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Focused Cardiac Ultrasound

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  1. Welcome

    Introduction to FoCUS
    2 Topics
  2. Section 1
    Video: Cardiac Anatomy
  3. Cardiac Anatomy
    3 Topics
  4. Section 2
    Key Video: Obtaining the 5 Views
  5. Acquisition & the 4Ps
    4 Topics
    |
    1 Quiz
  6. Acquiring The 5 Views
    5 Topics
    |
    1 Quiz
  7. Clinical Case Scenario
  8. Section 3
    Interpretation
    11 Topics
    |
    2 Quizzes
  9. Interpretation: The RUSH Protocol
    1 Quiz
  10. Section 4
    Medical Management
  11. Foundations of Echocardiography
  12. References
    References & Further Reading

Quizzes

Focused Cardiac Ultrasound Introduction to FoCUS Indications & Limitations of FoCUS
Lesson 1, Topic 2
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Indications & Limitations of FoCUS

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Windows to the Heart

May 2021

In this section we will look at the indications & limitations of FoCUS. The use of FoCUS has been described in virtually all acute front line medical specialties.

I-AIM Framework

The I-AIM Framework can be used when learning, applying, integrating & teaching point of care ultrasound. It can be used for all of the organs commonly scanned.

I = Indications

A= Acquisition

I = Interpretation

M = Medical Management

Further Reading

I-AIM. A novel method for teaching and performing focused ultrasound. Bahner et al. Journal of Ultrasound in Medicine. 2012. Click here for pdf copy.

Indications:

1. Evaluation of Undifferentiated Hypotension:

  • Hypovolemic
  • Cardiogenic
  • Obstructive
  • Distributive Shock.

2. Chest Pain / Dyspnea

3. Blunt Chest Trauma

4. Post MI Mechanical Complications

5. Serial Studies for Evaluation of Progression of Disease

6. Evaluation of Response to Therapy

7. Diagnosis of Potentially Reversible Causes of Cardiac Arrest

8. Pre Operative Evaluation of Cardiac Function

We can use FoCUS to ResCUE patients in emergencies.

Rescue Cardiac Ultrasound in Emergencies (ResCUE) allows rapid evaluation of:

  • Global Left Ventricular Systolic Function
  • Global Right Ventricular Function
  • Gross Valvular Function
  • Preload & Intravascular Volume
  • Pericardial Pathology – Effusions / Tamponade
  • Pleural Pathology – Effusions
  • Intracardiac Mass / Thrombi / Devices
  • Aortic Disease – Dilatation / Aneurysm / Dissection

Further Reading:

Focused Cardiac Ultrasound in the Emergent Setting: A Consensus Statement of the American Society of Echocardiography and American College of Emergency Medicine. Labovitz et al. JASE 2010.

FoCUS Limitations

1.Inferiority of the imaging devices typically used for FCU examination.

2. Narrow list of detectable evidence-based targets.

3. Limited data set due to restricted image acquisition protocol.

4. Typically unfavourable settings (emergencies, critically ill, time constrains).

5. ‘Absent/present’ or ‘yes/no’ reporting style.

6. Subtle/complex cardiac abnormalities may be difficult to assess.

7.Operator & experience dependent.

Further Reading:

Focused Cardiac Ultrasound. Andrus & Dean. Global Heart 2013.

International Evidence Based Recommendations for Focused Cardiac ULtrasound. Via Gabriele et al. JASE 2014.