Page 106 - Ultrasonography in Prehospital and Emergency Medicine - Rein Ketelaars
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Chapter 4
to be at.” (p.3)
“So yes, for that matter, I can see the added value. It is an imaging technique that is fast to perform. Basically, it takes a few minutes to complete an US examination.” (p.2)
“When I do an US examination and detect free fluid, I’m not afraid to be energetic and rush the patient to the CT scanner. That is added value, the logistics process.” (p.3)
ঌ Quality assurance of skills
In over half of the hospitals, EPs were looking for a suitable quality assurance system. In one hospital, together with radiologists they developed an in-hospital training program. In another, they planned to commence radiologist-supervised US examinations.
Quality assurance of US skills was frequently mentioned. On the one hand, individual re- sponsibility was highlighted.
“Yes, I believe that during time one has to develop their skills. You then have to decide for yourself whether to make official statements about your examinations or not.” (p.7)
On the other hand, there appeared to be a clear need for a certification system in which knowledge and skills would be documented. On one ED, the EPs themselves determined that they were not qualified to perform diagnostic US scans.
“Well, the biggest objection the other consultants had to implementing US on the ED was they couldn’t tell how our knowledge and skills were going to be assured. We discussed this and realized we couldn’t tell either. So, they are right! We feel it is important and we want to practice so we can take US usage by EPs to another level. But now we are not ready for it, yet.” (p.6)
Others reported initial suspicion as well but took a different approach.
“I can really empathize with the surgeon who witnesses an EP do an US examination he has never seen do one before and then wonders: are you sure you can do this? I feel that is a logical reaction. And it is up to us to prove this can be implemented for years to come. It will take time, but that’s the case for a lot of novelties.” (p.2)
Five out of eight participants were developing a system to document every EP’s US skills. Frequently mentioned was the performance of radiologist-supervised examinations.

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