Point-of-care ultrasound – an essential tool for emergency medicine

Dr Rip Gangahar, Trauma Lead for the Pennine Acute Hospitals NHS Trust and Chair of the International Federation for Emergency Medicine Ultrasound Group, discusses the past, present and future of ultrasound training for emergency medicine.

Dr Rip Gangahar uses the X-Porte™
Dr Rip Gangahar uses the X-Porte™
Source: The Pennine Acute Hospitals NHS Trust

Point-of-care ultrasound systems are now a ubiquitous sight in UK hospitals, with applications across virtually every discipline from anaesthesia to palliative care. In the emergency setting, it has found a wide range of uses, offering huge potential time savings by helping to rule in or rule out conditions much earlier. The flexibility and advanced scanning capabilities of SonoSite’s latest instrument – the X-Porte™ – have probably been the biggest leap forward, making the stethoscope virtually obsolete for competent users. Beyond the obvious applications of FAST scanning and vascular access, ultrasound has a role to play in many other patient pathways, including aortic scanning, echocardiograms for cardiac arrest, gall stones and even initial assessment of fractures in children.

Ultrasound is a powerful diagnostic tool which can be used to inform a wide variety of clinical decisions, and suitable, rigorous training in ultrasound for emergency medicine is vital to ensuring patients are not put at risk unnecessarily. On a national level, ultrasound is now a compulsory element of a consultant’s accreditation by the College of Emergency Medicine (CEM), with Level 1 certification requiring basic skills including vascular access, aortic scanning, FAST (focussed assessment with sonography in trauma) and ELS (echocardiography in life support). There is also a real drive towards incorporating ultrasound into the general medical curriculum at a much earlier stage, as it is an increasingly valuable skill across all disciplines, giving medical students a much better understanding of cross-sectional anatomy.

The rate at which the switch from the stethoscope to ultrasound can be achieved will largely depend on the support of ultrasound equipment manufacturers, and SonoSite has always led the field in this regard. In terms of pushing ultrasound education forward, I don’t think that any other company has done as much. This means more than anything else, as there is no point having a nice ultrasound machine and nobody coming through the system that knows how to use it.

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