Praxis
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Biography Historical Article
[Figures in the history of medicine. Virginia Apgar].
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Point-of-care lung ultrasound represents an emerging and useful technique in the management of pulmonary diseases. For many years, thoracic ultrasonography was limited to the study of pleural effusion and thoracic superficial masses because alveolar air and bones of the thoracic cage limit the propagation of the ultrasound beam. Only recently has been highlighted that, by the fact, lung ultrasound works like a real densitometer that is highly sensitive to variations of the pulmonary content and balance between air and fluids. ⋯ Sonography is useful in the diagnostic process of lung diseases where the alveolar air is reduced and interstitial fluids are increased, but also when air or fluids are collected in the pleural space. This article analyzes the basic principles of point-of-care lung ultrasound and all the supposed limitations to the diagnostic usefulness of this technique. Moreover, the article reviews the three main fields of application for lung ultrasound: interstitial, alveolar and pleural syndromes.
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Review
[Emergency ultrasound diagnosis of the thorax for internal medicine and traumatology patients].
Thoracic ultrasound has a high significance in emergency medicine. In case of dyspnoea, it leads quickly and reliably to the causative disease. ⋯ After thoracic trauma, most of the injuries can be detected with sonography: lung contusion, pleural effusion, pericardial effusion, pneumothorax, rib fractures and sternal fractures. In clinically unstable patients, vital decisions can be made based on sonographic results.
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The legitimacy of intensivists and emergency physicians to use ultrasound in their daily practice is no longer questioned. This new tool is now considered essential in the acute care setting. After overcoming the technological and political obstacles, the current challenge is to implement technology in units. Here we give some recommendations based on our experience of the last fifteen years.