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Notfall + Rettungsmedizin

, Volume 18, Issue 6, pp 465–470 | Cite as

Fokussierte Notfallechokardiographie

Must- oder nice-to-have?
  • J. SchmidtEmail author
Leitthema
  • 817 Downloads

Zusammenfassung

Hintergrund

Die bettseitige Diagnostik von kardiorespiratorisch instabilen Patienten ist zeitkritisch und für das weitere erfolgreiche Management von betroffenen Patienten essentiell („golden hour of shock“). Die fokussierte Echokardiographie (Focused Cardiac Ultrasound: FOCUS) ergänzt die körperliche Untersuchung. Sie hilft dem Notfallmediziner, durch die direkte Visualisierung des Herzens rasch behandelbare Ursachen zu identifizieren.

Ergebnisse

Der diagnostische Stellenwert dieser Untersuchungsmethode wird durch interdisziplinäre Empfehlungen internationaler Fachgesellschaften unterstützt. Jeder in der Notfall- und Intensivmedizin tätige Arzt sollte diese Methodik, die auch durch den Nichtkardiologen schnell erlernbar ist, als „must-have“ beherrschen. Die sich auf wenige kardiale Pathologien beschränkenden getroffenen Aussagen sind mit hoher Validität für das weitere therapeutische Management verwertbar. Jedoch müssen die Limitationen der Methodik bekannt sein.

Schlussfolgerung

Die FOCUS ersetzt nicht die ausführliche Echokardiographie des kardiologisch erfahrenen Kollegen, sondern stellt ein „must-have“ in der Erstevaluation für die kritische Notfallsituation dar.

Schlüsselwörter

FOCUS Echokardiographie Ultraschall Notaufnahme Schock 

Focused cardiac ultrasound

must- or nice-to-have?

Abstract

Background

The timely diagnostic evaluation of critically ill patients presenting to the emergency department or the intensive care unit is mandatory for further management of affected patients (golden hour of shock). In addition to a physical examination, rapid focused cardiac ultrasound (FoCUS) is increasingly used to evaluate cardiac function and pathologies.

Results

FoCUS is recommended as a bedside diagnostic tool by international societies in the evaluation and prompt management of patients in shock. A wide range of emergency and critical care specialists should be able to perform this evidence-based cardiac ultrasound technique. The use of FoCUS can be learned relatively easily by expert-guided and subsequent training under supervision. Of note, the accuracy of diagnosing a limited number of critical cardiac pathologies by FoCUS is high even for noncardiologists. However, inherent limitations of FoCUS have to be appreciated.

Conclusion

Thus, FoCUS is a „must-have“ to evaluate the critically ill patient in shock but cannot replace expert-guided comprehensive echocardiography.

Keywords

FoCUS Echocardiography Ultrasonography Emergency department Shock 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

J. Schmidt gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Supplementary material

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Klinik für Innere Medizin 2Klinikum Dritter OrdenMünchenDeutschland

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