Focused Echocardiography in Life Support: The Subcostal Window

What the Surgeon Should Know for Critical Care Applications
  • Raoul Breitkreutz
  • Felix Walcher
  • Hendrik Ilper
  • Florian  H. Seeger
  • Susanna Price
  • Gabriele Via
  • Holger Steiger
Focus on Ultrasound in Trauma and Emergency Surgery

Abstract

Context:

Focused echocardiography evaluation in life support (FEEL) for emergency and critical caremedicine is an innovative approach to introducing limited-in-scope echocardiography in a timely fashion into periresuscitation care. FEEL is an advanced life support-conformed concept and a simple procedure that can be readily used in shock roomor pre-hospital scenarios as an extension of focused abdominal sonography for trauma (FAST). The subcostal window plays a pivotal role in this context, because it can easilybe applied inthesupine position, and is usually better than other windows in patients with mechanical ventilation or during resuscitation maneuvers. Most information can be obtained at a glance.

Aim:

As the FAST exam was not developed for implementation in resuscitation or cardiac arrest procedures, herewedescribe an accurate and easymethod that allows non-cardiologists to add FEEL to the FAST exam. As a result, it conforms to actual resuscitation guidelines. To perform the FEEL procedure and the subcostal window, a specific training seems to bemandatory. The aim of this paper is to set special emphasis on the use of the subcostal window.

Key Words

Time Training Periresuscitation care Nonspecialist Focused Echocardiography in life support 

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Copyright information

© Springer 2009

Authors and Affiliations

  • Raoul Breitkreutz
    • 1
    • 7
  • Felix Walcher
    • 2
  • Hendrik Ilper
    • 1
  • Florian  H. Seeger
    • 3
  • Susanna Price
    • 4
  • Gabriele Via
    • 5
  • Holger Steiger
    • 6
  1. 1.Clinics of Anesthesiology, Intensive Care Medicine and Pain TherapyHospital of the Johann Wolfgang Goethe-UniversityFrankfurt am MainGermany
  2. 2.Trauma SurgeryHospital of the Johann Wolfgang Goethe-UniversityFrankfurt am MainGermany
  3. 3.Department of CardiologyHospital of the Johann Wolfgang Goethe-UniversityFrankfurt am MainGermany
  4. 4.Adult Intensive Care UnitRoyal Brompton HospitalLondonUK
  5. 5.1st Department of Anesthesia and Intensive, Care, FondazioneIRCCS Policlinico San MatteoPaviaItaly
  6. 6.Department of CardiologyKerckhoff Heart CenterBad NauheimGermany
  7. 7.Clinics of Anesthesiology, Intensive Care Medicine and Pain TherapyHospital of the Johann Wolfgang Goethe-UniversityFrankfurt am MainGermany

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