Speciality Medical Dialogues
    • facebook
    • twitter
    Login Register
    • facebook
    • twitter
    Login Register
    • Medical Dialogues
    • Education Dialogues
    • Business Dialogues
    • Medical Jobs
    • Medical Matrimony
    • MD Brand Connect
    Speciality Medical Dialogues
    • Editorial
    • News
        • Anesthesiology
        • Cancer
        • Cardiac Sciences
        • Critical Care
        • Dentistry
        • Dermatology
        • Diabetes and Endo
        • Diagnostics
        • ENT
        • Featured Research
        • Gastroenterology
        • Geriatrics
        • Medicine
        • Nephrology
        • Neurosciences
        • Nursing
        • Obs and Gynae
        • Ophthalmology
        • Orthopaedics
        • Paediatrics
        • Parmedics
        • Pharmacy
        • Psychiatry
        • Pulmonology
        • Radiology
        • Surgery
        • Urology
    • Practice Guidelines
        • Anesthesiology Guidelines
        • Cancer Guidelines
        • Cardiac Sciences Guidelines
        • Critical Care Guidelines
        • Dentistry Guidelines
        • Dermatology Guidelines
        • Diabetes and Endo Guidelines
        • Diagnostics Guidelines
        • ENT Guidelines
        • Featured Practice Guidelines
        • Gastroenterology Guidelines
        • Geriatrics Guidelines
        • Medicine Guidelines
        • Nephrology Guidelines
        • Neurosciences Guidelines
        • Obs and Gynae Guidelines
        • Ophthalmology Guidelines
        • Orthopaedics Guidelines
        • Paediatrics Guidelines
        • Psychiatry Guidelines
        • Pulmonology Guidelines
        • Radiology Guidelines
        • Surgery Guidelines
        • Urology Guidelines
    LoginRegister
    Speciality Medical Dialogues
    LoginRegister
    • Home
    • Editorial
    • News
      • Anesthesiology
      • Cancer
      • Cardiac Sciences
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endo
      • Diagnostics
      • ENT
      • Featured Research
      • Gastroenterology
      • Geriatrics
      • Medicine
      • Nephrology
      • Neurosciences
      • Nursing
      • Obs and Gynae
      • Ophthalmology
      • Orthopaedics
      • Paediatrics
      • Parmedics
      • Pharmacy
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
    • Practice Guidelines
      • Anesthesiology Guidelines
      • Cancer Guidelines
      • Cardiac Sciences Guidelines
      • Critical Care Guidelines
      • Dentistry Guidelines
      • Dermatology Guidelines
      • Diabetes and Endo Guidelines
      • Diagnostics Guidelines
      • ENT Guidelines
      • Featured Practice Guidelines
      • Gastroenterology Guidelines
      • Geriatrics Guidelines
      • Medicine Guidelines
      • Nephrology Guidelines
      • Neurosciences Guidelines
      • Obs and Gynae Guidelines
      • Ophthalmology Guidelines
      • Orthopaedics Guidelines
      • Paediatrics Guidelines
      • Psychiatry Guidelines
      • Pulmonology Guidelines
      • Radiology Guidelines
      • Surgery Guidelines
      • Urology Guidelines
    • Home
    • Practice Guidelines
    • Cardiac Sciences Guidelines
    • Ultrasound in...

    Ultrasound in critically ill patients: Society of Critical Care Medicine Guidelines

    Written by supriya kashyap kashyap Published On 2016-08-27T14:35:18+05:30  |  Updated On 27 Aug 2016 2:35 PM IST
    Ultrasound in critically ill patients: Society of Critical Care Medicine Guidelines
    With the supreme importance of prompt diagnostics in critical care patients, evidence-based guidelines for the use of bedside ultrasound by intensivists and specialists in the ICU and equivalent care sites for diagnostic and therapeutic purposes for organs of the chest, abdomen, pelvis, neck, and extremities are mandated.

