Paediatric emergency ultrasound in critically ill children: Can we improve the management?
Institute of Paediatric, Hospital Kuala Lumpur Malaysia
Ultrasound (US) in critically-ill child in PICU has become an invaluable bedside tool; providing important clinical information leading to major impact in patient’s care. It allows immediate assessment of cardiopulmonary assessment. The ultrasound can be carried out quickly, and provides immediate answersto specific clinical queries. The most obvious advantage is ease of repeatability in good hands which proof to be utmost beneficial in critical care setting. The application can be divided into a) Echocardiography: diagnostic and hemodynamic assessment; b) Thoracic/Lung Ultrasound; c) Procedural: vascular cannulation and paracentesis; d) Others: airway, cranial and trans-cranialdoppler ultrasound and abdomen.Bedside-US is also useful when repeatedexaminations are required when assessing response to therapeutic interventions. Inappropriate therapeutic decision made by inadequately trained physicians may cause harm in patients. Hence, it is important that Paediatric Intensivists are well trained at utilizing critical care US. Standardized training and curriculum are important for the practice of point of care of US. There is also need to established appropriate credentialing for the physicians. Critical care US is increasingly in use however, it can neither supersede goodclinical examination nor replace good clinical acumen.
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