Ultrasound in emergency medicine

Published on 14/03/2015 by admin

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Last modified 14/03/2015

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Chapter 5 Ultrasound in emergency medicine

Emergency department ultrasound continues to be an area of rapidly expanding importance in the practice of emergency medicine. It is a safe and reliable technology that is relatively inexpensive and easily learned.

The Australasian College for Emergency Medicine (ACEM) promotes the use of ultrasound in the emergency department and advocates the availability of timely ultrasound examinations 24 hours per day. The emphasis has been on the ability of the emergency physician and trainee to perform focused emergency department ultrasound examinations on trauma patients (focused assessment with sonography in trauma, or FAST) and on patients with suspected abdominal aortic aneurysm. The advantages of ultrasound examinations in these clinical entities have been clearly established. Other applications of ultrasound in the emergency department include providing guidance for difficult procedures and identifying pathological conditions such as ectopic pregnancy and deep vein thrombosis.

This chapter focuses on: the basic physical principles of ultrasound; ultrasound equipment; common applications of ultrasound in the emergency department; training, credentialling and quality review.

BASIC PHYSICAL PRINCIPLES

‘Ultrasound’ is sound whose frequency is above the range of human hearing. The audible human range is 20–20,000 hertz (Hz), while diagnostic ultrasound employs frequencies of 1–20 megahertz (MHz), with the most common range being 3–12 MHz.

Propagation of sound is the transfer of energy, not matter, from one place to another within a medium.