Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI; Survival Flight, University of Michigan Health, Ann Arbor, MI.
Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI.
Air Med J. 2024 Sep-Oct;43(5):445-449. doi: 10.1016/j.amj.2024.04.001. Epub 2024 Jun 8.
The use of bedside ultrasound imaging has become a valuable tool in emergency medicine, and its use in the transport environment is increasing. Survival Flight, the critical care transportation program at University of Michigan/Michigan Medicine, began to train flight nurses in its use beginning in 2014. Nurses were trained during mandatory training sessions, with different skills and interpretations gradually added. Nurses who have been trained in procedures such as pericardiocentesis are empowered to use that training to perform procedures via online or, if necessary, offline medical direction. The Butterfly IQ+ devices are currently utilized. Pericardiocentesis can be a lifesaving procedure for pericardial tamponade. However, its use in relieving tamponade caused by thoracic aortic dissection remains controversial due to the possibility of worsening the dissection with restoration of more normal blood pressure. We report 2 cases of in-transport, ultrasound-guided pericardiocentesis for 2 patients with tamponade caused by type A aortic dissection and discuss its use in this clinical situation.
在急诊医学中，床边超声成像已成为一种有价值的工具，其在转运环境中的应用也在不断增加。密歇根大学/密歇根医学的危重症转运项目“生存飞行”（Survival Flight）于 2014 年开始培训飞行护士使用这项技术。护士在强制性培训课程中接受培训，逐渐增加不同的技能和解释。经过心包穿刺术等程序培训的护士有权使用该培训通过在线或必要时的离线医疗指导来进行操作。目前使用的是 Butterfly IQ+设备。心包穿刺术在心包填塞时可作为一种救生程序。然而，由于恢复更正常的血压可能使夹层恶化，其在缓解因胸主动脉夹层引起的填塞中的应用仍存在争议。我们报告了 2 例在转运过程中，对 2 例因急性主动脉夹层导致填塞的患者进行超声引导下心包穿刺术的病例，并讨论了其在这种临床情况下的应用。
