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NEPI » Emergency Medicine » Emergency Medicine

ULTRASOUND- THE NEW ARSENAL
morpheus	#1 Posted on 17-10-2007 11:10
Senior Captain Posts: 65 Joined: 01/12/2006 21:06	ultrasound usage in ED has been growing with leaps and bounds in ED. there are now over 15 documented uses of ultrasound in ED, some of them well established and researched. others well... still under consideration but definitely useful. the aim of this thread on ultrasound is to teach people who are practicing emergency medicine,... some of the new advances in ultrasound in emergency medicine so people get ready to rock and rolll... or should i say...rotate and pan And leave footprints in the sands of time.......


stemlyns	#2 Posted on 31-10-2007 15:25
Super Senior Posts: 32 Joined: 31/10/2007 15:18	Ultrasound is always been a gr8 tool and its scope in A&E is unlimited.For example you can use it from Nerve Blocks to FAST scan which could be life saving. I personally think ultrasound as great only when used by experienced hands.All the EM physicians must get ultrasound training as part of their trainig programme. Hope our Radiology colleagues will not feel the heat now as they think that we are trading in their grounds with their tools.


imron	#3 Posted on 01-11-2007 18:14
Senior Captain Posts: 52 Joined: 17/06/2007 20:52	Have you heard of Trans-Cranial Doppler for use in bleeds?


stemlyns	#4 Posted on 02-11-2007 14:11
Super Senior Posts: 32 Joined: 31/10/2007 15:18	Tras-cranial color doppler????????????????/// Yeah i heard of it and i wonder if anyone has got proper sensitivity and specificity of this test in different clinical situations.I think if we discuss about the ultrasound skills for EM docs i would like to start with simple things like FAST scan and once we gain good credibility(by diagnosing intra abdominal pathology with wasting the patient's the golden period in the radiation doughnut) we can get more and more approval and other departments on the reliability of our skills. Start simple and take it from there.These type of new fancy stuff sound gr8 but just imagine how long it takes to get a proper study to approve this diagnostic tool and to get people trained in India and then move it to EM area. Some snippets I know about Trans Cranial Doppler Procedures using TCD 1.Vasomotor reactivity testing 2.Detection of cerebral microembolic signals 3.Carotid endarterectomy (CEA) 4.Coronary artery bypass graft (CABG) surgery 5.Cerebral thrombolysis monitoring Already established clinical utility is in -Screening of children aged 2 to 16 years with sickle cell disease for assessing stroke risk although the optimal frequency of testing is unknown. -Detection and monitoring of angiographic vasospasm spontaneous subarachnoid hemorrhage (sSaH). I think of all this more data is needed if it has got any impact on clinical outcome. You can try the cardio echo machine in the CCU to practice on your colleagues with a differnt probe if you got one.


imron	#5 Posted on 03-11-2007 03:12
Senior Captain Posts: 52 Joined: 17/06/2007 20:52	The residents at our center in Hyderabad have been using ultrasound in the ED since the last one year. In the initial days, the recieving specialties doubted the validity of FAST scans done by EM physicians. But we managed to prove the high degree of accuracy of our scans by a comparative study with our radiologists. FAST done by our EM residents now plays a major role in decision making in trauma patients.


stemlyns	#6 Posted on 04-11-2007 20:37
Super Senior Posts: 32 Joined: 31/10/2007 15:18	Thats a great news and i hope the skill is dessiapted to more trainees in future and it comes to old saying ''practice makes a man perfect''

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