    In November 2015, Society of Critical Care Medicine came out with Guidelines for the appropriate use of bedside general and cardiac ultrasonography in the evaluation of critically ill patients-part I: general ultrasonography.

    Following are the major recommendations of the guidelines



    Noncardiac Thoracic Imaging


    Pleural Effusion


    Suitability of Ultrasound to Establish the Diagnosis and Assist in Drainage




    • The Panel recommends that ultrasound should be used to complement physical examination and conventional chest radiography to diagnose and localize a pleural effusion. Grade 1A.

    • The Panel recommends that ultrasound guidance should be used to assist in drainage (including needle guidance), particularly of small or loculated effusions compared with landmark technique. Grade 1B.

    • The Panel has no recommendation regarding the preference for use of either static or dynamic technique to do so.


    Diagnosis of Pneumothorax

    The Panel recommends that ultrasound should be used to complement or replace conventional chest radiography to diagnose a pneumothorax, depending on the clinical setting and need for rapid results. Grade 1A.


    Diagnosis of Interstitial and Parenchymal Lung Pathology


    The Panel suggests that a systematic approach incorporating bedside ultrasound may be a primary diagnostic modality for the intensive care unit (ICU) patient with respiratory failure. Grade 2B.


    Abdominal Imaging


    Ascites (Nontrauma Setting)


    Suitability of Ultrasound to Establish the Diagnosis to Assist in Drainage


    The Panel recommends that ultrasound guidance (instead of the landmark technique), whether real-time or preprocedure, should be used to determine the optimal location for performance of paracentesis. Grade 1B.


    Acalculous Cholecystitis


    Suitability of Ultrasound to Establish the Diagnosis


    The Panel suggests that bedside ultrasonography may be used to provide additional valuable information to the clinical presentation to establish the diagnosis of acalculous cholecystitis. Grade 2C.


    Ability of the Intensivist to Use Ultrasound to Establish the Diagnosis Accurately


    The Panel suggests that intensivists/critical care providers should not personally perform ultrasound primarily for the diagnosis of acute cholecystitis. Grade 2B.


    Mechanical Causes of Anuria/Oliguria


    Suitability of Ultrasound to Establish the Diagnosis Thereof


    The Panel suggests that ultrasonography may be used to exclude mechanical causes of acute renal failure in the ICU. Grade 2C.


    Ability of the Critical Care Provider to Use Ultrasound to Establish the Diagnosis Accurately


    The Panel has no recommendations regarding this issue due to the paucity of data.


    Vascular Imaging


    Deep Venous Thrombosis (DVT)


    Complete versus Focused Examination of the Lower Extremities


    The Panel recommends that a focused ultrasound technique using gray scale imaging to evaluate vein compression at the common femoral and popliteal veins should be used to diagnose most proximal DVTs (compared with contrast venography). Grade 1B.


    Accuracy of Focused DVT Screening by Critical Care Providers


    The Panel recommends that intensivists can reliably perform a focused screening examination by ultrasound to diagnose lower extremity proximal DVT. Grade 1B.


    Imaging to Assist Intravascular Catheter Insertion


    General Consideration


    The Panel recommends that ultrasound guidance of vessel cannulation (compared with landmark technique) should be used to improve the success rate, shorten procedure time and reduce the risk of procedure-related complications such as pneumothorax. Grade 1B.


    Components of the Examination


    Static versus Dynamic (Preprocedure vs Real-time)


    The Panel recommends that in most patients, the use of realtime ultrasound is preferred over static, preprocedure marking. Grade 1B.


    Long Versus Short Axis


    Although there are benefits to visualizing the vasculature in both short- and long-axis images by ultrasound, the Panel recommends that the short-axis view be used during insertion to improve success rate. Grade 1B.


    One Versus Two-person Ultrasound-guided Vascular Cannulation


    The Panel recommends that one (rather than two) person technique is sufficient for ultrasound guided vascular cannulation. Grade 1C.


