9 Feb 2020

병상 초음파 검사는 소아 응급의료 진료에 기본이다, Bedside ultrasound examination in the pediatric emergency department is essential tests

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  • 요즘 응급실에서 환자를 진료할 때 병력을 들어보고 시진, 촉진, 청진, 타진 등의 결과를 종합해 병을 진단할 수도 있하지만 병상 초음파 검사를 이용해 더 효과적으로 진단할 수 있다.
  • 소아과 진료에도 병상 초음파 검사가 거의 기본으로 이용할 수 있다.
  • 소아 응급의료 진료를 할 때 다음과 같은 진료 영력에서 병상 초음파 검사를 이용할 수 있다. 그러나 병상 초음파 검사에 한정성이 있고 더 많은 연구가 필요하다고 한다.
    • 각종 외상–혈종, 복강 내 체액 우무, 복강 내 고형장기 상처, 비장 열상, 간장 열상, 복강 내 출혈 유무, 횡격막 손상, 복강 내 해부, 맹장염,
    • 임신–임신 여부, 자궁 내 임신, 자궁 외 임신, 골반강 내 통증, 질강 내 출혈, 사춘기 여아들의 골반 통증,
    • 복부 대동맥 동맥류.
    • 심장 초음파 검사–심막 액,
    • 간 담관 질환–담석,
    • 비뇨 생식기–수신증,
    • 진료시술– 정맥 주사, 정맥 카테터 삽입, 방광내 카세타,
    • 농양 배농,
    • 피하 이물 제거,
    • 중심 정맥 접근,
    • 뇌척수액 천자,
    • 피하에 있는 고무, 플라스틱, 나무, 가시, 유리, 금속 등 이물질,
    • 연조직 심부 정맥혈전,
    • 연조직 생긴 감염병, 이물질,
    • 골절,
    • 기흉,
    • 안과– 시신경 상태, 망막 박리,
    • 혈액 량 및 탈수 평가,
    • 장 중첩증, 유문 협착증,
    • 그 외

Bed ultrasound examination is fundamental to pediatric emergency medical care.

Bedside ultrasound examination in the pediatric emergency department is essential tests posted in:
These days, when treating a patient in the emergency room, it is possible to diagnose the disease by the results of physical examination such as palpation, auscultation, visual examination, tasting, smelling, and percussion, and listening to the medical history.
Bed ultrasound also can be used almost as a basis for pediatric care.
When performing pediatric emergency medical care, bed ultrasound can be used in the following medical capabilities.
However, it is said that bed ultrasound examination is limited and more research is needed.
  • Various trauma-hematoma,
  • fluid in the abdominal cavity,
  • solid organ wounds in the abdominal cavity,
  • spleen lacerations,
  • liver lacerations,
  • presence of intraperitoneal bleeding,
  • diaphragm injury,
  • intraperitoneal dissection,
  • appendicitis,
  • Pregnancy–pregnant status,
  • intrauterine pregnancy,
  • ectopic pregnancy,
  • pain in the pelvic cavity,
  • bleeding in the vaginal cavity,
  • pelvic pain in adolescent girls,
  • Abdominal aortic aneurysm.
  • Echocardiography-pericardial fluid,
  • Hepatobiliary disease–gallstones,
  • Genitourinary tract-nephropathy,
  • Treatment procedures-intravenous injection,
  • intravenous catheterization,
  • intravesical case,
  • Abscess drainage,
  • Removal of subcutaneous foreign bodies,
  • Central venous access,
  • Cerebrospinal fluid puncture,
  • Foreign substances such as rubber,
  • plastic, wood,
  • thorns, glass, metal, etc. under the skin,
  • Soft tissue deep vein thrombosis,
  • Infectious diseases,
  • foreign substances in soft tissues,
  • Fracture,
  • Pneumothorax,
  • Ophthalmology – optic nerve condition, retinal detachment,
  • Assessment of blood volume and dehydration,
  • Intestinal volvulus,
  • pyloric stenosis,
  • etc

출처 및 참조 문헌 Sources and references

  • NelsonTextbook of Pediatrics 22ND Ed
  • The Harriet Lane Handbook 22ND Ed
  • Growth and development of the children
  • Red Book 32nd Ed 2021-2024
  • Neonatal Resuscitation, American Academy Pediatrics
  • Contemporary pediatrics 4 2011
  • Siegel MJ, ed. Pediatric Sonography 4th Ed. Philadelphia: Lippincott Williams & Wilkins, 2011
  • Fox JC et al. Prospective evaluation of emergency physician performed bedside ultrasound to detect acute appendicitis. Eur J Emerg Med 2008; 15(2): 80-85 60
  • Division of Emergency Medicine, Children’s Hospital Boston, Boston, Massachusetts 02115, USA. jason.levy@childrens.harvard.edu.
  • Emergency Medical Service for Children, By Ross Lab. May 1989. p.10
  •  Emergency care, Harvey grant, and Robert murray• Emergency Care Transportation of Sick and Injured American  Academy of Orthopaedic Surgeons
  •  Emergency Pediatrics A Guide to Ambulatory Care, Roger M. Barkin, Peter Rosen
  •  Quick Reference To Pediatric Emergencies, Delmer J. Pascoe, M.D., Moses Grossman, M.D. with 26 contributors
  • Manual of Emergency Care 응급환자관리 정담미디어
  • 소아가정간호백과-부모도 반의사가 되어야 한다, 이상원 저
  • The pregnancy Bible. By Joan stone, MD. Keith Eddleman, MD
  • Preparation for Birth. Beverly Savage and Dianna Smith
  • 임신에서 신생아 돌보기까지.  이상원
  • Breastfeeding. by Ruth Lawrence and Robert Lawrence
  • Nelson Textbook of Pediatrics 14th ed. Beherman,
  • The Johns Hopkins Hospital, The Harriet Lane Handbook, 18th edition
  • Red book 29th edition-31st 2021
  • Nelson Text Book of Pediatrics 19th-21st Edition
  • Infectious disease of children, Saul Krugman, Samuel L Katz, Ann A. Gershon, Catherine Wilfert
  • The Harriet Lane Handbook 19th Edition
  • Growth and Development of Children, George H. Lowrey 8th edition
  • 소아과학 대한교과서
  • 제1권 소아청소년 응급의료 참조문헌과 출처
  • Other 

Copyright ⓒ 2015 John Sangwon Lee, MD., FAAP

“부모도 반의사가 되어야 한다”-내용은 여러분들의 의사로부터 얻은 정보와 진료를 대신할 수 없습니다.

“The information contained in this publication should not be used as a substitute for the medical care and advice of your doctor. There may be variations in treatment that your doctor may recommend based on individual facts and circumstances. “Parental education is the best medicine.”