Page 111 - Ultrasonography in Prehospital and Emergency Medicine - Rein Ketelaars
P. 111

                 Implementing ultrasound in Dutch emergency departments after a two-day training 109
“I do remember that when we got our first US machine and especially afterwards, at the political level there has been quite some quibbling about it. The radiologists still feel US belongs to them. Obviously, it is no longer true that certain diagnostic techniques are a prerogative of a particular discipline.” (p.2)
ঌ Confidence in own US diagnosis
There was a wide variety in the degree of confidence that each participant had in their US diagnosis.
“I lack the confidence, so I always ask somebody else to do another US examination.” (p.6) “in 95% of cases I’m confident about my diagnosis.” (p.4)
“I do the exam myself, I interpret it myself, and if necessary I take action.” (p.5)
The importance of practice was emphasized and it was mentioned that after 50 examinations confidence would grow.
“You just have to do it often and must expose yourself to repeated US examinations and that just requires an investment of time and energy. A lot of time has to be invested.” (p.1)
Differences in perceived difficulty between assessment of the chest and abdomen appear to be personal.
“Well, it can be hard sometimes to detect a pneumothorax. Free intraperitoneal fluid, on the other hand, isn’t hard to detect at all.” (p.2)
ঌ Additional barriers
In addition to the lack of a US machine preventing the use of US, other limitations were a lack of time and a shared responsibility between physicians for a patient.
“Whenever there is an indication to do an US examination and, um, I am there, I’ll do it myself primarily. If there is a lack of time or somebody else is caring for the patient, then I’ll call the radiologists.” (p.2)

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