system and a physiological parameter, oxygen requirement. We believe this CLUE protocol can help risk-stratify patients presenting to ED with suspected COVID-19 and aid clinicians in making appropriate disposition decisions.
肺部超声(LUS)在 SARS-CoV-2 大流行中发挥着关键作用。越来越多的证据表明,它可用于诊断、评估严重程度,并作为急诊科的分诊工具。超声特征与计算机断层扫描(CT)胸部检查结果密切相关,经过培训的临床医生在床边进行 LUS 检查,结合临床检查,可能替代高度传染性患者的胸部 X 线和 CT 胸部检查。在本文中,我们描述了一种针对 COVID 患者的 LUS 逐步方法和 CLUE(急诊科 COVID-19 LUS)方案,该方案涉及一个解剖参数,即使用经过验证的 LUS 评分系统客观评分的肺部变化严重程度,以及一个生理参数,即氧气需求。我们相信,这个 CLUE 方案可以帮助风险分层急诊科中出现 COVID-19 疑似症状的患者,并帮助临床医生做出适当的处置决策。