Page 109 - Ultrasonography in Prehospital and Emergency Medicine - Rein Ketelaars
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Implementing ultrasound in Dutch emergency departments after a two-day training 107
ume status were mentioned.
“We are continuously expanding, also in respect to US. We will be using US for DVT as well. Um, so yes, we are expanding, but specifically within the scope of emergency US.” (p.7)
ঌ Relation of US with other diagnostics
All participants agreed that US examination has taken a prominent place in diagnostic im- aging techniques and was considered by some participants for certain indications to be more reliable than chest X-ray.
“For instance, in a trauma victim with suspected pneumothorax, we will put more confidence in our own US than in one supine chest X-ray without pathology.” (p.4)
US might replace some other imaging techniques, too.
“In the case of a hemodynamically instable patient, we actually let it guide treatment decisions. If the patient is suspected of intra-abdominal injury and there is also free fluid detected by US... Well, we put two and two together and rush the patient to surgery.” (p.8)
Whenever US was followed by another imaging technique, this was considered to be an important verification.
“Whenever, for instance, a CT scan is performed, to us there is the added value to verify the results of our US examination. That is very important to us.” (p.7)
Conversely, gaining experience by performing an US examination after a diagnosis is made with other diagnostics was also mentioned.
“... the other day there was a pneumothorax. I thought: ah, let’s have a look with ultrasound. You know, let’s see if I can see it, too.” (p.1)
Barriers
ঌ Presence and usage of a US machine
In four out of eight hospitals, the ED owned an US machine. Three departments have entered into a loan agreement with either the radiology or urology department. One ED had no dis- posal of a US machine at all.
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