Ultrasound applications to support nursing care in critically ill COVID-19 patients

• Published in: Intensive & critical care nursing 2020-12, Vol.61, p.102918-102918, Article 102918
• Main Authors: Cao, Lan, Zhang, Lina, Wang, Xiaoting
• Format: Article
• Language: English
• Subjects: Betacoronavirus; Bladder; Blood Vessels - diagnostic imaging; Catheterization; Catheterization, Peripheral - methods; Catheters; Chest; Coronavirus Infections - nursing; Coronaviruses; COVID-19; Critical care; Critical Care Nursing - methods; Critical Illness; Ears; Gloves; Humans; Injuries; Intensive care; Intubation, Gastrointestinal - methods; Latex; Lung - diagnostic imaging; Medical screening; Nasogastric tubes; Nursing; Nursing care; Oliguria; Pandemics; Patient Positioning; Physical Therapy Modalities; Physiotherapy; Pneumonia, Viral - nursing; Positioning; Posture; Pressure ulcers; Prone Position; Protective clothing; Salt; SARS-CoV-2; Sound; Stomach; Stomach - diagnostic imaging; Thrombosis; Ulcers; Ultrasonic imaging; Ultrasonography - methods; Ventilators; Visualization
• ISSN: 0964-3397; 1532-4036
• DOI: 10.1016/j.iccn.2020.102918

Following our experience of using critical care ultrasound in the epidemic in Wuhan, we summarised how ultrasound can be utilised in COVID-19 patients.Low success rates of peripheral venous and arterial punctures At grade III protection state (disposable working cap, protective glasses and/or protective face screen, medical protective mask, disposable protective clothing, disposable latex gloves, disposable shoe covers, quick-drying hand sanitiser), protective goggles can easily form fog, thereby hampering smooth insertion of the catheter. (Walldorf et al., 2020). [...]at grade III protection state, ears are wrapped in protective clothing and gurgling sound cannot be heard by auscultation. Difficulty Ultrasound application Peripheral venous and arterial punctures Position arterial and vein, guide the puncture process Positioning gastric tube Double-track sign in esophagus long axis and gastric body, ‘‘Fogging’’ effect visualization (pushing salt solution through the tube and seeing it inside the stomach by ultrasound) Gastric residual volume gastric antrum area measured by using ultrasound gastric antral single-section method Effectiveness of postural chest physiotherapy Dynamic change of B lines(multifocal, discrete, or confluent), non-translobar and translobar consolidation Oliguria Bladder volume estimations calculated and Foley position assessment using ultrasound Thrombosis screening Lack of compressibility of the vessel, echogenic material within the lumen Deep tissue injury in pressure ulcers Unclear layered structure, hypoechoic lesion, discontinuous fascia, and heterogeneous hypoechoic area.