Focused Echocardiography in Life Support:The Subcostal Window What the Surgeon Should Know for Critical Care Applications

摘要

Context: Focused echocardiography evaluation in life support (FEEL) for emergency and critical care medicine is an innovative approach to introducing limited-in-scope echocardiography in a timely fashion into periresuscita-tion care. FEEL is an advanced life support-conformed concept and a simple procedure that can be readily used in shock room or 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 easily be applied in the supine 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, here we describe an accurate and easy method that allows non-cardiologists to add FEELto the FAST exam.Asa result, it conforms to actual resuscitation guidelines. To perform the FEEL procedure and the subcostal window, a specific training seems to be mandatory. The aim of this paper is to set special emphasis on the use of the subcostal window.