    The Use of Doppler


    The Panel suggests that conventional B-mode imaging to assist in vessel cannulation should be used compared with using audible Doppler only with no imaging. Grade 2B.


    The Use of Needle Guides


    The Panel has no recommendation regarding routine use of a device placed on the ultrasound transducer to guide needle placement. This should be left to provider discretion.


    Completion Examination


    The Panel suggests that a detailed post cannulation ultrasound examination may be used (instead of conventional chest radiography) to confirm catheter location and exclude a pneumothorax in adult patients. Grade 2B.


    Internal Jugular Location


    The Panel recommends that dynamic ultrasound-guided internal jugular (IJ) venous cannulation should be used (instead of landmark technique) to improve success rate, shorten procedure time and reduce the risk of procedure-related complications in adult patients. Grade 1A.


    Subclavian/Axillary Location


    The Panel suggests that ultrasound dynamic guidance is of limited value for most operators to guide subclavian vein catheterization in adult patients (and that landmark technique is used instead). Grade 2C.


    Femoral Location


    The Panel recommends that ultrasound dynamic guidance (instead of the landmark technique) should be used to improve the success rate and reduce complications for femoral venous cannulation although this benefit is mostly realized by novice operators in adult patients. Grade 1A.


    Other Locations


    The Panel suggests that the use of ultrasound dynamic guidance (instead of the landmark technique) may improve the success rate and diminish complications during peripheral venous (adults and children) and arterial cannulation (adults). Grade 2B for venous and 2B for arterial catheterization.


    You can read the full guidelines by clicking on the following link: -


    Frankel HL, Kirkpatrick AW, Elbarbary M, Blaivas M, Desai H, Evans D, Summerfield DT, Slonim A, Breitkreutz R, Price S, Marik PE, Talmor D, Levitov A. Guidelines for the appropriate use of bedside general and cardiac ultrasonography in the evaluation of critically ill patients-part I: general ultrasonography. Crit Care Med. 2015 Nov;43(11):2479-502. [106 references] PubMed External Web Site Policy

    cardiac ultrasonographyDeep Venous ThrombosisDVTICUintensive care unitsrespiratory failure

    Disclaimer: This site is primarily intended for healthcare professionals. Any content/information on this website does not replace the advice of medical and/or health professionals and should not be construed as medical/diagnostic advice/endorsement or prescription. Use of this site is subject to our terms of use, privacy policy, advertisement policy. © 2020 Minerva Medical Treatment Pvt Ltd

    supriya kashyap kashyap
    supriya kashyap kashyap
      Show Full Article
      Next Story
      Similar Posts
      NO DATA FOUND

      • Email: info@medicaldialogues.in
      • Phone: 011 - 4372 0751

      Website Last Updated On : 12 Oct 2022 7:06 AM GMT
      Company
      • About Us
      • Contact Us
      • Our Team
      • Reach our Editor
      • Feedback
      • Submit Article
      Ads & Legal
      • Advertise
      • Advertise Policy
      • Terms and Conditions
      • Privacy Policy
      • Editorial Policy
      • Comments Policy
      • Disclamier
      Medical Dialogues is health news portal designed to update medical and healthcare professionals but does not limit/block other interested parties from accessing our general health content. The health content on Medical Dialogues and its subdomains is created and/or edited by our expert team, that includes doctors, healthcare researchers and scientific writers, who review all medical information to keep them in line with the latest evidence-based medical information and accepted health guidelines by established medical organisations of the world.

      Any content/information on this website does not replace the advice of medical and/or health professionals and should not be construed as medical/diagnostic advice/endorsement or prescription.Use of this site is subject to our terms of use, privacy policy, advertisement policy. You can check out disclaimers here. © 2025 Minerva Medical Treatment Pvt Ltd

      © 2025 - Medical Dialogues. All Rights Reserved.
      Powered By: Hocalwire
      X
      We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok